A nurse is caring for a client with a medical diagnosis of acute exacerbation of chronic obstructive pulmonary disease (COPD). The client's assessment reveals a respiratory rate of 28/min, SpO2 at 90%, and complaints of mild dyspnea and anxiety at rest. What should the nurse include in the client's discharge teaching plan?

Use bronchodilators every 2 hours as needed.

Instructions on pursed-lip breathing.

Increase home oxygen from 3L/min to 5L/min as needed.

Use huff coughing to loosen secretions.

Answer and Explanation

The Correct Answer is B

Choice A reason:
Using bronchodilators every 2 hours as needed may not be appropriate for all clients. Bronchodilators are typically used on a schedule or as needed based on symptoms, but overuse can lead to tolerance and decreased effectiveness. The nurse should provide education on the proper use and timing of bronchodilators.

Choice B reason:
Pursed-lip breathing is a technique that helps control shortness of breath and improve ventilation. It can slow down the client's breathing, promote relaxation, and ensure more effective lung function. This technique is particularly beneficial during an acute exacerbation of COPD and should be included in the discharge teaching plan.

Choice C reason:
Increasing home oxygen without proper assessment can be dangerous. Oxygen therapy should be titrated based on the client's oxygen saturation and clinical status. Clients with COPD are at risk of CO2 retention, and too much oxygen can suppress their drive to breathe. The nurse should educate the client on monitoring their SpO2 and when to adjust oxygen levels, typically under the guidance of a healthcare provider.

Choice D reason:
Huff coughing is a technique used to clear mucus from the airways. While it can be effective, it should be taught by a respiratory therapist or nurse who can assess the client's ability to perform the technique correctly. It is not the first-line teaching for a client being discharged with an acute exacerbation of COPD.

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Correct Answer is A

Explanation

Choice a reason:
Increasing fiber intake is crucial for clients with diverticular disease. A high-fiber diet softens the stool and helps it pass more easily, reducing the pressure in the digestive tract. Fresh fruits and vegetables are excellent sources of fiber and other nutrients essential for maintaining a healthy digestive system. The Dietary Guidelines for Americans recommend a dietary fiber intake of 14 grams per 1,000 calories consumed, which equates to 28 grams per day for a 2,000-calorie diet.

Choice b reason:
While avoiding foods high in sugar is generally good advice for overall health, it is not specifically related to the management of diverticular disease. There is no direct link between sugar intake and the symptoms or complications of diverticular disease. However, a diet high in sugar can contribute to obesity, which is a risk factor for the development of diverticulosis.

Choice c reason:
Decreasing fluid intake is not recommended for clients with diverticular disease. In fact, adequate hydration is essential when increasing fiber intake. Fluids help fiber work better by allowing it to absorb water and expand, aiding in easier passage through the intestines.

Choice d reason:
The previous belief that small seeds and nuts should be avoided by individuals with diverticular disease has been debunked. Recent studies have shown that these foods do not increase the risk of complications and are not harmful to individuals with this condition. Therefore, this advice is outdated and no longer considered necessary as part of dietary teaching for diverticular disease.

A. Decrease my intake of vitamin K-rich foods." B. Reduce my intake of sodium. C. Avoid drinking carbonated soda. D. Limit caffeinated beverages.

Correct Answer is A

Explanation

Choice a reason:
Decreasing intake of vitamin K-rich foods is not recommended for the prevention of osteoporosis. Vitamin K is essential for bone health because it helps in the synthesis of proteins required for bone formation and mineralization. A deficiency in vitamin K can lead to weakened bone structure and increased risk of fractures. Foods rich in vitamin K include green leafy vegetables like spinach, kale, and broccoli, which should be a part of a balanced diet aimed at preventing osteoporosis.

Choice b reason:
Reducing sodium intake can be beneficial for bone health. Excessive sodium consumption can cause calcium loss through urine, which may contribute to bone demineralization and increase the risk of osteoporosis. The American Heart Association recommends no more than 2,300 milligrams a day and moving toward an ideal limit of no more than 1,500 mg per day for most adults.

Choice c reason:
Avoiding carbonated soda, especially those containing phosphoric acid, is advisable for osteoporosis prevention. Some studies suggest that phosphoric acid in soda can leach calcium from bones and decrease calcium absorption, potentially weakening bones and increasing the risk of osteoporosis.

Choice d reason:
Limiting caffeinated beverages is a prudent step in preventing osteoporosis. Caffeine can interfere with calcium absorption and lead to its increased excretion in urine. It is generally recommended to limit caffeine intake to about 400 mg per day, equivalent to around four 8-ounce cups of brewed coffee.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who has just been diagnosed with diverticular disease. What dietary teaching will the nurse provide?

Correct Answer is A

Explanation

The nurse is teaching a client about preventing osteoporosis. Which statement made by the client indicates a need for further teaching? "I will:

Correct Answer is A

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)

A nurse is assessing a client newly diagnosed with early-onset osteoarthritis. Which manifestation should the nurse expect?

For a client newly diagnosed with Type 2 diabetes mellitus who has a BMI index of 28, which information should the nurse include in the teaching plan? (Select all that apply)

The nurse is sitting with a client diagnosed with schizophrenia, who starts to laugh uncontrollably, although the nurse has not said anything funny. The nurse should say:

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