A nurse in the emergency department is caring for a client who has COPD with exacerbations. Which of the following interventions should the nurse provide?
Apply oxygen via nasal cannula at 10 L/min.
Administer a bronchodilator.
Administer a loop diuretic.
Place the client in a lateral recumbent position.
The Correct Answer is B
A. Oxygen via nasal cannula at 10 L/min is too high for COPD clients and may suppress their respiratory drive; oxygen should be administered cautiously, usually starting at low flow (1–3 L/min) and titrated to maintain target saturation (usually 88-92%).
B. Administering a bronchodilator is appropriate to relieve bronchospasm and improve airflow during a COPD exacerbation.
C. Loop diuretics are not first-line treatment for COPD exacerbations unless there is concurrent fluid overload or heart failure.
D. The lateral recumbent position is not standard for COPD exacerbations; clients typically benefit from sitting upright or semi-Fowler’s position to ease breathing.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Offering oral fluids every 4 hours may not be frequent enough to effectively manage dehydration in an older adult.
B. Checking urinary output every 4 hours is important to monitor hydration status and kidney function in a client with dehydration.
C. Furosemide is a diuretic and would worsen dehydration, so it is contraindicated.
D. Monitoring hemoglobin is not a priority intervention for dehydration management.
Correct Answer is C
Explanation
A. The catheter site should be cleansed using a circular motion, starting at the exit site and moving outward, not a side-to-side motion, to prevent introducing microorganisms.
B. Taping down only the corners does not adequately secure the dressing. All edges should be sealed to reduce the risk of infection.
C. Placing a mask on the client (and the nurse) during dressing changes helps prevent contamination of the peritoneal catheter site, which is highly susceptible to infection. This is an essential aseptic practice.
D. An occlusive dressing is not typically recommended over peritoneal dialysis catheter sites, as it can trap moisture and increase the risk of infection. A sterile gauze dressing is generally preferred.
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