A patient has a long history of chronic obstructive pulmonary disease (COPD). During the assessment, the nurse will most likely observe which of these?
a. Unequal chest expansion
b. Increased tactile fremitus
c. Atrophied neck and trapezius muscles
d. Anteroposterior-to-transverse diameter ratio of 1:1
ANS: D
An anteroposterior-to-transverse diameter ratio of 1:1 or barrel chest is observed in individuals with COPD because of hyperinflation of the lungs. The ribs are more horizontal, and the chest appears as if held in continuous inspiration. Neck muscles are hypertrophied from aiding in forced respiration. Chest expansion may be decreased but symmetric. Decreased tactile fremitus occurs from decreased transmission of vibrations.
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Certification in long-term care (CLTC) encompasses pharmacology, aging, pediatrics, and other key topics
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After genetic testing, a patient learns of having a predisposition for developing cardiovascular disease at a young age. What should the nurse instruct the patient regarding this information?
A. "I would not place too much emphasis on these test results because most of the time they are inconclusive." B. "This information can help guide you to make lifestyle changes to reduce the chance of developing cardiovascular disease." C. "At least you know now that you will need cardiac bypass surgery." D. "Since you will most likely develop the disease early in life, enjoy your life as much as possible now."