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1. A community nurse is conducting a home visit for a 65-year-old man with
chronic obstructive pulmonary disease (COPD). The nurse observes that the patient
has difficulty breathing, cyanosis, and a productive cough with yellowish sputum.
The nurse also notes that the patient smokes half a pack of cigarettes per day and
lives alone in a poorly ventilated apartment. What is the most appropriate nursing
diagnosis for this patient?
a) Ineffective airway clearance related to increased mucus production and smoking
b) Impaired gas exchange related to ventilation-perfusion imbalance and hypoxia
c) Activity intolerance related to decreased oxygen delivery and fatigue
d) Risk for infection related to impaired ciliary function and chronic inflammation
*Answer: b) Impaired gas exchange related to ventilation-perfusion imbalance and
hypoxia
Rationale: Impaired gas exchange is the most appropriate nursing diagnosis for this
patient because it reflects the underlying pathophysiology of COPD, which is a
chronic condition that causes airflow obstruction, alveolar damage, and
hypoxemia. Ineffective airway clearance, activity intolerance, and risk for infection
are also relevant nursing diagnoses for this patient, but they are not as specific or as
urgent as impaired gas exchange.
2. A community nurse is planning a health promotion program for a group of lowincome pregnant women who live in a rural area. The nurse identifies that one of
the main health problems affecting this population is iron-deficiency anemia. What
is the best strategy for the nurse to implement to prevent and treat iron-deficiency
anemia in this group?
a) Provide iron supplements and educate the women on the importance of taking
them regularly
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