The nurse is assessing the client diagnosed with COPD. Which of the following would require immediate attention by the nurse?

Use of accessory muscles during inspiration.

Large amounts of thick white sputum

Presence of a barrel chest and clubbing

Oxygen flowmeter set on 8 LPM

Answer and Explanation

The Correct Answer is D

A. Use of accessory muscles during inspiration is common in COPD as clients work harder to breathe. While this indicates respiratory distress, it is not necessarily an immediate emergency.
B. Large amounts of thick white sputum can indicate mucus production, which is common in COPD. If the sputum were yellow or green, it could suggest infection, requiring further assessment.
C. A barrel chest and clubbing are chronic changes in COPD due to prolonged air trapping and hypoxia. These findings do not require immediate intervention.
D. Oxygen flowmeter set on 8 LPM is correct. High-flow oxygen can suppress the hypoxic drive in COPD clients, leading to respiratory depression. The nurse should immediately lower the oxygen to a safer level (typically 1-3 LPM) and monitor the client’s respiratory status.

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Correct Answer is C

Explanation

A. Hypertension is not a direct risk factor for COPD. However, COPD and hypertension can coexist, especially in smokers.
B. Being male was once associated with a higher COPD prevalence, but COPD affects both sexes, especially as smoking habits have become more equal.
C. Alpha-1 Antitrypsin (AAT) deficiency is correct. AAT deficiency is a genetic disorder that leads to early-onset emphysema, even in non-smokers. It impairs the lungs' ability to protect themselves from enzymatic damage.
D. History of pulmonary embolism is not a primary risk factor for COPD, though lung damage from recurrent emboli can contribute to respiratory issues.

A. "I recommend you exercise daily and avoid smoking to decrease your risk." B. “Tell me more about these fears of dying from a heart attack." C. "Of course you aren't going to die, at least not in the immediate future." D. "Perhaps you should discuss this with your physician.”

Correct Answer is B

Explanation

A. Providing health recommendations is important, but the immediate concern is addressing the client's fear.
B. Encouraging the client to express emotions allows the nurse to assess and provide appropriate emotional support.
C. Dismissing the client's fears can make them feel unheard and may increase anxiety.
D. Referring the client to the physician too soon may shut down communication and miss an opportunity for emotional support.

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The nurse is assessing the client diagnosed with COPD. Which of the following would require immediate attention by the nurse?

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Naxlex Comprehensive Predictor Exams

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Explanation

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