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 ["A","B","D"]

Explanation

Choice A reason:
Being free of chest pain and dyspnea is a significant indicator of successful nursing intervention in a sickle cell crisis. Chest pain and dyspnea can occur due to acute chest syndrome, a life-threatening complication of sickle cell disease characterized by vaso-occlusion in the pulmonary microcirculation. Effective pain management and oxygen therapy can alleviate these symptoms, reflecting improved respiratory function and gas exchange.

Choice B reason:
Educating the client on the importance of increasing fluid intake is crucial in managing sickle cell crisis. Adequate hydration helps to reduce blood viscosity and prevent sickling of red blood cells, which can lead to vaso-occlusive episodes. When a client verbalizes understanding and the importance of hydration, it demonstrates the effectiveness of patient education and the client's engagement in self-care.

Choice C reason:
While increasing aerobic exercises may promote endurance, it is not typically a short-term outcome measure for a sickle cell crisis. Exercise must be approached with caution in these clients, as it can increase the risk of a vaso-occlusive crisis due to dehydration and increased oxygen demand during a sickle cell crisis.

Choice D reason:
Control of acute pain to a level of 3 on a standard pain scale indicates successful pain management, a primary goal in the treatment of sickle cell crisis. Pain in sickle cell crisis is due to ischemia from obstructed blood flow by sickled cells. Effective analgesic administration and pain management strategies are essential to achieve this outcome.

Choice E reason:
A leukocyte count of 18,000/mm³ is above the normal range (4,500 to 11,000/mm³) and may indicate an infection or inflammation, which are common complications of sickle cell disease. However, this is not a direct outcome of nursing interventions aimed at managing a sickle cell crisis and thus is not a correct choice.

A. Obesity B. The client drinks several glasses of beer every night. C. Use of a thiazide diuretic. D. Depression. E. Hypertension.

Correct Answer is ["A","B","C","E"]

Explanation

Choice A reason:
Obesity is a significant risk factor for gout. It can lead to increased production and decreased excretion of uric acid, which in turn can cause gout attacks. The normal body mass index (BMI) range is 18.5 to 24.9, and a BMI of 30 or above is considered obese.

Choice B reason:
Regular consumption of beer can increase the risk of gout. Beer is high in purines, which the body breaks down into uric acid, and alcohol can reduce the excretion of uric acid by the kidneys. Moderation in alcohol consumption is advised, with the recommendation being up to one drink per day for women and up to two drinks per day for men.

Choice C reason:
Thiazide diuretics are associated with an increased risk of gout. They can decrease the kidney's ability to remove uric acid from the body, leading to its accumulation. When prescribing thiazide diuretics, healthcare providers often monitor uric acid levels and consider alternative medications if the patient has a history of gout.

Choice D reason:
Depression is not directly identified as a risk factor for developing gout. However, some lifestyle factors associated with depression, such as poor diet and inactivity, could indirectly increase the risk.

Choice E reason:
Hypertension is a known risk factor for gout. High blood pressure can impair kidney function, which is responsible for excreting uric acid, thus leading to hyperuricemia and gout. The normal range for blood pressure is considered to be below 120/80 mmHg.

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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

How can the nurse determine that the outcomes of nursing interventions have been successful for the client diagnosed with a sickle cell crisis? (SELECT ALL THAT APPLY)

Correct Answer is ["A","B","D"]

Explanation

A nurse is discussing gout with a client who is concerned about developing the disorder. Which of the following findings should the nurse identify as risk factors for this disease? (Select all that apply)

Correct Answer is ["A","B","C","E"]

Explanation

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