護理師正在為慢性阻塞性肺病（COPD）病人提供出院衛教。關於圓唇呼吸（Pursed-lip breathing）的使用，護理師應強調哪項指導？
A nurse is providing discharge teaching to a client with chronic obstructive pulmonary disease (COPD). Which instruction should the nurse emphasize regarding the use of pursed-lip breathing?
- AUse the technique only during periods of severe dyspnea僅在嚴重呼吸困難期間使用此技巧
- BInhale through the mouth and exhale through the nose經口吸氣，經鼻呼氣
- CThe exhalation phase should be twice as long as the inhalation phase✓ 正解呼氣階段應為吸氣階段的兩倍長
- DTighten the abdominal muscles during inhalation吸氣時收縮腹部肌肉
圓唇呼吸（Pursed-lip breathing）是 COPD 病人管理呼吸困難的核心技術。其生理機轉是透過增加呼吸道內壓，防止小氣道在呼氣時過早塌陷，從而促進 CO2 排出並減少氣體陷閉（Air trapping）。正確的指導原則是：吸氣與呼氣的比例約為 1:2。這能確保病人有足夠的時間將滯留在肺泡中的空氣呼出。選項 B 錯誤，應為鼻吸口呼；選項 A 錯誤，此技術應在活動時或平時練習，而非僅限嚴重困難時；選項 D 錯誤，吸氣時應放鬆腹肌（腹式呼吸），呼氣時可輕微收縮。這題測驗護理師對呼吸復健基礎生理的掌握。
Pursed-lip breathing is a key technique for COPD clients to manage dyspnea. The physiology: it raises airway pressure during expiration, preventing premature small-airway collapse and improving CO2 elimination while reducing air trapping. The correct teaching is that exhalation should be approximately twice as long as inhalation, ensuring sufficient time to exhale trapped alveolar air. B is wrong—inhale through the nose, exhale through the mouth. A is wrong—use during daily activities, not only during severe dyspnea. D is wrong—relax the abdominal muscles during inhalation (diaphragmatic breathing); they may contract gently during exhalation. This question tests the basic respiratory rehabilitation physiology.
美國 NCLEX 考題非常重視病人自我照護技術的細節描述（如 1:2 比例）。在台灣臨床衛教中，護理師同樣會教導此技術，但有時會簡化為『慢慢吐氣』，較少精確要求時間比例的量化說明。