A patient will be receiving oral theophylline (Theo-Dur), 600 mg/day, in three divided doses.

Identify how many milligrams the patient will receive per dose.

Choice A rationale

Fine crackles are typically associated with fluid in the small airways or alveoli, as seen in conditions like pneumonia or heart failure, rather than the bronchoconstriction characteristic of asthma. During an acute asthma attack, the primary issue is narrowing of the bronchioles, leading to different adventitious sounds.

Choice B rationale

Coarse rhonchi are often indicative of secretions in larger airways, which can be cleared by coughing. While some mucus production can occur in asthma, coarse rhonchi are not the classic or primary auscultatory finding during an acute asthma attack, where airway smooth muscle constriction is the dominant pathology.

Choice C rationale

Expiratory wheezing is the hallmark auscultatory finding in an acute asthma attack. It is produced by the turbulent flow of air through narrowed lower airways, particularly during exhalation, as the bronchial smooth muscles constrict, and the airways become obstructed due to inflammation and mucus plugging.

Choice D rationale

Decreased breath sounds at the lung bases can indicate poor air entry into those areas, often due to atelectasis, pleural effusion, or severe airway obstruction. While severe asthma can lead to diminished breath sounds if airflow is severely compromised, expiratory wheezing is the more specific and classic initial finding during an acute exacerbation.

Choice A rationale

While support groups can be beneficial, this response is premature and dismisses the client's immediate emotional expression. It focuses on a generalized solution rather than exploring the client's individual feelings and the specific reasons for their social withdrawal. Understanding the underlying psychological impact of chronic illness is crucial for providing person-centered care.

Choice B rationale

Prescribing medication is outside the nurse's scope of practice. Furthermore, immediately suggesting an antianxiety agent without a comprehensive assessment of the client's mental and emotional state can mask the true source of their distress and prevent exploration of coping mechanisms or other interventions.

Choice C rationale

This therapeutic communication technique prioritizes active listening and allows the client to elaborate on their feelings and experiences. It demonstrates empathy and respect, fostering a trusting relationship. Understanding the client's perspective is fundamental to developing an individualized and effective care plan for managing the psychosocial challenges of COPD.

Choice D rationale

While friends can offer support, this statement generalizes and might not be relevant to the client's specific situation. It also shifts the focus away from the client's internal experience and onto external factors, potentially minimizing their current distress and the impact of their condition on social engagement.