A nurse observes that a client's anteroposterior (AP) chest diameter is the same as the lateral chest diameter. Which question would the nurse ask the client in response to this finding?

Correct Answer: B

Rationale: The correct answer is B: Do you have any chronic breathing problems? This question is appropriate because equal AP and lateral chest diameters could indicate barrel chest, which is often associated with chronic obstructive pulmonary disease (COPD) or other chronic breathing problems. Asking about chronic breathing problems can help the nurse further assess the client's respiratory health. Incorrect answers: A: Are you taking any medications or herbal supplements? This question is not directly related to the observed chest diameter findings. C: How often do you perform aerobic exercise? This question is not relevant to the physical assessment findings and does not address the potential respiratory issue. D: What is your occupation and what are your hobbies? This question does not directly address the equal AP and lateral chest diameters and does not help in assessing the respiratory status of the client.

Correct Answer: D

Rationale: The correct answer is D: What is your occupation? This is the most important question because inhalation anthrax is commonly associated with certain occupations, like handling animal products or working in agricultural settings. Knowing the client's occupation can help identify potential sources of exposure. A: Are any family members also ill? - While important for assessing potential spread of infection, this question does not directly help in determining the cause of the anthrax infection. B: Have you traveled recently? - Travel history is relevant for certain infectious diseases, but for inhalation anthrax, occupational exposure is a more crucial factor to consider. C: How long have you been ill? - Timing of symptoms is important for diagnosis and treatment, but knowing the client's occupation provides more specific information in the case of suspected inhalation anthrax.

Correct Answer: B

Rationale: The correct answer is B. Persistent hoarseness is a hallmark symptom of laryngeal cancer. A (bacterial infection) may cause temporary hoarseness but not persistent. C (aphonia) refers to complete loss of voice, not hoarseness. D (peritonsillar abscess) affects the throat but does not typically cause persistent hoarseness.

Correct Answer: D

Rationale: In caring for a client with recently diagnosed asthma, it is crucial to provide accurate and comprehensive education to empower the individual in managing their condition effectively. Option D, "Be sure to get at least 8 hours of rest and sleep every night," is the correct answer. Adequate sleep is essential for overall health, including immune function and respiratory health. Consistent rest can help reduce stress, which is a common trigger for asthma symptoms. Moreover, proper rest supports the body in managing inflammation and maintaining a healthy immune response, which is beneficial for individuals with asthma. Option A, "Avoid potential environmental asthma triggers such as smoke," is a common recommendation for asthma management. It is essential to educate patients to avoid smoke, strong odors, pollutants, and other environmental triggers that can exacerbate asthma symptoms. Option B, "Use inhaler 30 minutes before exercising to prevent bronchospasm," is also a valuable strategy for some individuals with exercise-induced asthma. However, it may not apply to all asthma patients, as not everyone with asthma experiences symptoms triggered by exercise. Individualized care and assessment are crucial to determine the necessity of pre-exercise inhaler use. Option C, "Wash all bedding in cold water to reduce and destroy dust mites," while a good practice for individuals with allergies to dust mites, may not be a top priority in asthma management. While reducing exposure to allergens can be beneficial, it may not be as critical as ensuring proper rest, avoiding triggers like smoke, and personalized asthma medication use. In an educational context, it is important to emphasize personalized care plans for asthma management. Patients should be encouraged to work closely with healthcare providers to develop individualized strategies that consider their specific triggers, symptoms, and lifestyle factors. Providing comprehensive education empowers individuals to take an active role in managing their asthma effectively and improving their quality of life.

Correct Answer: D

Rationale: In assessing the lungs of a 92-year-old female patient with severe shortness of breath, the nurse should use the approach of assessing the anterior (front) of the chest first, followed by the posterior (back) of the chest. This approach is correct (option D) because it allows the nurse to systematically evaluate different lung fields and identify any abnormalities such as reduced breath sounds, wheezing, or crackles effectively. Option A (apex to base) is incorrect as it focuses on assessing the lungs from top to bottom. This approach may miss important findings in the lower lung fields, which are commonly affected in conditions like pneumonia or heart failure. Option B (base to apex) is also incorrect as it is the reverse of the correct approach. Starting from the base may lead to missing critical findings in the upper lung fields. Option C (lateral sequence) is not the recommended approach for assessing the lungs in this scenario. Lateral assessment is important in specific situations like identifying pleural effusion but is not the primary method for initial lung assessment. In an educational context, it is crucial to teach nursing students the proper technique for assessing the lungs, which involves a systematic and thorough approach to ensure all lung fields are adequately evaluated. Understanding the rationale behind the correct assessment technique is essential for providing comprehensive care to patients presenting with respiratory distress.