When teaching a client with chronic obstructive pulmonary disease (COPD) about nutrition, what information should be included? (Select all that apply)

Correct Answer: D

Rationale: The correct answer is D: Eat high-fiber foods to promote gastric emptying. In COPD, patients may experience slow gastric emptying due to decreased lung function. High-fiber foods can help with digestion and prevent constipation. A: Avoid drinking fluids just before and during meals - Incorrect. Hydration is important for COPD patients, but timing of fluid intake is not directly related to nutrition in this context. B: Rest before meals if experiencing dyspnea - Incorrect. While resting before meals can help with dyspnea, it is not directly related to nutrition education. C: Have about six small meals a day - Incorrect. While small frequent meals may be beneficial for some COPD patients, this is not a universal recommendation for all individuals with COPD in terms of nutrition.

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: A

Rationale: Rationale for Correct Answer A: 1. Shaking the inhaler well before use helps ensure proper mixing of the medication. 2. This action helps to distribute the medication evenly for effective delivery. 3. It prevents clogging and ensures the client receives the correct dose. 4. Shake-and-use approach is essential for optimal therapeutic benefits. Summary of Incorrect Choices: B: Inhaling rapidly may lead to improper medication delivery and increase the risk of side effects. C: Administering medication while lying down may not allow the client to inhale the medication effectively. D: Holding the inhaler too far away can result in decreased medication intake and reduced efficacy.

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.