A nurse is assessing an older adult client at a health fair. Which of the following statements by the client is the nurse's priority?

"I can't seem to get reading materials far enough away to see the words."

"I'm having more difficulty telling the difference between blues and greens."

"I've noticed that there is a gray ring around the colored part of my eye."

"In the last day, I have had a severe headache and pain around my right eye."

Answer and Explanation

The Correct Answer is D

Rationale:

A. "I can't seem to get reading materials far enough away to see the words." This statement may indicate presbyopia, which is a common age-related change in vision. It does not require immediate intervention, though corrective lenses may help.

B. "I'm having more difficulty telling the difference between blues and greens." This could indicate age-related changes in color vision or cataracts, which is common but not immediately concerning. It does not represent an urgent need for intervention.

C. "I've noticed that there is a gray ring around the colored part of my eye." This could suggest a cataract, which is common in older adults. However, it is a chronic condition that progresses slowly and is not an emergency.

D. "In the last day, I have had a severe headache and pain around my right eye." This is a priority, as it could indicate acute angle-closure glaucoma, a medical emergency that requires immediate attention to prevent permanent vision loss. Symptoms include severe headache, eye pain, nausea, and blurred vision, all of which need urgent assessment and intervention.

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Correct Answer is A

Explanation

Rationale:

A. Dyspnea at rest: Dyspnea at rest is a sign of advanced COPD, indicating that the client is experiencing significant respiratory difficulty. Pulmonary rehabilitation can help improve exercise tolerance and breathing, making this an appropriate reason for referral.

B. Pursed-lip breathing: Pursed-lip breathing is a technique often used by clients with COPD to help manage shortness of breath. It is not an indication for pulmonary rehabilitation, but rather a self-management strategy.

C. Clubbing of the fingers: Clubbing of the fingers can be a sign of chronic hypoxia and is commonly seen in advanced COPD. However, it does not directly indicate the need for pulmonary rehabilitation, although the condition may benefit from comprehensive care.

D. SPO2 90%: A SpO2 of 90% is low but not necessarily an indication for referral to pulmonary rehabilitation. It is important to monitor oxygen levels, but this alone does not trigger the need for rehabilitation.

A. "Drink a glass of milk with each meal." B. "Plan to include high-protein foods in each of your meals." C. "Increase your intake of vegetables such as broccoli and brussels sprouts." D. "Consume three large meals throughout the day."

Correct Answer is B

Explanation

Rationale:

A. "Drink a glass of milk with each meal." While milk can be a good source of calcium and protein, it may increase mucus production, which can be uncomfortable for clients with COPD or increase the work of breathing.

B. "Plan to include high-protein foods in each of your meals. "High-protein foods are essential for clients with COPD, as they help maintain muscle mass, support immune function, and prevent weight loss. These benefits are important for COPD patients, who may experience increased energy expenditure due to labored breathing.

C. "Increase your intake of vegetables such as broccoli and brussels sprouts." While vegetables are important, certain cruciferous vegetables like broccoli and brussels sprouts can cause gas and bloating, which can lead to discomfort for clients with COPD.

D. "Consume three large meals throughout the day." Clients with COPD may have difficulty consuming large meals due to breathlessness or early satiety. It is better to recommend smaller, more frequent meals to ensure adequate caloric intake.

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A nurse is assessing an older adult client at a health fair. Which of the following statements by the client is the nurse's priority?

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