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The nurse is caring for a client with emphysema who is mildly dyspneic after ambulation. Which instruction should the nurse provide to the client to improve gas exchange?

A.

Lay down on each side with knees bent and breathe from abdomen.

B.

Increase breathing rate for a full 30 seconds.

C.

Raise hands above the head to expand the diaphragm.

D.

Draw air in through nose and exhale slowly through pursed lips.

Answer and Explanation

The Correct Answer is D

Choice A rationale

 

Laying down on each side with knees bent and breathing from the abdomen is not an effective technique for improving gas exchange in emphysema patients.

 

Choice B rationale

 

Increasing the breathing rate for a full 30 seconds can lead to hyperventilation and is not recommended for improving gas exchange.

 

Choice C rationale

 

Raising hands above the head to expand the diaphragm is not a recognized technique for improving gas exchange in emphysema patients.

 

Choice D rationale

 

Drawing air in through the nose and exhaling slowly through pursed lips is an effective technique for improving gas exchange in emphysema patients. This method helps to keep the airways open longer and improves the removal of trapped air.


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Correct Answer is A

Explanation

Choice A rationale

Reviewing with the client the need to avoid foods rich in milk and cream is crucial. Dairy products can increase gastric acid secretion, which can exacerbate duodenal ulcers.

Choice B rationale

Suggesting frequent small meals can help reduce discomfort but does not address the issue of dairy products exacerbating the ulcer.

Choice C rationale

Switching to decaffeinated coffee and tea is beneficial but not as critical as avoiding dairy products.

Choice D rationale

Reinforcing teaching by asking the client to list dairy foods does not address the need to avoid these foods.

Correct Answer is A

Explanation

Choice A rationale

The severity of nausea and vomiting and serum amylase results are crucial in diagnosing and managing pancreatitis. Elevated serum amylase levels are a key indicator of pancreatitis, and the severity of nausea and vomiting can help assess the patient’s condition and response to treatment.

Choice B rationale

Reports of chronic constipation and serum gastrin levels are not directly related to the acute management of pancreatitis. Chronic constipation is more associated with gastrointestinal motility disorders, and serum gastrin levels are typically measured in conditions like Zollinger-Ellison syndrome.

Choice C rationale

Serum Helicobacter pylori (H. pylori) antibody results and urine output amounts are not directly relevant to the acute management of pancreatitis. H. pylori is associated with peptic ulcer disease, and urine output is more relevant in assessing renal function.

Choice D rationale

The presence of bowel sounds and the degree of abdominal pain are important but not as specific as serum amylase levels in diagnosing pancreatitis. Bowel sounds can be affected by various conditions, and abdominal pain is a common symptom in many gastrointestinal disorders.

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