A nurse is reinforcing teaching with a client who is preoperative following abdominal surgery about deep breathing and coughing exercises. Which of the following client statements should indicate to the nurse an understanding of the instructions?
"I start to use the incentive spirometer when I can get out of bed."
"I breathe deeply and cough every 4 hours."
"I splint my incision with a pillow to cough."
"I lie flat in bed to cough and deep breathe."
The Correct Answer is C
Choice A reason: Using the incentive spirometer is important, but it is not specifically related to deep breathing and coughing exercises.
Choice B reason: Breathing deeply and coughing every 4 hours is part of postoperative care, but it does not indicate understanding of the technique to protect the incision.
Choice C reason: Splinting the incision with a pillow while coughing is a recommended technique to support the incision and reduce pain during coughing, indicating an understanding of the instructions.
Choice D reason: Lying flat is not recommended for deep breathing and coughing exercises as it can inhibit lung expansion and is not conducive to effective coughing.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Respiratory depression is not a typical finding associated with anemia; it is more related to respiratory or central nervous system issues.
Choice B reason: Intense abdominal pain is not a common symptom of anemia and would likely indicate other medical conditions.
Choice C reason: Bradycardia, or slow heart rate, is not commonly associated with anemia. Anemia usually causes tachycardia, or a fast heart rate, as the body attempts to compensate for the reduced oxygen-carrying capacity of the blood.
Choice D reason: Dyspnea on exertion is a common symptom of anemia, as the reduced number of red blood cells leads to decreased oxygen delivery to the tissues, causing shortness of breath during activities.
Correct Answer is B
Explanation
Choice A reason: Notifying the physician is important, but it is not the immediate action to take. The nurse should first assess the patient's condition before contacting the physician.
Choice B reason: Evaluating the distal pulses is the correct action because it provides information on the blood flow to the extremities, which is crucial for patients with PAD.
Choice C reason: Having the patient lie in bed with a pillow under the knees is not recommended for PAD patients as it can decrease blood flow to the lower extremities.
Choice D reason: Covering the patient with a blanket may provide comfort, but it does not address the underlying issue of impaired blood flow in PAD.
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