Which statement best describes how pursed-lip breathing assists clients during an asthma attack?
It helps to distract the client and reduce anxiety.
It gets rid of carbon dioxide more quickly.
The bronchioles are opened by backflow air pressure.
It increases the serum oxygen levels.
The Correct Answer is C
Choice A rationale
While any controlled breathing technique may provide a minor psychological calming effect, distraction and anxiety reduction are secondary outcomes rather than the primary physiological purpose of pursed-lip breathing. In the context of an asthma attack, the priority is addressing the mechanical ventilation deficit. This choice fails to explain the complex pressure changes within the thoracic cavity that are necessary to counteract the premature collapse of small airways during the expiratory phase of respiration.
Choice B rationale
This statement is technically inaccurate because the primary goal of pursed-lip breathing is not the speed of carbon dioxide removal, but the completeness of the exhalation. By creating resistance at the lips, the client slows the expiratory flow, which prevents the rapid drop in airway pressure that leads to alveolar air trapping. Speeding up exhalation without this backpressure would actually worsen airway collapse and lead to increased hypercapnia, which is a rise in carbon dioxide.
Choice C rationale
This is the correct description because pursed-lip breathing creates positive end-expiratory pressure. This resistance at the mouth maintains higher pressure throughout the bronchial tree during exhalation. This backflow air pressure physically props open the distal bronchioles and alveoli, which are prone to collapsing due to the inflammation and mucus associated with asthma. Consequently, it allows for more efficient air emptying, reduces the work of breathing, and helps prevent the structural trapping of stagnant gases.
Choice D rationale
While an improvement in ventilation can eventually lead to better gas exchange, pursed-lip breathing does not directly or instantly increase serum oxygen levels in the way supplemental oxygen therapy does. Its primary scientific function is mechanical stabilization of the airways. Any rise in oxygen saturation is a tertiary result of improved alveolar ventilation and the reduction of residual volume. Standard pulse oximetry ranges are typically 95.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
While a cough is a common symptom of pulmonary tuberculosis, it is typically productive rather than non-productive as the disease progresses. The inflammatory response to the Mycobacterium tuberculosis bacteria in the lung tissue leads to the production of purulent sputum, which may also contain blood, a condition known as hemoptysis. A completely dry, non-productive cough is less characteristic of the cavitary lesions and tissue necrosis that usually occur in active pulmonary tuberculosis cases.
Choice B rationale
Skin discoloration is not a classic or primary diagnostic finding associated with the initial evaluation of pulmonary tuberculosis. While chronic illness can eventually lead to pallor due to anemia or cyanosis if oxygenation is severely impaired, these are non-specific signs. Tuberculosis primarily affects the respiratory system and causes systemic constitutional symptoms rather than specific dermatological changes. Diagnostic focus remains on respiratory secretions, chest imaging, and systemic inflammatory responses like fevers and weight loss.
Choice C rationale
Leg cramps are generally unrelated to the pathophysiology of Mycobacterium tuberculosis infection. Cramping is more commonly associated with electrolyte imbalances, such as low potassium or magnesium, or peripheral vascular issues. While a patient with advanced tuberculosis may experience generalized muscle wasting or weakness due to cachexia, localized leg cramps do not help rule in or rule out a diagnosis of tuberculosis during a clinical evaluation of a suspected respiratory infection.
Choice D rationale
Night sweats are one of the hallmark constitutional symptoms of active pulmonary tuberculosis. This occurs due to the body's cytokine response to the chronic infection, which alters the hypothalamic thermoregulatory set point. These sweats are often profuse and occur specifically during the night, frequently soaking the patient's clothes or bed linens. Along with a low-grade afternoon fever, weight loss, and a persistent cough, night sweats strongly suggest the presence of a chronic mycobacterial infection.
Correct Answer is A
Explanation
Choice A rationale
Empyema is the medical term for the accumulation of purulent, pus-filled drainage within the pleural space. This typically occurs as a complication of pneumonia or lung abscess where bacteria invade the pleural cavity. The normal pleural fluid is clear and minimal, but in empyema, white blood cell counts are high and the fluid becomes thick and opaque. The temperature of 102°F or 38.8°C (normal 98.6°F or 37°C) indicates a systemic inflammatory response to this infection.
Choice B rationale
Sputum is mucus that is expectorated from the lower airways through coughing. While sputum can be purulent if an infection like pneumonia is present, it is found within the bronchi and trachea, not the pleural cavity. The fluid aspirated during a thoracentesis comes from the space between the parietal and visceral pleura. Therefore, while both might contain pus, their anatomical locations differ significantly. Sputum is a product of the airway, while empyema is a pleural collection.
Choice C rationale
An embolus is a detached mass, such as a blood clot, air bubble, or fat globule, that travels through the bloodstream and can cause an obstruction. It has no relation to purulent drainage or fluid accumulation in the pleural cavity. The symptoms of an embolus, particularly a pulmonary one, include sudden chest pain and dyspnea, but it would not result in the aspiration of pus via a thoracentesis. It is a vascular pathology rather than an infectious pleural collection.
Choice D rationale
Emphysema is a chronic obstructive pulmonary disease characterized by the destruction of the alveolar walls and permanent enlargement of the air spaces. This leads to air trapping and impaired gas exchange, but it does not involve the accumulation of pus in the pleural cavity. While an emphysematous patient might develop an infection, the term itself refers to structural lung tissue changes. It should not be confused with empyema, which specifically describes the infected fluid found during thoracentesis.
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