A nurse is teaching a client who is obese and has obstructive sleep apnea how to decrease the number of nightly apneic episodes. Which of the following client statements indicates an understanding of the teaching?

"If I could lose about 50 pounds, I might stop having so many apneic episodes."

"I sleep better if I take a sleeping pill at night."

"It might help if I tried sleeping only on my back."

"I should get a humidifier to run at my bedside at night."

Answer and Explanation

The Correct Answer is A

This statement indicates an understanding of the teaching, as weight loss is one of the most eﬀective ways to decrease the number of nightly apneic episodes in clients who are obese and have obstructive sleep apnea. Obstructive sleep apnea is a condition in which the upper airway collapses or becomes blocked during sleep, causing pauses in breathing and hypoxia. Obesity is a major risk factor for obstructive sleep apnea, as excess fat tissue around the neck and throat can narrow the airway and increase its collapsibility. Losing weight can reduce the pressure on the airway and improve its patency.

b)   "I sleep better if I take a sleeping pill at night." This statement indicates a lack of understanding of the teaching, as sleeping pills are not recommended for clients who have obstructive sleep apnea. Sleeping pills can worsen the condition by relaxing the muscles of the throat and tongue, which can further obstruct the airway and decrease the arousal response to hypoxia. The nurse should advise the client to avoid sleeping pills and other sedatives or alcohol before bedtime.
c)   "It might help if I tried sleeping only on my back." This statement indicates a lack of understanding of the teaching, as sleeping on the back is not helpful for clients who have obstructive sleep apnea. Sleeping on the back can increase the risk of airway obstruction by allowing gravity to pull the tongue and soft palate backward, which can block the airway and cause snoring and apnea. The nurse should suggest that the client try sleeping on the side or elevate the head of the bed to prevent this.
d)   "I should get a humidifier to run at my bedside at night." This statement indicates a lack of understanding of the teaching, as a humidifier is not likely to decrease the number of nightly apneic episodes in clients who have obstructive sleep apnea. A humidifier can moisten the air and ease breathing for clients who have dry or irritated nasal passages, but it does not address the underlying cause of airway obstruction or hypoxia. The nurse should inform the client that a humidifier may not be eﬀective for obstructive sleep apnea and may increase the risk of infection or mold growth if not cleaned properly.

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Correct Answer is ["A","B","D"]

Explanation

A. Dyspnea:
Dyspnea (shortness of breath) is a common symptom in emphysema due to the destruction of alveolar walls and the resulting reduction in surface area for gas exchange. As the disease progresses, the patient experiences increasing difficulty in breathing, especially during exertion or when the disease becomes more severe.

B. Barrel chest:
A barrel chest is often seen in emphysema, as it results from hyperinflation of the lungs. The increased air trapping due to damaged alveoli causes the chest to expand and become rounded, leading to the characteristic "barrel chest" appearance. This happens because the lungs are constantly overinflated, and the chest wall becomes rigid and rounded as a result.

D. Clubbing of the fingers:
Clubbing of the fingers can occur in chronic respiratory conditions like emphysema due to prolonged hypoxia (low oxygen levels in the blood). This is a compensatory mechanism that involves changes in the nails and fingers. The tips of the fingers become rounded and bulbous over time, and this is commonly associated with long-standing pulmonary diseases.

Correct Answer is ["0.8"]

Explanation

To calculate the amount of mL to administer, the nurse should use the following formula:

(mg ordered / mg available) x mL available = mL to administer

Substituting the values from the question, the nurse should do the following:

(100 mg / 250 mg) x 2 mL = 0.8 mL

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A nurse is teaching a client who is obese and has obstructive sleep apnea how to decrease the number of nightly apneic episodes. Which of the following client statements indicates an understanding of the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has emphysema. Which of the following findings should the nurse expect to assess in this client? (Select all that apply)

Correct Answer is ["A","B","D"]

Explanation

A nurse is preparing to administer hydrocortisone 100 mg IM daily to a client. Available is hydrocortisone 250 mg/2 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["0.8"]

Explanation

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