A nurse is reinforcing teaching for a client who was admitted with an exacerbation of COPD. Which of the following should the nurse include in the client teaching?

"You should consume small, frequent meals each day."

"You should decrease your caloric intake by 200 calories per day."

"You should increase your oxygen to 5 liters per minute if you have shortness of breath."

"You should discontinue your prednisone when your symptoms improve."

Answer and Explanation

The Correct Answer is A

Choice A Reason;
"You should consume small, frequent meals each day." This statement is advisable for COPD management. Eating smaller, more frequent meals can help prevent bloating or feeling overly full, which might interfere with breathing due to increased pressure on the diaphragm.
Choice B Reason:
"You should decrease your caloric intake by 200 calories per day." While maintaining a healthy weight is important for COPD management, reducing caloric intake without specific guidance or assessment might not be suitable. It's crucial to consult with a healthcare provider or dietitian for individualized dietary recommendations.
Choice C Reason:
"You should increase your oxygen to 5 liters per minute if you have shortness of breath." Adjusting oxygen flow should be done based on a healthcare provider's prescribed guidelines. Self-adjustment of oxygen flow without medical advice can be risky and might not address the underlying cause of shortness of breath during a COPD exacerbation.
Choice D Reason:
"You should discontinue your prednisone when your symptoms improve." Prednisone or other corticosteroids are often prescribed during a COPD exacerbation to reduce inflammation in the airways. However, discontinuing corticosteroids abruptly without a healthcare provider's guidance can lead to a recurrence of symptoms or potential complications. It's important to follow the prescribed regimen and complete the course as directed.

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Correct Answer is A

Explanation

Choice A Reason:
Replace the unit when the drainage chamber is full is correct. Regularly emptying the drainage chamber when it becomes full is essential to ensure the drainage system functions properly and continues to effectively remove fluids or air from the chest cavity.

Choice B Reason:
Clamp the tube for 30 min every 8 hr. is incorrect.
Clamping a chest tube without a specific medical order or indication can lead to complications such as a buildup of pressure within the chest cavity or potential damage to the lungs. It's generally not a routine action to clamp the tube without proper instruction.

Choice C Reason:
Pin the tubing to the client's bed sheets is incorrect. Pinning the tubing to the bed sheets can cause tension on the chest tube, leading to accidental dislodgment or obstruction. The tubing should be secured but not pinned to prevent inadvertent movement.

Choice D Reason:
Monitor for at least 150 mL of drainage every hour is incorrect. There isn't a standard or prescribed amount of drainage that should occur hourly. The nurse should monitor the drainage rate and characteristics but shouldn't expect a specific volume within a set timeframe. Monitoring for excessive or decreased drainage and changes in characteristics is crucial, but an hourly volume expectation isn't appropriate.

A. Locate the injection site 5 cm (2 in) to the right or left of the umbilicus. B. Check the medication administration record to verify the client's allergies. C. Slowly inject the medication into the site without aspirating. D. Pinch clean skin at the injection site and dart the needle into the skinfold at a 90° angle. E. Ensure an air bubble is present in the prefilled enoxaparin syringe.

Correct Answer is B, E, A, D, C

Explanation

B. Check the medication administration record to verify the client's allergies. Before preparing or administering any medication, the nurse must verify the client’s medication order and allergies to ensure safety. E. Ensure an air bubble is present in the prefilled enoxaparin syringe. The prefilled syringe contains an air bubble that should remain to ensure the entire dose is administered and to prevent medication from tracking back through the tissue. A. Locate the injection site 5 cm (2 in) to the right or left of the umbilicus. Enoxaparin should be administered in the subcutaneous tissue of the abdomen, avoiding areas near the umbilicus to reduce the risk of irritation and bruising. D. Pinch clean skin at the injection site and dart the needle into the skinfold at a 90° angle. Pinching the skin ensures the medication is delivered into the subcutaneous tissue, and injecting at a 90° angle minimizes pain and ensures proper technique. C. Slowly inject the medication into the site without aspirating. Aspiration is not necessary for subcutaneous injections. Slowly injecting reduces discomfort and ensures proper absorption.

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A nurse is reinforcing teaching for a client who was admitted with an exacerbation of COPD. Which of the following should the nurse include in the client teaching?

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Naxlex Comprehensive Predictor Exams

A nurse is assisting with the care of a client who has a closed-chest tube drainage system. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

A nurse is preparing to administer subcutaneous enoxaparin. In which order should the nurse perform the following steps? (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

Correct Answer is B, E, A, D, C

Explanation

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