A client has chronic obstructive pulmonary disease (COPD) and right-sided heart failure. Which statement by the nurse is correct?

"Eat six small meals a day to limit oxygen needs."

"Increase the intake of protein to decrease intravascular hydrostatic pressure."

"Drink large amounts of fluid to help liquefy secretions."

"Lie down after eating to conserve energy needed for digestion."

Answer and Explanation

The Correct Answer is A

A. Eating six small meals a day prevents excessive oxygen demand during digestion and reduces bloating, which can impair breathing.
B. Protein intake is important, but it does not directly impact intravascular hydrostatic pressure in a way that would help with COPD and right-sided heart failure.
C. While adequate hydration is necessary, excessive fluid intake can worsen right-sided heart failure by increasing fluid retention and edema.
D. Lying down after eating can worsen dyspnea and lead to reflux, which is not advisable for COPD patients.

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Correct Answer is C

Explanation

A. Encouraging increased fluid intake is incorrect. Clients with heart failure are at risk for fluid overload, and excessive fluid intake can worsen symptoms.
B. Simply monitoring and documenting findings is insufficient. A 2-pound weight gain in a short period suggests fluid retention and worsening heart failure, requiring further assessment and possible intervention.
C. Performing a head-to-toe assessment, including vital signs, is correct. The nurse should assess for worsening heart failure, including lung sounds (crackles), respiratory effort, blood pressure, and oxygen saturation, to determine if immediate interventions are needed.
D. Checking code status is not the priority. While knowing a client’s code status is important, the immediate concern is assessing for signs of fluid overload and potential decompensation.

A. “I will be discharged on Warfarin so that a clot will not develop in the future." B. "A Heparin infusion is going to keep the blood clot from getting bigger." C. "The purpose of the Inferior Vena Cava (IVC) Filter is to prevent the development of DVTs." D. "An embolectomy is a procedure to physically remove a blood clot."

Correct Answer is C

Explanation

A. Warfarin is commonly prescribed for long-term anticoagulation to prevent future clot formation. This statement is correct and does not require further teaching.
B. A Heparin infusion does not dissolve existing clots but prevents them from enlarging and new clots from forming, making this statement accurate.
C. The purpose of the Inferior Vena Cava (IVC) filter is to trap emboli from deep vein thrombosis (DVT) before they reach the lungs, not to prevent DVT formation. This statement is incorrect and requires further teaching.
D. An embolectomy is a surgical procedure to remove a pulmonary embolism, making this statement correct.

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A client has chronic obstructive pulmonary disease (COPD) and right-sided heart failure. Which statement by the nurse is correct?

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Naxlex Comprehensive Predictor Exams

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