A student nurse is preparing to care for a patient with bronchiectasis. The student nurse should recognize that this patient is likely to experience respiratory difficulties related to what pathophysiologic process?

Correct Answer: C

Rationale: Bronchiectasis involves chronic, irreversible dilation of bronchi and bronchioles from repeated inflammation or infection, destroying muscle and elastic tissue. This widening traps mucus, fostering recurrent infections and obstruction, leading to respiratory difficulties like chronic cough and dyspnea. Acute bronchospasm, tightening of airways, is asthma's hallmark, not bronchiectasis's structural damage. Alveolar distention and impaired diffusion occur in emphysema, affecting gas exchange at the alveolar level, not bronchial dilation. Excessive gas exchange isn't a feature bronchiectasis reduces effective ventilation. The student nurse's recognition of this pathophysiology confirmed by imaging (e.g., CT showing bronchial widening) prepares them to anticipate copious sputum and infection risk, guiding care like chest physiotherapy to manage this distinct airway disease.

Correct Answer: B

Rationale: A peak flow meter measures the highest airflow during a forced expiration, known as peak expiratory flow rate (PEFR), in liters per minute. This handheld device assesses airway obstruction in asthma patients exhale maximally after a deep breath, gauging how fast air exits narrowed passages. Lower readings signal worsening bronchospasm or inflammation, guiding therapy (e.g., rescue inhaler use) via personal best zones (green, yellow, red). Forced inspiration isn't measured inhalation isn't limited in asthma. Normal inspiration or expiration reflects tidal breathing, not obstruction severity. The educator's teaching demonstrating technique (e.g., standing, full effort) ensures the patient tracks lung function daily, aligning with asthma self-monitoring to prevent exacerbations effectively.

Correct Answer: D

Rationale: Leg exercises prevent venous stasis and thrombus formation post-anesthesia by promoting circulation in the lower extremities. General anesthesia slows blood flow, and immobility reduces muscle contractions that pump venous blood, increasing clot risk. Exercises like ankle circles or calf pumps, done regularly, counteract this, reducing deep vein thrombosis odds. Coughing, diaphragmatic breathing, and incentive spirometry target lung expansion, preventing atelectasis, not circulatory stasis. The nurse's focus on leg exercises demonstrated pre- and postoperatively ensures blood flow, aligning with protocols to minimize thromboembolism, a significant postoperative risk.

Correct Answer: A

Rationale: A cup of coffee before a 7:30 surgery, breaching fasting guidelines (clear liquids 2-3 hours, solids 6-8 hours pre-anesthesia), risks aspiration, so the nurse anticipates a delay or cancellation. This protects airway safety during general or regional anesthesia. Coffee components (e.g., milk) might adjust delay length, but the breach itself triggers action. Asking 'why' or reviewing education, while useful later, isn't immediate. The nurse's report ensures the anesthesia provider adjusts timing e.g., delaying hours if milk was added prioritizing patient safety over proceeding, per fasting protocols.

Correct Answer: C

Rationale: Assessing intake and bladder distention is most appropriate, as anesthesia can delay urinary control 6-8 hours. Palpating for a full bladder and reviewing fluids (e.g., IVs) determines if retention exists, needing intervention like catheterization if distended. Waiting may work if non-distended, but assessment precedes. Immediate catheterization requires physician order post-assessment. Dismissing the feeling as universal ignores individual variation. This step ensures tailored care, preventing retention complications, per postoperative standards.