A nurse on a medical-surgical unit is performing an admission assessment of a client who has COPD with emphysema. The client reports that he has a frequent productive cough and is short of breath. The nurse should anticipate which of the following assessment findings for this client?

Oxygen saturation level 96%

Respiratory alkalosis

Increased anteroposterior diameter of the chest

Petechiae on chest

Answer and Explanation

The Correct Answer is C

Increased anteroposterior diameter of the chest, also known as barrel chest, is a common finding in clients who have COPD with emphysema. It is caused by chronic air trapping and hyperinﬂation of the lungs, which results in fattening of the diaphragm and widening of the rib cage.

a) Oxygen saturation level 96% is within the normal range of 95% to 100% and does not indicate hypoxemia or impaired gas exchange. Clients who have COPD with emphysema typically have lower oxygen saturation levels, ranging from 88% to 92%.
b) Respiratory alkalosis is a condition in which the blood pH is elevated due to decreased carbon dioxide levels. It is caused by hyperventilation, which can occur in response to hypoxia, anxiety, or pain. Clients who have COPD with emphysema usually have respiratory acidosis, which is a condition in which the blood pH is lowered due to increased carbon dioxide levels. It is caused by hypoventilation, which results from impaired lung function and airway obstruction.
d) Petechiae on chest are small red or purple spots on the skin caused by bleeding from capillaries. They are not a typical finding in clients who have COPD with emphysema, unless they have severe coughing episodes or coagulation disorders. They can indicate infection, inﬂammation, trauma, or vascular disease.

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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

A. The medication will prevent wheezing. B. The medication will decrease coughing episodes. C. The medication will reduce inﬂammation. D. The medication will open the airways. E. The medication will stimulate ﬂow of mucus.

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

Explanation

These responses are correct and explain how albuterol helps the client's breathing. Albuterol is a short- acting beta2-agonist that causes bronchodilation and relieves bronchospasm, which are the main causes of wheezing and dyspnea in clients who have asthma or COPD. By opening the airways, albuterol improves gas exchange and oxygenation.

b) The medication will decrease coughing episodes. This response is incorrect and does not explain how albuterol helps the client's breathing. Albuterol does not have a direct eﬀect on coughing, which is a reﬂex response to irritation or obstruction of the airways. Coughing may be beneficial for clearing secretions and mucus from the lungs, but it may also cause bronchoconstriction and inﬂammation. The nurse should advise the client to use other measures to decrease coughing, such as drinking ﬂuids, using a humidifier, or taking an expectorant.
c) The medication will reduce inﬂammation. This response is incorrect and does not explain how albuterol helps the client's breathing. Albuterol does not have an anti-inﬂammatory eﬀect on the airways, which are often inﬂamed and swollen in clients who have asthma or COPD. Inﬂammation can contribute to airway obstruction and mucus production, which impair gas exchange and oxygenation. The nurse should inform the client that albuterol is used for quick relief of acute symptoms, but not for long-term control or prevention of inﬂammation. The client may need to use another medication, such as an inhaled corticosteroid, to reduce inﬂammation.
e) The medication will stimulate ﬂow of mucus. This response is incorrect and does not explain how albuterol helps the client's breathing. Albuterol does not have a direct eﬀect on mucus production or clearance, which are often increased in clients who have asthma or COPD. Mucus can cause airway obstruction and infection, which impair gas exchange and oxygenation. The nurse should advise the client to use other measures to stimulate ﬂow of mucus, such as drinking ﬂuids, using a humidifier, or taking an expectorant.

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A nurse on a medical-surgical unit is performing an admission assessment of a client who has COPD with emphysema. The client reports that he has a frequent productive cough and is short of breath. The nurse should anticipate which of the following assessment findings for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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

A nurse is caring for a client who asks how albuterol helps his breathing. Which of the following responses should the nurse make? (Select all that apply.)

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

Explanation

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