A nurse is assessing a client who has COPD. The nurse should identify which of the following is an expected finding?

Correct Answer: B

Rationale: In this NCLEX-style question regarding a client with COPD, the correct answer is B) Clubbing of the fingers. Clubbing is a common finding in individuals with chronic respiratory conditions like COPD due to chronic hypoxia. Clubbing is characterized by the enlargement of the fingertips and the abnormal curving of the nails. This occurs as a result of chronic tissue hypoxia leading to changes in the nail bed and soft tissues of the fingers. Option A) Jugular vein distention is not typically associated with COPD but may be seen in conditions like heart failure. Option C) Heart murmur is not a typical finding in COPD but may be present in conditions like valvular heart disease. Option D) Paradoxical breathing is not a common finding in COPD but is seen in conditions like diaphragmatic paralysis. Educationally, understanding these expected findings in COPD patients is crucial for nurses to provide comprehensive care, assess for complications, and intervene appropriately. Recognizing clubbing in a patient with COPD can prompt further assessment and interventions to manage the condition effectively. This knowledge enhances nurses' ability to provide holistic care to clients with respiratory conditions.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Surfactant. Surfactant is a substance produced by the alveoli in the lungs that helps reduce surface tension, preventing alveolar collapse or atelectasis. When alveoli collapse, it can lead to decreased gas exchange and impaired oxygenation. By maintaining the surface tension at the alveoli, surfactant plays a crucial role in maintaining lung compliance and preventing atelectasis. Looking at the other options: A) Lymphatic fluid: Lymphatic fluid does not play a direct role in preventing alveolar collapse. Its main function is to transport immune cells and maintain fluid balance in the body. B) Oxygenated blood: While oxygenated blood is essential for gas exchange in the alveoli, it does not directly prevent alveolar collapse. C) Synovial fluid: Synovial fluid is found in joints and helps reduce friction between articulating surfaces. It is not involved in preventing alveolar collapse. In an educational context, understanding the role of surfactant in maintaining lung function is crucial for nursing practice. Nurses need to be aware of the factors that can lead to atelectasis and the interventions, such as positioning, deep breathing exercises, and mobilization, that can help prevent it. Knowledge of the respiratory system and its components is essential for providing effective care to patients with respiratory conditions.

Correct Answer: B

Rationale: In this scenario, option B, respiratory rate of 8 breaths/minute, is the most concerning finding for the nurse. A respiratory rate of 8 breaths/minute is abnormally low and may indicate respiratory depression, which can be life-threatening. This finding requires immediate intervention to prevent hypoxia and respiratory failure. Option A, fine bibasilar crackles, is a common finding in patients with emphysema due to air trapping and inflammation in the lungs. While this finding should be monitored, it is not as immediately concerning as a low respiratory rate. Option C, the patient sitting up and leaning over the nightstand, suggests a position that can improve ventilation in patients with respiratory distress. While this position may indicate respiratory distress, it is not as concerning as a low respiratory rate. Option D, a large barrel chest, is a characteristic physical finding in patients with emphysema due to hyperinflation of the lungs. While it indicates a chronic respiratory condition, it is not an acute concern that requires immediate attention. In an educational context, understanding the significance of vital sign abnormalities like respiratory rate is crucial for nurses caring for patients with respiratory conditions. Recognizing abnormal vital signs and their implications allows for prompt intervention and prevention of complications in patients with compromised oxygenation.

Correct Answer: C

Rationale: Rationale: The correct answer is C) "I can increase the oxygen flow rate if I feel short of breath." This statement indicates a need for further teaching because altering the oxygen flow rate without healthcare provider guidance can be dangerous. Adjusting the flow rate without proper assessment and instruction can lead to oxygen toxicity or inadequate oxygen delivery, both of which can be harmful to the client's health. Option A) "I can use the device during air travel" is a correct statement as portable oxygen concentrators are allowed on airplanes with prior approval. Option B) "I should avoid using the device near open flames" is also correct as oxygen supports combustion, and using oxygen near open flames can lead to a fire hazard. Option D) "I need to check the battery life before leaving home" is a valid statement as ensuring the device has sufficient battery life is essential for uninterrupted oxygen therapy. In an educational context, it is crucial to emphasize the importance of following healthcare provider instructions regarding oxygen therapy, including not adjusting the flow rate without proper guidance. Educating clients on the safe use of portable oxygen concentrators helps ensure their well-being and prevent potential complications.

Correct Answer: B

Rationale: The correct answer is B) Ensure the mask fits snugly to prevent air leaks. This is the nurse's priority teaching point for a client using a CPAP device for sleep apnea. Proper mask fit is crucial to ensure effective delivery of continuous positive airway pressure, which helps keep the client's airway open during sleep. If the mask does not fit snugly, air leaks can occur, reducing the effectiveness of the therapy and potentially leading to inadequate treatment of sleep apnea. Option A) The device should be used only when symptoms occur is incorrect because CPAP therapy is typically prescribed for nightly use to manage sleep apnea, regardless of symptoms. Option C) Increase the air pressure if breathing becomes difficult is incorrect because changing the air pressure without healthcare provider guidance can be dangerous and should not be done without proper instruction. Option D) Limit use of the device to 4 hours nightly is incorrect because CPAP therapy is typically recommended for continuous use throughout the night to effectively manage sleep apnea. In an educational context, understanding the importance of proper mask fit in CPAP therapy is essential for nurses to effectively teach and support clients with sleep apnea. Ensuring that clients have a clear understanding of how to use and maintain their CPAP devices correctly can significantly improve treatment outcomes and quality of life for individuals with sleep apnea.