The nurse is assisting the client with arm and shoulder exercises on the first post-op day following a right-sided thoracotomy. The client reports pain with the exercise and wants to know why they must be performed. What explanation should the nurse provide? The exercises:

Increase blood flow back to your heart.

Will promote expanding the left lung.

Prevent stiffening and loss of function.

Rebuild the muscle that was removed.

Answer and Explanation

The Correct Answer is C

Choice A reason: Increasing blood flow back to the heart is not the primary reason for performing arm and shoulder exercises after a thoracotomy. While exercise can improve circulation, the main goal of these specific exercises is to maintain mobility and prevent complications related to immobility.

Choice B reason: Promoting the expansion of the left lung is not the primary purpose of arm and shoulder exercises. While deep breathing exercises and the use of an incentive spirometer are crucial for lung expansion and preventing atelectasis, arm and shoulder exercises focus more on maintaining joint and muscle function.

Choice C reason: Preventing stiffening and loss of function is the primary reason for performing arm and shoulder exercises after a thoracotomy. These exercises help maintain the range of motion in the shoulder and arm, prevent joint stiffness, and reduce the risk of muscle atrophy. Postoperative immobility can lead to significant functional impairments, and these exercises are essential for a smooth recovery.

Choice D reason: Rebuilding the muscle that was removed is not accurate in this context. Thoracotomy involves accessing the thoracic cavity, and while muscle tissue may be affected, the primary goal of postoperative exercises is to maintain existing muscle function and prevent stiffness, not to rebuild muscle tissue.

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Correct Answer is D

Explanation

Choice A reason:

An increase in cellular size of the bronchi and bronchioles is not the primary issue in emphysema. Emphysema primarily affects the alveoli, the tiny air sacs in the lungs, rather than the bronchi and bronchioles.

Choice B reason:

Overexpansion of the diaphragm is not a primary problem in emphysema. While the diaphragm may become flattened due to hyperinflation of the lungs, this is a secondary effect rather than the primary issue.

Choice C reason:

A decreased ability to inhale is not the main problem in emphysema. The primary issue is difficulty exhaling due to the loss of elasticity in the alveolar walls, which leads to air trapping and hyperinflation

Choice D reason:

Destruction of alveolar walls and loss of lung elasticity is the primary physiologic problem in emphysema. This destruction leads to reduced surface area for gas exchange and impaired lung function. The loss of elasticity makes it difficult for the lungs to expel air, leading to air trapping and hyperinflation.

A. Have a pulse oximetry reading of 95% or greater by discharge. B. Exhibit a respiratory rate of 12-20/minute by discharge. C. Perform self-care activity without dyspnea by discharge. D. Have clear breath sounds bilaterally by discharge.

Correct Answer is C

Explanation

Choice A reason:

Have a pulse oximetry reading of 95% or greater by discharge: While maintaining a pulse oximetry reading of 95% or greater is important, it may not fully address the client’s activity intolerance. Pulse oximetry measures the oxygen saturation in the blood, and normal readings typically range from 95% to 100%. However, achieving this reading alone does not ensure that the client can perform activities without experiencing dyspnea or fatigue.

Choice B reason:

Exhibit a respiratory rate of 12-20/minute by discharge: A normal respiratory rate for adults is between 12 and 20 breaths per minute. While this is a good indicator of respiratory function, it does not directly address the client’s ability to perform self-care activities without dyspnea. The goal should focus on the client’s functional ability rather than just physiological parameters.

Choice C reason:

Perform self-care activity without dyspnea by discharge: This outcome directly addresses the client’s activity intolerance. Dyspnea, or difficulty breathing, is a significant symptom that affects the client’s ability to perform daily activities. By setting a goal for the client to perform self-care activities without dyspnea, the care plan focuses on improving the client’s functional status and quality of life.

Choice D reason:

Have clear breath sounds bilaterally by discharge: Clear breath sounds are an important indicator of improved lung function and resolution of pneumonia. However, this outcome does not specifically address the client’s activity intolerance. While clear breath sounds are desirable, the primary goal should be to ensure the client can perform activities without experiencing dyspnea.

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The nurse is assisting the client with arm and shoulder exercises on the first post-op day following a right-sided thoracotomy. The client reports pain with the exercise and wants to know why they must be performed. What explanation should the nurse provide? The exercises:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse recognizes that the primary physiologic problem affecting clients with emphysema is:

Correct Answer is D

Explanation

A client with left lower lobe pneumonia has activity intolerance related to impaired oxygen supply and demand as evidenced by fatigue, dyspnea, and difficulty performing self-care. Which expected outcome must be included in the care plan related to this problem? The client will:

Correct Answer is C

Explanation

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