A client with chronic bronchitis has a non-productive cough, rhonchi in bilateral lung fields, and difficulty expectorating the secretions. Which intervention should the nurse incorporate into the plan of care?

Place the client on a 35% Venturi mask.

Encourage the client to increase liquid intake throughout the day.

Administer dextromethorphan 30 mg PO every six hours as needed.

Encourage pursed-lip breathing when the client is out of bed.

Answer and Explanation

The Correct Answer is B

Choice a reason:
Placing the client on a 35% Venturi mask would provide a controlled amount of oxygen which is beneficial for clients with chronic obstructive pulmonary disease (COPD) who may retain carbon dioxide. However, this intervention is not directly related to the management of a non-productive cough and difficulty expectorating secretions.

Choice b reason:
Encouraging the client to increase liquid intake throughout the day can help thin the bronchial secretions, making them easier to expectorate. Adequate hydration is essential in the management of chronic bronchitis to help clear mucus from the airways.

Choice c reason:
Administering dextromethorphan, a cough suppressant, may be used to control a non-productive cough. However, it would not assist with the expectoration of secretions and could potentially inhibit the cough reflex needed to clear the airways.

Choice d reason:
Encouraging pursed-lip breathing can help improve ventilation and oxygenation by promoting more effective exhalation. This technique can be beneficial for clients with COPD but does not directly address the issue of expectorating secretions.

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Correct Answer is D

Explanation

Choice A Reason
While maintaining a stable blood pressure is important for a client with hypertension, furosemide is primarily a diuretic, and its therapeutic effect is to reduce fluid overload, not directly to stabilize blood pressure. Therefore, this finding alone does not best indicate the therapeutic effect of furosemide.

Choice B Reason
Clear lungs upon auscultation suggest an improvement in pulmonary edema, which can be associated with fluid overload in conditions such as heart failure. However, for a client with peripheral edema, the primary therapeutic goal of furosemide is to reduce the excess fluid in the extremities, not just the lungs.

Choice C Reason
A decrease in serum potassium is a known side effect of furosemide due to its action on the kidneys, leading to increased excretion of potassium. While it's important to monitor for hypokalemia, a decrease in potassium does not directly indicate the therapeutic effect of reducing edema.

Choice D Reason
An increase in urine output from 30 mL per hour to 100 mL per hour is a direct indication that furosemide is achieving its therapeutic effect. Furosemide is a loop diuretic that increases urine production to help the body eliminate excess fluid, thereby reducing edema associated with conditions like hypertension.

A. Diuretic use. B. Emotional or physical trauma. C. Overweight. D. Being an adolescent male.

Correct Answer is B

Explanation

Choice a reason:

Diuretic use is not typically associated with an increased risk of developing fibromyalgia. Diuretics are commonly used to treat conditions like hypertension and edema by helping the body eliminate excess fluid, but they do not contribute to the onset of fibromyalgia¹.

Choice b reason:

Emotional or physical trauma has been identified as a risk factor for fibromyalgia. Individuals who experience significant stress or traumatic events may develop the disorder due to changes in how their central nervous system processes pain. Stress can lead to long-lasting effects on the body and may trigger fibromyalgia or worsen its symptoms²³⁴.

Choice c reason:

Being overweight is not a direct risk factor for fibromyalgia, but it can exacerbate symptoms in those who have the condition. Excess weight can increase the strain on the body and may contribute to the chronic pain and fatigue associated with fibromyalgia. However, it is not considered a causative factor¹.

Choice d reason:

Being an adolescent male is not a recognized risk factor for fibromyalgia. The disorder is more commonly diagnosed in women, and while it can occur at any age, it is most often diagnosed during middle age. Gender and age alone are not sufficient to determine the risk of developing fibromyalgia.

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A client with chronic bronchitis has a non-productive cough, rhonchi in bilateral lung fields, and difficulty expectorating the secretions. Which intervention should the nurse incorporate into the plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After administering furosemide 20 mg PO to a client diagnosed with hypertension and peripheral edema, which finding would best indicate that the therapeutic effect of the medication has been achieved?

Correct Answer is D

Explanation

A nurse is discussing fibromyalgia with a client who is concerned about developing the disorder. Which finding would the nurse identify as a risk factor for this disease?

Correct Answer is B

Explanation

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