After an acute exacerbation of chronic obstructive pulmonary disease (COPD), the nurse prepares an older adult for discharge to home. Which is the most important client teaching for the nurse to include for the prevention of hospitalizations for exacerbations of COPD?
Avoid sick people and wash hands
Use low-flow oxygen for dyspnea
Ease breathing by sitting upright
Eat nutrient- and calorie-dense foods
The Correct Answer is A
Choice A reason: Avoiding sick people and washing hands is the most important client teaching for the nurse to include for the prevention of hospitalizations for exacerbations of COPD, as it can reduce the exposure to respiratory infections, which are the main cause of COPD exacerbations. The nurse would advise the older adult to stay away from people who have colds, flu, or other contagious illnesses, and to wash their hands frequently with soap and water or use alcohol-based hand sanitizer.
Choice B reason: Using low-flow oxygen for dyspnea is a possible client teaching for the nurse to include for the prevention of hospitalizations for exacerbations of COPD, but it is not the most important one, as it depends on the severity of the condition and the oxygen saturation level of the patient. The nurse would advise the older adult to use oxygen therapy as prescribed by their doctor, and to monitor their oxygen level with a pulse oximeter.
Choice C reason: Easing breathing by sitting upright is a helpful client teaching for the nurse to include for the prevention of hospitalizations for exacerbations of COPD, but it is not the most important one, as it is a supportive measure that does not address the underlying cause of the exacerbation. The nurse would advise the older adult to sit upright or lean forward when they have difficulty breathing, and to use pursed-lip breathing or abdominal breathing techniques.
Choice D reason: Eating nutrient- and calorie-dense foods is a beneficial client teaching for the nurse to include for the prevention of hospitalizations for exacerbations of COPD, but it is not the most important one, as it is a long-term strategy that does not prevent the immediate risk of exacerbation. The nurse would advise the older adult to eat a balanced diet that provides enough protein, carbohydrates, fats, vitamins, and minerals, and to avoid foods that can cause gas, bloating, or reflux.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: ASA (aspirin) is not the best choice, as it can cause bleeding, ulcers, and allergic reactions in some older adults. ASA is also metabolized by the liver, which may be affected by chronic kidney disease.
Choice B reason: Meperidine (Demerol) is not the best choice, as it is a narcotic analgesic that can cause respiratory depression, sedation, and dependence in older adults. Meperidine is also excreted by the kidneys, which may be impaired by chronic kidney disease.
Choice C reason: Ibuprofen (Advil, Motrin) is not the best choice, as it is a nonsteroidal anti-inflammatory drug (NSAID) that can cause kidney damage, fluid retention, and hypertension in older adults. Ibuprofen is also contraindicated in patients with chronic kidney disease.
Choice D reason: Acetaminophen (Tylenol) is the best choice, as it is a mild analgesic that can relieve pain without causing significant side effects in older adults. Acetaminophen is also safe to use in patients with chronic kidney disease, as long as the dose is adjusted according to the liver function.
Choice E reason: None of the above is not the correct answer, as there is one choice that is the best choice for treating mild back pain in an older adult who has chronic kidney disease.
Correct Answer is C
Explanation
Choice A reason: FACE pain rating scale is not the most useful assessment tool for a cognitively impaired patient who cannot accurately report pain, as it relies on the patient's ability to match their pain intensity to a series of facial expressions. The patient may not be able to understand or use the scale appropriately.
Choice B reason: OLDCART-based assessment tool is not the most useful assessment tool for a cognitively impaired patient who cannot accurately report pain, as it relies on the patient's ability to provide detailed information about the onset, location, duration, characteristics, aggravating factors, relieving factors, and treatment of their pain. The patient may not be able to recall or communicate this information effectively.
Choice C reason: PAINAD scale is the most useful assessment tool for a cognitively impaired patient who cannot accurately report pain, as it relies on the nurse's observation of the patient's behavior and physiological responses to pain. The scale consists of five items: breathing, vocalization, facial expression, body language, and consolability. Each item is scored from 0 to 2, and the total score ranges from 0 to 10. A higher score indicates more pain.
Choice D reason: 0 to 10 numeric pain scale is not the most useful assessment tool for a cognitively impaired patient who cannot accurately report pain, as it relies on the patient's ability to rate their pain intensity on a scale from 0 (no pain) to 10 (worst possible pain). The patient may not be able to comprehend or use the scale correctly.
Choice E reason: None of the above is not the correct answer, as there is one choice that is the most useful assessment tool for a cognitively impaired patient who cannot accurately report pain.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.