A nurse is reinforcing discharge teaching with a client who has COPD and reports problems with maintaining adequate nutrition. Which of the following instructions should the nurse include?

"Self-administer oxygen through your nasal cannula at 6 milliliters per minute during meals."

"Drink at least 240 milliliters of water during each meal."

"Perform pulmonary hygiene 1 hour before meals."

"Lie down for 30 minutes after eating."

Answer and Explanation

The Correct Answer is C

A. "Self-administer oxygen through your nasal cannula at 6 milliliters per minute during meals." is incorrect. Oxygen should not typically be increased during meals unless specifically prescribed by the provider. If the client has difficulty eating due to breathlessness, a more individualized plan is needed.

B. "Drink at least 240 milliliters of water during each meal." is incorrect. Clients with COPD may have difficulty breathing when consuming large amounts of fluids during meals. Overhydration could also worsen fluid retention in some cases. The amount of fluid should be tailored to the client’s needs and prescribed by the healthcare provider.

C. "Perform pulmonary hygiene 1 hour before meals." is correct. Pulmonary hygiene (such as postural drainage, coughing techniques, and deep breathing exercises) should be performed before meals to clear the airways and improve the ability to breathe while eating, preventing aspiration and difficulty breathing.

D. "Lie down for 30 minutes after eating." is incorrect. Lying down after eating can increase the risk of aspiration, especially in clients with COPD who may already have a compromised respiratory system. The client should be advised to remain upright after meals to prevent reflux and aspiration.

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Correct Answer is B

Explanation

A. You wish you were no longer alive?: This response might sound accusatory and may invalidate the client's feelings. The nurse should express empathy and understanding instead of making the client feel misunderstood.

B. "It is common for people who have a terminal illness to feel that way.": This response validates the client's feelings by acknowledging the emotional distress that often accompanies a terminal illness. It normalizes the experience without minimizing it and opens the door for further discussion.

C. "Why do you wish you weren't alive any longer?": While this response is direct, it might sound too probing and may feel intrusive or dismissive of the client's emotional state. A softer, more empathetic approach is usually preferred.

D. "We should talk about the treatment plan your provider has suggested.": While discussing treatment plans is important, this response may deflect the client's emotional distress and shift the focus away from their immediate emotional needs. The nurse should first address the emotional aspect before discussing treatment.

A. Verify the medication three times with the medication administration record. B. Administer time-critical medication 60 min before or after the scheduled time. C. Identify the client by using one identifier before giving the medication. D. Document medication administration prior to administering medication.

Correct Answer is A

Explanation

A. "Verify the medication three times with the medication administration record.": This is the best practice for ensuring the correct medication is administered. The nurse should verify the medication when removing it from storage, before preparing the medication, and at the bedside before giving it to the patient to ensure the right drug, dose, patient, time, and route.

B. "Administer time-critical medication 60 min before or after the scheduled time.": Time-critical medications should be administered within a specified window of 30 minutes before or after the scheduled time, not 60 minutes. Administering medication too early or late could compromise its effectiveness.

C. "Identify the client by using one identifier before giving the medication.": The correct approach is to use two identifiers (e.g., name and date of birth) to verify the client's identity, not just one. This reduces the risk of medication errors.

D. "Document medication administration prior to administering medication.": Documentation should occur after medication administration, not before, to ensure accurate recordkeeping of the event.

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A nurse is reinforcing discharge teaching with a client who has COPD and reports problems with maintaining adequate nutrition. Which of the following instructions should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a terminal illness. The client states, "I wish I would die now." Which of the following responses should the nurse make?

Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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