During transport of a morbidly obese patient with chest pain, which of the following reflects a key priority regarding breathing?

• A. place personal items in view.
• B. do not restrict breathing.
• C. increase aspirin dosage.
• D. move the patient to a supine position.

Answer: (B)

The key idea is preserving adequate ventilation by keeping the chest and abdomen free to move. In morbid obesity, the chest wall is stiff and lung volumes are reduced, so the work of breathing is already higher. Anything that constrains the chest—tight clothing, restraints, or laying completely flat—can further limit chest expansion and worsen oxygenation. That’s why not restricting breathing is the best choice: it directly supports the patient’s ability to ventilate effectively during transport.

The other options don’t address breathing as the priority. Personal items in view don’t impact respiration. Increasing aspirin targets cardiac therapy but doesn’t help ventilation. Moving the patient to a supine position can impede breathing in obesity by reducing chest wall compliance and diaphragmatic excursion. If possible and tolerated, positioning toward semi‑Fowler’s or upright can aid breathing.