A patient diagnosed with chronic obstructive pulmonary disease (COPD) asks the nurse why clubbing occurs. Which response by the nurse is the most therapeutic?

"Your disease often makes patients lose mental status."

"Your disease will be helped if you pursed-lip breathe."

"Your disease affects both your lungs and your heart, and not enough blood is being pumped."

"Your disease doesn't send enough oxygen to your fingertips."

Answer and Explanation

The Correct Answer is D

A. "Your disease often makes patients lose mental status." While severe hypoxia can cause confusion, this response does not address the reason for clubbing and lacks therapeutic communication.

B. "Your disease will be helped if you pursed-lip breathe." Pursed-lip breathing helps with air trapping and exhalation in COPD, but it does not explain clubbing of the fingers.

C. "Your disease affects both your lungs and your heart, and not enough blood is being pumped." COPD primarily affects oxygen exchange in the lungs, not necessarily blood pumping from the heart. Clubbing is due to chronic hypoxia, not poor cardiac output.

D. "Your disease doesn't send enough oxygen to your fingertips." Chronic hypoxia in COPD leads to increased capillary growth and tissue changes, resulting in clubbing of the fingers. This response is accurate and appropriately explains the cause.

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Correct Answer is C

Explanation

A. 4, 3, 2, 1 (Pulmonic → Tricuspid → Aortic → Mitral): This sequence incorrectly places the pulmonic valve first instead of the tricuspid.

B. 1, 3, 2, 4 (Mitral → Tricuspid → Aortic → Pulmonic): This sequence incorrectly starts with the mitral valve (left side of the heart), instead of the tricuspid (right side of the heart).

C. 3, 4, 1, 2 (Tricuspid → Pulmonic → Mitral → Aortic): Blood flow through heart valves follows this order:

Tricuspid Valve (Right atrium → Right ventricle)
Pulmonic Valve (Right ventricle → Pulmonary artery → Lungs)
Mitral Valve (Left atrium → Left ventricle)
Aortic Valve (Left ventricle → Aorta → Body)

D. 2, 4, 1, 3 (Aortic → Pulmonic → Mitral → Tricuspid): This sequence incorrectly places the aortic valve first, which is incorrect for blood flow through the heart.

A. Aortic and Mitral B. Mitral and Pulmonic C. Mitral and Tricuspid D. Aortic and Pulmonic

Correct Answer is D

Explanation

A. Aortic and Mitral: The mitral valve is associated with the S1 sound, not S2. S2 occurs when the semilunar valves (aortic and pulmonic) close.

B. Mitral and Pulmonic: The mitral valve closure is heard in S1, while the pulmonic valve closure is part of S2. However, the mitral valve is not involved in S2.

C. Mitral and Tricuspid: The mitral and tricuspid valves close during S1, not S2. These valves are atrioventricular (AV) valves, not semilunar valves.

D. Aortic and Pulmonic: The second heart sound (S2) is produced by the closure of the aortic and pulmonic valves at the beginning of diastole. This marks the end of systole.

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A patient diagnosed with chronic obstructive pulmonary disease (COPD) asks the nurse why clubbing occurs. Which response by the nurse is the most therapeutic?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching the patient with mitral valve problems about the valves of the heart. Starting on the right side of the heart, describe the sequence of blood flow through these valves. 1. Mitral; 2. Aortic; 3. Tricuspid; 4. Pulmonic

Correct Answer is C

Explanation

A nurse auscultates heart sounds. When the nurse hears S2, which valves is the nurse hearing close?

Correct Answer is D

Explanation

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