A nurse is caring for a client who has COPD. The nurse should identify that which of the following findings is the priority to report?
Hgb 20 g/dL
Oxygen saturation 92%
Productive cough with green sputum
Chest x-ray shows hyperinflation of lungs
The Correct Answer is A
Answer: A
Rationale:
A) Hgb 20 g/dL:
A hemoglobin level of 20 g/dL is elevated and suggests polycythemia, which can occur in chronic respiratory conditions like COPD due to chronic hypoxia. Elevated hemoglobin levels can increase blood viscosity, leading to complications such as increased risk of thrombosis and cardiovascular stress. This finding indicates a potentially serious issue and should be reported to the healthcare provider immediately to address any underlying causes and manage the client's condition effectively.
B) Oxygen saturation 92%:
An oxygen saturation of 92% is slightly below the typical normal range (95-100%) but is not immediately life-threatening. While it indicates mild hypoxemia, it is a common finding in COPD patients, and the management would typically involve supplemental oxygen or adjustment of therapy. This finding should be monitored but is not the most critical issue to report immediately.
C) Productive cough with green sputum:
A productive cough with green sputum suggests a possible infection or exacerbation of COPD. Although this is an important finding that requires evaluation and possible treatment, it is less critical than an elevated hemoglobin level, which indicates a more acute systemic issue. The green sputum should be reported and managed, but it is not the priority compared to the elevated hemoglobin.
D) Chest x-ray shows hyperinflation of lungs:
Hyperinflation of the lungs is a common radiological finding in COPD due to air trapping. While it is a significant finding, it is generally consistent with the disease's progression and does not indicate an acute problem requiring immediate intervention. Monitoring and managing the underlying COPD are necessary, but this finding is less urgent than the elevated hemoglobin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Answer: C
Rationale:
A) Apply a topical corticosteroid ointment to the scalp: Corticosteroids are not indicated for the treatment of Pediculosis capitis (head lice). The treatment focuses on eliminating the lice and nits, typically through pediculicide medications like permethrin or ivermectin. Corticosteroids are used to reduce inflammation and itching, but they do not kill the lice or their eggs.
B) Soak hair brushes and combs in soapy water: Soaking hair brushes and combs in soapy water alone is not sufficient to kill lice. Items such as hair brushes should be soaked in hot water (130°F or higher) for at least 5-10 minutes to ensure any lice or nits present are killed. This is a critical step to prevent reinfestation.
C) Wash the bed linens in hot water: Washing bed linens in hot water (130°F or higher) is essential to eliminate lice and nits that may have transferred onto bedding. This prevents the spread and recurrence of lice. Items that cannot be washed should be sealed in a plastic bag for 2 weeks to kill the lice.
D) Clean the child's toys with a 1:10 bleach solution: Lice are spread through direct contact and cannot live on inanimate objects for long periods. Cleaning toys with bleach is unnecessary for lice removal and can be harmful to the toys or the child if not properly rinsed.

Correct Answer is D
Explanation
Grapes are a common choking hazard for young children, especially toddlers, due to their small size, round shape, and slippery texture. The size and shape of grapes can block the airway and pose a significant risk if not properly cut or prepared before being given to a toddler. It is recommended to cut grapes into small pieces or slice them lengthwise to reduce the risk of choking.
While potatoes, corn, and oranges can also pose a choking risk if not properly prepared or cut into age-appropriate sizes, they are not as commonly associated with choking incidents in toddlers as grapes are. Nonetheless, it is essential for parents and caregivers to be aware of appropriate food preparation techniques and supervise children during meals to ensure their safety.
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