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?
Lay down on each side with knees bent and breathe from abdomen.
Increase breathing rate for a full 30 seconds.
Raise hands above the head to expand the diaphragm.
Draw air in through nose and exhale slowly through pursed lips.
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 B
Explanation
Choice A rationale
An increase in B-lymphocytes and IgM is not how HIV suppresses the immune system. B-lymphocytes are responsible for producing antibodies, and IgM is a type of antibody. HIV primarily affects T-lymphocytes, specifically helper T-cells (CD4 cells), rather than B-lymphocytes.
Choice B rationale
The destruction of helper T-cells and CD4 cells is the primary mechanism by which HIV suppresses the immune system. HIV targets and infects these cells, leading to their depletion. Helper T-cells play a crucial role in coordinating the immune response, and their loss results in a weakened immune system, making the body more susceptible to infections and diseases.
Choice C rationale
A deficiency of cytotoxic T cells is not the primary mechanism by which HIV suppresses the immune system. Cytotoxic T cells (CD8 cells) are involved in directly killing infected cells, but the main impact of HIV is on helper T-cells (CD4 cells), which are essential for orchestrating the immune response.
Choice D rationale
The proliferation of suppressor T-cells is not how HIV suppresses the immune system. Suppressor T-cells (regulatory T cells) help regulate and control the immune response, but HIV primarily affects helper T-cells (CD4 cells), leading to their destruction and a weakened immune system.
Correct Answer is A
Explanation
Choice A rationale
Isoniazid is an antitubercular drug used to treat active tuberculosis. The effectiveness of this medication is evaluated by observing a decrease in symptoms such as cough and sputum production. This indicates that the infection is being controlled and the bacteria are being eradicated.
Choice B rationale
A positive sputum smear and culture would indicate the presence of active tuberculosis bacteria, suggesting that the treatment is not effective. Therefore, this is not an expected outcome of effective treatment.
Choice C rationale
Decreased appetite and weight loss are not indicators of the effectiveness of tuberculosis treatment. In fact, these symptoms could indicate a worsening of the condition or side effects of the medication.
Choice D rationale
Vertigo and tinnitus are not related to the effectiveness of tuberculosis treatment. These symptoms could be side effects of the medication but do not indicate the success of the treatment.