A client with chronic obstructive pulmonary disease (COPD) is being assessed by a nurse. Which finding should the nurse expect?

Correct Answer: A

Rationale: The correct answer is A: Increased anterior-posterior (AP) chest diameter. In COPD, air trapping causes hyperinflation of the lungs, leading to an increase in the AP chest diameter known as barrel chest. This is a classic physical finding in patients with COPD due to chronic airway obstruction. Explanation of other choices: B: Decreased respiratory rate - In COPD, patients typically have an increased respiratory rate due to difficulty breathing. C: Weight gain - Weight gain is not a typical finding in COPD and is more often associated with other medical conditions or lifestyle factors. D: Productive cough with yellow sputum - While a productive cough is common in COPD, yellow sputum is more indicative of a bacterial infection rather than COPD alone.

Correct Answer: C

Rationale: The correct answer is C because daily exercise may exacerbate COPD symptoms in some cases. Individuals with COPD may experience increased shortness of breath and fatigue during physical activity. Therefore, it is crucial to tailor an exercise plan to each client's specific needs and capabilities. Choices A, B, and D are correct as they align with COPD management strategies of smoking cessation, dietary modifications, and hydration to help with mucus clearance, respectively.

Correct Answer: C

Rationale: The correct answer is C: Pursed-lip breathing. In emphysema, air becomes trapped in the lungs due to damaged air sacs, making it difficult to exhale. Pursed-lip breathing helps to prolong exhalation, preventing air trapping. Decreased chest expansion (A) is more indicative of conditions like pleural effusion. Cyanosis (B) is a sign of inadequate oxygenation, which is not a primary manifestation of emphysema. Bradypnea (D) refers to slow breathing rate, which is not typically associated with emphysema. Pursed-lip breathing is a characteristic and effective coping mechanism seen in clients with emphysema.

Correct Answer: D

Rationale: The correct answer is D: Silent chest. This finding indicates severe airway obstruction and impending respiratory failure, requiring immediate intervention to prevent respiratory arrest. Silent chest means minimal or absent breath sounds, suggesting no air movement, which is a critical emergency situation. Wheezing (A), increased respiratory rate (B), and use of accessory muscles (C) are common in asthma attacks but do not indicate as severe a condition as a silent chest. Monitoring and addressing a silent chest promptly is crucial in managing acute asthma exacerbations.

Correct Answer: C

Rationale: The correct answer is C because a client with TB should not return to work immediately due to the risk of spreading the infection. Taking medication as prescribed (A), having regular follow-up chest x-rays (B), and using tissues to cover the mouth when coughing (D) are all important aspects of managing TB and preventing its spread. Returning to work immediately can put coworkers at risk of contracting TB. Therefore, the client should understand the importance of taking precautions and following healthcare provider recommendations to ensure proper treatment and prevent transmission of the disease.