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SELECT ALL THAT APPLY NCLEX PRACTICE QUESTIONS QUIZ #2 (50 ITEMS)

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SELECT ALL THAT APPLY NCLEX PRACTICE QUESTIONS QUIZ #2 (50 ITEMS)Question A nurse is admitting a client with a possible diagnosis of chronic bronchitis. The nurse collects data from the client and notes which of the following signs supports this diagnosis? Select all that apply. o A. Scant mucus o B. Early onset cough o C. Marked weight loss o D. Purulent mucus production o E. Mild episodes of dyspnea Incorrect Correct Answer: B, D, & E. Key features of pulmonary emphysema include dyspnea that is often marked, late cough (after the onset of dyspnea), scant mucus production, and marked weight loss. By contrast, chronic bronchitis is characterized by an early onset of cough (before dyspnea), copious purulent mucus production, minimal weight loss, and milder severity of dyspnea. o Option A: Most patients with emphysema present with very nonspecific symptoms of chronic shortness of breath and cough with or without sputum production. As the disease process advances, the shortness of breath and cough progressively get worse. o Option B: The most common symptom of patients with chronic bronchitis is a cough. The history of a cough typical of chronic bronchitis is characterized to be present for most days in a month lasting for 3 months with at least 2 such episodes occurring for 2 years in a row. The characteristic cough of bronchitis is caused by the copious secretion of mucus in chronic bronchitis. o Option C: As COPD advances, patients can lose significant body weight due to systemic inflammation and increased energy spent in the work of breathing. Also, there are frequent intermittent exacerbations as the obstruction of the airways increases. o Option D: The airways become clogged by debris and this further increases the irritation. A productive cough with sputum is present in about 50% of patients. The sputum color may vary from clear, yellow, green, or at times blood-tinged. The color of the sputum may be dependent on the presence of secondary bacterial infection. o Option E: During an acute exacerbation of chronic bronchitis, the bronchial mucous membrane becomes hyperemic and edematous with diminished bronchial mucociliary function. This, in turn, leads to airflow impediment because of luminal obstruction to small airways. 2. 2. Question A nurse, assigned to a client with emphysema, is providing shift report. Which nursing interventions would be appropriate to include? Select all that apply. o A. The nurse should reduce fluid intake to less than 850 ml per shift. o B. The nurse should teach diaphragmatic, pursed-lip breathing. o C. The nurse should administer low-flow oxygen. o D. The nurse should keep the client in a supine position as much as possible. o E. The nurse should encourage alternating activity with rest periods. o F. The nurse should teach the use of postural drainage and chest physiotherapy. Incorrect

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