Certified Medical-Surgical Registered Nurse Practice Exam

What conditions are signs of a patient with emphysema?

1. Acute shortness of breath and panic

2. Bloating and cyanosis

3. Marked dyspnea at rest and accessory muscle use

4. Severe cough and chest tightness

The correct answer is: Marked dyspnea at rest and accessory muscle use

The identification of marked dyspnea at rest and the use of accessory muscles as signs of emphysema is grounded in the pathophysiology of the disease. Emphysema is a chronic obstructive pulmonary disease (COPD) characterized by the destruction of alveoli, which leads to reduced surface area for gas exchange and increased airway resistance. As a result, patients experience significant difficulty breathing, particularly during physical activity or even at rest as the disease progresses. Marked dyspnea indicates a pronounced level of breathlessness, which is a hallmark of emphysema, especially as lung function declines. Patients often rely on accessory muscles such as the scalenes and sternocleidomastoid for breathing because their primary respiratory muscles, the diaphragm and intercostal muscles, are impaired due to the lung pathology. This compensatory mechanism further emphasizes the severity of their condition. While other options mention symptoms that may occur with different respiratory conditions, they do not capture the chronic and progressive nature of dyspnea and muscle use that is particularly characteristic of emphysema. For example, acute shortness of breath and panic may suggest other issues such as asthma or anxiety rather than emphysema, while symptoms like bloating and cyanosis might relate more to