A&E 1 Exam 2 questions WITH COMPLETE SOLUTIONS

1. After teaching a client how to perform diaphragmatic breathing, the nurse assesses the client's understanding. Which action demonstrates that the client correctly understands the teaching? a) The client lays on his or her side with his or her knees bent. b) The client places his or her hands on his or her abdomen. c) The client lays in a prone position with his or her legs straight. d) The client places his or her hands above his or her head. correct answer: b) The client places his or her hands on his or her abdomen. To perform diaphragmatic breathing correctly, the client should place his or her hands on his or her abdomen to create resistance. This type of breathing cannot be performed effectively while lying on the side or with hands over the head. This type of breathing would not be as effective lying prone. 2. A nurse cares for a client with chronic obstructive pulmonary disease (COPD). The client states that he no longer enjoys going out with his friends. How should the nurse respond? a) "There are a variety of support groups for people who have COPD." b) "I will ask your provider to prescribe you with an antianxiety agent." c) "Share any thoughts and feelings that cause you to limit social activities." d) "Friends can be a good support system for clients with chronic disorders." correct answer: c) "Share any thoughts and feelings that cause you to limit social activities." Many clients with moderate to severe COPD become socially isolated because they are embarrassed by frequent coughing and mucus production. They also can experience fatigue, which limits their activities. The nurse needs to encourage the client to verbalize thoughts and feelings so that appropriate interventions can be selected. Joining a support group would not decrease feelings of social isolation if the client does not verbalize feelings. Antianxiety agents will not help the client with social isolation. Encouraging a client to participate in activities without verbalizing concerns also would not be an effective strategy for decreasing social isolation. 3. A nurse cares for a client with a 40-year smoking history who is experiencing distended neck veins and dependent edema. Which physiologic process should the nurse correlate with this client's history and clinical manifestations? a) Increased pulmonary pressure creating a higher workload on the right side of the heart b) Exposure to irritants resulting in increased inflammation of the bronchi and bronchioles c) Increased number and size of mucus glands producing large amounts of thick mucus d) Left ventricular hypertrophy creating a decrease in cardiac output correct answer: a) Increased pulmonary pressure creating a higher workload on the right side of the heart Smoking increases pulmonary hypertension, resulting in cor pulmonale, or right-sided heart failure. Increased pressures in the lungs make it more difficult for blood to flow through the lungs. Blood backs up into the right side of the heart and then into the peripheral venous system, creating distended neck veins and dependent edema. Inflammation in bronchi and bronchioles creates an airway obstruction which manifests as wheezes. Thick mucus in the lungs has no impact on distended neck veins and edema. Left ventricular hypertrophy is associated with left heart failure and is not caused by a 40-year smoking history. 4. A nurse cares for a client with chronic obstructive pulmonary disease (COPD) who appears thin and disheveled. Which question should the nurse ask first? a) "Do you have a strong support system?" b) "What do you understand about your disease?" c) "Do you experience shortness of breath with basic activities?" d) "What medications are you prescribed to take each day?" correct answer: c) "Do you experience shortness of breath wi