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 ["A","B","E","F"]
Explanation
Choice A reason: Diaphoresis is a common symptom of hypoglycemia, as the body tries to increase blood flow and release adrenaline to raise blood sugar levels. The client may notice sweating on the face, palms, or underarms.
Choice B reason: Anxiety is a common symptom of hypoglycemia, as the low blood sugar affects the brain and nervous system. The client may feel nervous, restless, or fearful.
Choice C reason: Tachycardia is not a reliable symptom of hypoglycemia for this client, as he is taking metoprolol, a beta-blocker that lowers the heart rate. Metoprolol can mask the signs of hypoglycemia, such as palpitations, tremors, and increased heart rate.
Choice D reason: Impaired vision is not a reliable symptom of hypoglycemia for this client, as he is an older adult who may have other eye problems, such as cataracts, glaucoma, or macular degeneration. Impaired vision can also be caused by other factors, such as fatigue, stress, or medication side effects.
Choice E reason: Confusion is a common symptom of hypoglycemia, as the low blood sugar affects the brain and cognitive function. The client may have difficulty thinking clearly, remembering things, or making decisions.
Choice F reason: Dizziness is a common symptom of hypoglycemia, as the low blood sugar affects the balance and coordination. The client may feel lightheaded, faint, or unsteady.
Correct Answer is B
Explanation
Choice A reason: Measure the blood pressure in sitting and standing positions is not the next action by the nurse, as it is not relevant to the situation. The nurse should compare the blood pressure readings from both arms, not from different postures.
Choice B reason: Measure the blood pressure in the left arm is the next action by the nurse, as it can help determine if the high blood pressure is consistent or isolated to one arm. A difference of more than 10 mm Hg between the arms may indicate a vascular problem, such as atherosclerosis, aneurysm, or coarctation of the aorta.
Choice C reason: Document the findings in the medical record; elevated blood pressures are normal in older adults is not the next action by the nurse, as it is inaccurate and irresponsible. The nurse should not assume that elevated blood pressures are normal in older adults, as they may indicate hypertension, which is a risk factor for cardiovascular disease, stroke, and kidney damage. The nurse should also not document the findings without further assessment and intervention.
Choice D reason: Immediately contact the medical provider is not the next action by the nurse, as it may be premature and unnecessary. The nurse should first confirm the accuracy of the blood pressure readings by measuring the blood pressure in the left arm and checking the calibration of the device. The nurse should also consider other factors that may affect the blood pressure, such as pain, stress, caffeine, or medication.
Choice E reason: None of the above is not the correct answer, as there is one choice that is the next action by the nurse.
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