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This chapter is from the book

This chapter is from the book

Answer Rationales

  1. Answer B is correct. Clients with emphysema develop a barrel chest due to the trapping of air in the lungs, causing them to hyperinflate. Answers C and D are common in those with emphysema but do not cause the chest to become barrel shaped. Answer A does not occur in emphysema.
  2. Answer B is correct. The client with chronic obstructive pulmonary disease has increased difficulty breathing when lying down. His respiratory effort is improved by standing or sitting upright or by having the bed in high Fowler’s position. Answers A, C, and D do not alleviate the client’s dyspnea; therefore they are incorrect.
  3. Answer C is correct. The FEV1/FVC ratio indicates disease progression. As COPD worsens, the ratio of FEV1 to FVC becomes smaller. Answers A and B reflect loss of elastic recoil due to narrowing and obstruction of the airway. Answer D is increased in clients with obstructive bronchitis.
  4. Answer D is correct. In clients with COPD, respiratory effort is stimulated by hypoxemia. Answers A and C are incorrect because higher levels would rob the client of the drive to breathe. Answer B is an incorrect statement.
  5. Answer A is correct. Changes in smoking patterns should be discussed with the physician because they have an impact on the amount of medication needed. Answer B is incorrect because clients with COPD are placed on expectorants, not antitussives. Answer C is incorrect because an annual influenza vaccine is recommended for all those with lung disease. Answer D is incorrect because benefits from inhaler use should be increased when the client stops smoking.
  6. Answer A is correct. The therapeutic range for aminophylline is 10–20 mcg/mL. Answers B and D are incorrect. There are no indications that the results are questionable; therefore, repeating the test as offered by answer C is incorrect.
  7. Answer B is correct. Cor pulmonale, or right sided heart failure, is a possible complication of emphysema. Answers A and D do not cause weight gain, so they’re incorrect. Answer C would be reflected in pulmonary edema, so it’s incorrect.
  8. Answer C is correct. The client should wait 60 seconds before repeating the inhalation. Repeating the inhalation in 30 seconds indicates that the client needs further teaching. Answers A, B, and D indicate correct use of a metered dose inhaler; therefore, they are incorrect choices.
  9. Answer D. The client with COPD needs additional calories, protein, fat, vitamins, and minerals. Answer A is incorrect because the client needs more calories.
  10. Answer D is correct. The serum creatinine is elevated, indicating an adverse effect of the medication on the kidneys. Answers A, B, and C are within normal limits.
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