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 D

Explanation

A. Hold her breath for at least 10 seconds. Diaphragmatic breathing focuses on slow, deep breaths to promote lung expansion and oxygenation. Holding the breath is not part of this technique and may increase discomfort.

B. Place her hands on the sides of her rib cage. While hand placement is encouraged, the correct position is on the abdomen (below the rib cage), not the sides. This helps the client feel the diaphragm expanding.

C. Exhale forcefully through the nose. Exhalation should be slow and controlled through the mouth, not forceful through the nose, to prevent airway irritation.

D. Inhale slowly and evenly through her nose. The correct technique for diaphragmatic breathing is to inhale deeply through the nose while the abdomen expands. This promotes lung expansion and prevents atelectasis postoperatively.

A. Shortness of breath B. Adequate dietary intake C. Decrease level of consciousness D. Muscular Pain

Correct Answer is C

Explanation

A. Shortness of breath: While respiratory issues can reduce oxygenation and indirectly affect healing, shortness of breath is not a direct risk factor for pressure ulcer development.

B. Adequate dietary intake: Adequate nutrition prevents pressure ulcers rather than increasing the risk. Poor dietary intake, particularly protein and vitamin deficiencies, is a risk factor.

C. Decreased level of consciousness: Patients with a decreased level of consciousness (e.g., sedated, comatose, or confused patients) are at higher risk for pressure ulcers due to immobility, lack of repositioning, and unawareness of discomfort.

D. Muscular pain: While pain can limit movement, it is not a primary risk factor for pressure ulcer development. Immobility and prolonged pressure are the key contributors.

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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

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