A charge nurse is teaching a newly licensed nurse about caring for a client who has COPD. Which of the following instructions should the charge nurse include in the teaching?

"Notify me if you observe that the client has distended neck veins."

"Call the provider if you note clubbing of the client's fingernails."

"Maintain the client's oxygen saturation level above 95 percent."

"Have an assistive personnel ambulate the client just before meals."

Answer and Explanation

The Correct Answer is A

A. Distended neck veins can indicate right-sided heart failure, a potential complication of COPD, and should be reported promptly.
B. Clubbing of fingernails develops gradually in chronic hypoxemia and is not an acute change that requires immediate provider notification.
C. Maintaining oxygen saturation above 95% in COPD clients can suppress their hypoxic drive to breathe; the recommended target is usually 88–92%.
D. Ambulating the client just before meals is not appropriate, as activity may increase dyspnea and fatigue, potentially interfering with eating and nutrition.

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Correct Answer is B

Explanation

A. Removing fresh flowers is important for preventing infection in immunocompromised clients, but it is not specific to Clostridium difficile (C. difficile) infection control.

B. Wearing a gown (and gloves) is part of contact precautions, which are required when caring for clients with C. difficile. The gown protects the nurse from exposure to infectious spores present on the client or contaminated surfaces, reducing the risk of transmission.

C. Applying a mask is not necessary for C. difficile, as it is transmitted via the fecal-oral route, not through airborne droplets. Masks are used for airborne or droplet precautions.

D. Washing hands with an alcohol-based hand rub is ineffective against C. difficile spores. Proper hand hygiene requires washing with soap and water, which physically removes the spores from the hands.

A. Restart an infiltrated IV for a client whose IV antibiotic is scheduled for 0900. B. Administer pain medication to a client who has rheumatoid arthritis and received the last dose at 0400. C. Replace a client's enteral nutrition feeding solution that has been hanging for 24 hr. D. Obtain a breakfast tray for a client who received a morning dose of insulin aspart.

Correct Answer is C

Explanation

A. Restarting an IV for a client whose antibiotic is scheduled in 2 hours is important but not immediately urgent.

B. Administering pain medication is important for client comfort but is not as time-sensitive as a potential safety concern.

C. Replacing an enteral feeding solution that has been hanging for 24 hours is the highest priority because it poses a risk of bacterial contamination and infection. Immediate action is required to ensure client safety.

D. Obtaining a breakfast tray for a client who received insulin is important for preventing hypoglycemia, but the tray can be timed to coincide with insulin administration. The feeding solution replacement presents a more urgent safety risk.

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A charge nurse is teaching a newly licensed nurse about caring for a client who has COPD. Which of the following instructions should the charge nurse include in the teaching?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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