A nurse is reinforcing teaching with a client who is scheduled for abdominal surgery about coughing and deep breathing. Which of the following statements should the nurse make?
"Inhale through your mouth when deep breathing."
"Cough and deep breath every 4 hours."
"Lie supine to cough and deep breath."
"Splint your incision with a pillow when coughing."
The Correct Answer is D
A. Inhale through your mouth when deep breathing is incorrect. The client should be instructed to inhale deeply through the nose and exhale through the mouth, which is more effective for deep breathing and lung expansion.
B. Cough and deep breath every 4 hours is not frequent enough. The client should be encouraged to cough and deep breathe every 1-2 hours to prevent atelectasis and promote lung expansion.
C. Lie supine to cough and deep breath is incorrect. The client should be in an upright or semi-Fowler's position to optimize lung expansion and reduce strain on the incision when coughing.
D. Splint your incision with a pillow when coughing is the correct response. Splinting the incision with a pillow helps reduce pain and provides support to the surgical site while coughing, which can be painful after abdominal surgery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Hold your breath for 7 seconds when using the incentive spirometer is correct. To achieve optimal lung expansion, clients should inhale deeply and hold their breath for 3 to 5 seconds, though some guidelines may recommend up to 7 seconds, which helps to maximize the effectiveness of the inhalation.
B. Sit up at a 30-degree angle when using the incentive spirometer is not accurate. Clients should ideally sit upright or in a semi-Fowler’s position, but a 30-degree angle is not a strict requirement for using the spirometer. The key is to have an optimal posture for deep breathing.
C. Use the incentive spirometer once every 4 hours is incorrect. The incentive spirometer should be used every 1 to 2 hours while awake, not just once every 4 hours, to encourage frequent deep breathing and reduce the risk of atelectasis.
D. Inhale through the incentive spirometer 10 times with each use is not necessarily recommended. The general guidance is to perform 5 to 10 slow, deep breaths per session, but this can vary depending on the patient’s condition and specific instructions from their healthcare provider.
Correct Answer is C
Explanation
A. Vitamin E is a fat-soluble vitamin, not water-soluble. It is important for antioxidant function and skin health but does not fall into the water-soluble category.
B. Vitamin A is also a fat-soluble vitamin, essential for vision, immune function, and skin health. It is not water-soluble.
C. Vitamin C is a water-soluble vitamin that is essential for immune function, wound healing, and as an antioxidant. It must be consumed regularly since the body does not store it.
D. Vitamin D is a fat-soluble vitamin, important for bone health and calcium absorption, but not water-soluble.
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