During a home visit, the nurse should evaluate the effectiveness of a client's treatment for chronic obstructive pulmonary disease (COPD) by assessing for which primary symptom?

Tachycardia.

Edem of the ankles.

Dyspneal.

Unilateral diminished breath sounds.

Answer and Explanation

The Correct Answer is C

Choice A reason: Tachycardia, or a rapid heart rate, can be a symptom associated with COPD, especially during exacerbations or due to medication effects. However, it is not the primary symptom used to evaluate the effectiveness of COPD treatment.

Choice B reason: Edem of the ankles can occur in COPD patients due to right-sided heart failure (cur pulmonale) associated with chronic lung disease. While it is an important symptom to monitor, it is not the primary indicator of COPD treatment effectiveness.

Choice C reason: Dyspneal, or difficulty breathing, is the most significant and primary symptom of COPD. The primary goal of COPD treatment is to improve the client's breathing and reduce dyspneal. Assessing the client's level of breathlessness provides direct insight into how well the treatment is managing the condition.

Choice D reason: Unilateral diminished breath sounds can indicate localized issues such as pneumothorax or pleural effusion rather than the overall effectiveness of COPD treatment. Bilateral lung sounds and general respiratory status are more relevant to evaluating COPD management.

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Correct Answer is B

Explanation

Choice A reason: Lifting weights every other day might not be harmful, but it is not specifically relevant to managing chronic venous insufficiency. The statement does not indicate an understanding of the specific care needed for this condition.

Choice B reason: Avoiding sitting and crossing the legs is an important measure to prevent worsening of chronic venous insufficiency. Crossing legs can impede blood flow and worsen symptoms. This statement reflects an understanding of how to manage the condition.

Choice C reason: Standing for prolonged periods, even if there is no pain, can exacerbate venous insufficiency. This statement shows a misunderstanding of the importance of movement and elevation of the legs to promote blood flow.

Choice D reason: Walking is generally encouraged to promote circulation in clients with venous insufficiency. The statement about needing someone else to walk the dog may indicate a misunderstanding of the benefits of regular, gentle exercise.

A. A haemoglobin of 12 g/dL (7.45 mmol/L) and haematocrit of 42% (0.42 volume fraction). B. Vital signs are temperature 99.0°F (37.2°C) orally, heart rate 94 beats/minute, respirations 18 breaths/minute, blood pressure 110/70 mm Hg. C. Vomits coffee-grounds emesis. D. Reports having sharp epigastric pain.

Correct Answer is C

Explanation

Choice A reason: A haemoglobin level of 12 g/dL (7.45 mmol/L) and haematocrit of 42% (0.42 volume fraction) are slightly lower than the reference range but not critically low. This finding is important and needs to be monitored, but it does not require the most immediate intervention.

Choice B reason: The vital signs provided are within normal limits and do not indicate an urgent or life-threatening condition. These should be monitored, but they do not require immediate intervention compared to other findings.

Choice C reason: Vomiting coffee-grounds emesis is a sign of gastrointestinal bleeding, specifically indicating that blood has been in the stomach long enough to be partially digested by stomach acid, giving it a coffee-grounds appearance. This is a serious and potentially life-threatening condition requiring immediate medical intervention to stop the bleeding and prevent further complications.

Choice D reason: Sharp epigastric pain is a common symptom of peptic ulcer disease and indicates inflammation or ulceration. While it is painful and concerning, it does not require the most immediate intervention compared to active gastrointestinal bleeding.

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During a home visit, the nurse should evaluate the effectiveness of a client's treatment for chronic obstructive pulmonary disease (COPD) by assessing for which primary symptom?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is C

Explanation

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