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 D

Explanation

Oral candidiasis, also known as thrush, is a fungal infection of the mouth caused by Candida albicans. It is a common adverse eﬀect of inhaled corticosteroids, such as ﬂuticasone, which can suppress the normal ﬂora of the oral cavity and create a favorable environment for fungal growth. It manifests as white patches or plaques on the tongue, palate, or cheeks that can be scraped oﬀ.

a) Polyuria, or excessive urination, is not an adverse eﬀect of ﬂuticasone. It can be caused by diabetes mellitus, diabetes insipidus, diuretics, or kidney disease.
b) Hypoglycemia, or low blood glucose level, is not an adverse eﬀect of ﬂuticasone. It can be caused by
insulin overdose, oral hypoglycemic agents, alcohol intake, or prolonged fasting.
c) Hypertension, or high blood pressure, is not an adverse eﬀect of ﬂuticasone. It can be caused by stress, obesity, smoking, salt intake, or kidney disease.

A. "Use a bronchodilator 1 hour before eating." B. "Eat 3 large meals each day." C. "Limit water intake with meals." D. "Reduce protein intake." E. None F. None

Correct Answer is A

Explanation

Using a bronchodilator 1 hour before eating can help reduce dyspnea and improve appetite for a client who has COPD. It can also facilitate oxygen delivery to the tissues and prevent hypoxia.

b) Eating 3 large meals each day is not recommended for a client who has COPD, as it can cause abdominal distension and increase pressure on the diaphragm, leading to dyspnea and fatigue. A better option is to eat 5 to 6 small meals throughout the day.
c) Limiting water intake with meals is not advisable for a client who has COPD, as it can cause dehydration and increase the viscosity of secretions, making them harder to expectorate. A better option is to drink at least 2 L of ﬂuids per day, preferably between meals.
d) Reducing protein intake is not beneficial for a client who has COPD, as protein is essential for maintaining muscle mass and strength, especially of the respiratory muscles. A better option is to increase protein intake to at least 1.2 g/kg of body weight per day.

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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

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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