A home health care nurse is teaching a client about managing COPD. Which of the following client statements should the nurse identify as an understanding of the teaching?

"I'll use pursed-lip breathing when I feel short of breath."

"I'll skip my exercises for the week if I feel short of breath."

"I will use my inhaler 30 minutes after each meal."

"I will limit myself to drinking only 1 quart of water each day."

Answer and Explanation

The Correct Answer is A

A) "I'll use pursed-lip breathing when I feel short of breath.": Pursed-lip breathing is a beneficial technique for clients with COPD as it helps keep the airways open longer, reduces the work of breathing, and improves ventilation. This statement indicates the client understands a key management strategy for COPD.

B) "I'll skip my exercises for the week if I feel short of breath.": Regular exercise is important for managing COPD, and while adjustments may be necessary when symptoms are severe, completely skipping exercise can lead to deconditioning and worsening of symptoms. This statement does not reflect appropriate management of COPD.

C) "I will use my inhaler 30 minutes after each meal.": Inhalers should be used as prescribed, usually before activities that might trigger symptoms, such as eating, rather than on a fixed schedule unrelated to symptoms or physician's guidance. This statement indicates a misunderstanding of inhaler use.

D) "I will limit myself to drinking only 1 quart of water each day.": Staying hydrated is important for thinning mucus in COPD. Unless there are specific medical reasons to restrict fluids, such as heart failure, limiting water intake could lead to dehydration and thickened mucus, making breathing more difficult. This statement is not appropriate for managing COPD.

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

Explanation

A) Teach the client to void over a urine strainer: After lithotripsy, clients are often advised to void over a strainer to catch any small stone fragments that may pass. This helps in monitoring the passage of stone fragments and ensures that any remaining stones can be analyzed for further management.

B) Administer oxybutynin to the client twice per day: Oxybutynin is an anticholinergic medication used to treat bladder spasms. It is not routinely used after lithotripsy unless specifically prescribed for bladder spasms, which are not a common postoperative concern for this procedure.

C) Encourage frequent ambulation for the client: Frequent ambulation is beneficial after lithotripsy as it helps promote overall recovery, reduces the risk of complications like deep vein thrombosis, and can facilitate the passage of stone fragments. Encouraging movement is an essential aspect of postoperative care.

D) Check the client's urine for ketones three times per day: Monitoring for ketones is not typically required following lithotripsy unless there is a specific concern about diabetic ketoacidosis or another condition that warrants ketone monitoring. It is not a standard intervention for postoperative care after lithotripsy.

E) Instruct the client to drink 3 L of fluid per day: Increasing fluid intake is crucial after lithotripsy to help flush out any remaining stone fragments and to prevent new stone formation. Drinking 3 liters of fluid per day is generally recommended to maintain adequate hydration and support the urinary system.

A. Diarrhea B. Bradycardia C. Tinnitus D. Tetany

Correct Answer is D

Explanation

A) Diarrhea: Metabolic alkalosis is more likely to be associated with constipation rather than diarrhea. Diarrhea is typically a cause of metabolic acidosis due to the loss of bicarbonate in stool, rather than a result of metabolic alkalosis.

B) Bradycardia: Bradycardia is not a typical manifestation of metabolic alkalosis. Alkalosis can lead to arrhythmias, but it generally does not cause a slow heart rate. Instead, tachycardia might occur as the body compensates for the altered acid-base balance.

C) Tinnitus: Tinnitus is not a common symptom of metabolic alkalosis. It is more often associated with aspirin toxicity or other conditions affecting the auditory system, rather than changes in acid-base balance.

D) Tetany: Tetany is a common manifestation of metabolic alkalosis. The alkalosis causes a decrease in ionized calcium levels, which increases neuromuscular excitability and can lead to muscle cramps, spasms, and tetany. This is a key sign for nurses to monitor as it indicates significant electrolyte disturbances associated with the alkalotic state.

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A home health care nurse is teaching a client about managing COPD. Which of the following client statements should the nurse identify as an understanding of the teaching?

Nursing Test Bank

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Explanation

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