The patient with emphysema comes to the emergency department with difficulty breathing. What finding should the nurse anticipate during data collection? Select all that apply

diminished breath sounds

ruddy skin color

use of accessory muscles

excess mucus production

barrel shaped chest

Answer and Explanation

Correct Answer : A,C,E

A. Diminished breath sounds can occur in emphysema due to decreased air movement through damaged and enlarged air sacs (alveoli). The destruction of alveolar walls reduces the surface area available for gas exchange and can result in decreased breath sounds.
C. Patients with emphysema may use accessory muscles, such as neck and shoulder muscles, to assist with breathing during periods of respiratory distress. These muscles are recruited to help increase the size of the thoracic cavity and improve airflow.
E. A barrel-shaped chest is a common physical finding in patients with emphysema. It results from hyperinflation of the lungs and is characterized by an increased anterior-posterior diameter of the chest. This change in chest shape is due to air trapping in the lungs, leading to overinflation of the alveoli and increased residual volume.
B. Ruddy skin color, which refers to a reddish or flushed complexion, is not typically associated with emphysema. Instead, patients with emphysema may exhibit cyanosis (bluish discoloration of the skin) during periods of hypoxemia (low oxygen levels).
D. Excess mucus production (mucus hypersecretion) is a characteristic feature of chronic bronchitis, which is often present alongside emphysema in chronic obstructive pulmonary disease (COPD) but it is not typically a primary feature of emphysema itself.

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Correct Answer is B

Explanation

B. Orange juice is highly acidic and can irritate the esophagus, leading to increased heartburn symptoms. Regular consumption of acidic beverages like orange juice can exacerbate GERD symptoms, making this a likely contributing factor to the client's heartburn.
A. Consuming low-fat meats is generally not a contributing factor to heartburn. Low-fat meats are less likely to cause reflux compared to high-fat foods, which can relax the lower esophageal sphincter and increase the risk of acid reflux.
C. Eating dinner early in the evening is generally recommended for managing GERD. This practice allows more time for the stomach to empty before lying down to sleep, reducing the likelihood of acid reflux during the night.
D. Sleeping on a large wedge-style pillow is also generally recommended for managing GERD. Elevating the head and upper body during sleep can help prevent acid from flowing back into the esophagus.

A. I will learn to carefully check my blood glucose since I am prone to ketoacidosis. B. My pancreas may have started to attack itself after a childhood viral infection. C. may be genetically prone since diabetes goes back for several generations. D. I know that I am obese and can reduce my need for insulin with weight loss.

Correct Answer is D

Explanation

D. Obesity and weight loss are more directly linked to type 2 diabetes but they are not primary factors in the management of type 1 diabetes. Type 1 diabetes is characterized by the autoimmune destruction of beta cells, leading to an absolute deficiency of insulin. Weight loss can improve insulin sensitivity, which might be relevant for type 2 diabetes or insulin resistance, but type 1 diabetes patients will always require exogenous insulin regardless of weight changes.
A. Patients with type 1 diabetes are at risk for diabetic ketoacidosis (DKA), a serious condition caused by high blood glucose levels and ketone buildup due to insufficient insulin. Monitoring blood glucose levels is crucial in preventing DKA.
B. Type 1 diabetes is an autoimmune disease where the immune system attacks the insulin- producing beta cells in the pancreas. A viral infection can sometimes trigger this autoimmune response in genetically susceptible individuals.
C. There is a genetic component to type 1 diabetes, and having a family history of the disease can increase the risk, although environmental factors also play a role.

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The patient with emphysema comes to the emergency department with difficulty breathing. What finding should the nurse anticipate during data collection? Select all that apply

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who has gastroesophageal reflux disease (GERD) and reports having heartburn every night. Which of the following actions should the nurse identify as a contributing factor to the client's heartburn?

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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