Certified Medical-Surgical Registered Nurse Practice Exam

Which assessment finding is commonly associated with chronic obstructive pulmonary disease (COPD)?

1. Hyperventilation during rest

2. Leaning forward with arms braced

3. Frequent respiratory infections

4. Persistent dry cough

The correct answer is: Leaning forward with arms braced

Leaning forward with arms braced, known as the tripod position, is commonly seen in patients with chronic obstructive pulmonary disease (COPD). This posture helps to optimize breathing mechanics, allowing the patient to use accessory muscles for respiration more effectively. Patients with COPD often experience difficulty breathing due to proximal obstruction of airways from mucus production and destruction of lung tissue, which can lead to inadequate ventilation. By leaning forward, they can reduce the work of breathing and enhance lung expansion, making it an important compensatory mechanism. The other options may not be as directly associated with the characteristic manifestations of COPD. For example, hyperventilation during rest is not typical for those with COPD; instead, they may experience hypoventilation due to air trapping and other issues. While frequent respiratory infections can occur in COPD patients, it’s more of a secondary complication rather than a distinctive assessment finding. A persistent dry cough can be seen in patients with COPD but is not as definitive as the tripod position, which is a more direct indicator of the condition's impact on patient physiology and comfort.