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."
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Relying on recall of information from past lectures and textbooks. Critical thinking involves applying knowledge, not just recalling it. Nurses must analyze patient-specific data and adapt care accordingly.
B. Using the nursing process. The nursing process (assessment, diagnosis, planning, implementation, evaluation) is a structured approach that guides clinical decision-making and ensures patient-centered care.
C. Drawing on past clinical experiences to formulate standardized care plans. Past experiences can inform decision-making, but care plans must be individualized to the patient’s current condition rather than relying solely on standardization.
D. Depending on the charge nurse to determine priorities of care. While charge nurses provide leadership, each nurse is responsible for critical thinking and independent decision-making based on their assessment.
Correct Answer is A
Explanation
A. "Have you had any changes in your diet?" While diet can impact skin health, this question is not the most relevant for an immediate skin assessment. More direct questions about onset, symptoms, and exacerbating factors should be prioritized.
B. "Does your skin condition keep you awake at night?" Pruritus (itching), pain, or discomfort from a skin condition can disrupt sleep. Asking this helps assess the impact on daily life and quality of sleep.
C. "How does your skin condition make you feel?" Skin conditions can affect self-esteem and mental health. This question is therapeutic and appropriate to assess emotional impact.
D. "How do you handle stress?" Many skin conditions, such as eczema and psoriasis, worsen with stress. This question is relevant for identifying triggers.
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