An 82-year-old client with COPD presents with restlessness, dyspnea, pursed lips, and tripod position complaining of "not being able to breathe". The nurse should question which of the following orders?
Rescue inhaler
Diazepam
Ipratropium
Hydromorphone
Oxygen via nasal cannula 2 L/min
Correct Answer : B,D
A. Rescue inhaler is appropriate for a COPD exacerbation as it helps to dilate the airways and improve breathing.
B. Diazepam is a benzodiazepine, which is a sedative. Sedating a patient with severe respiratory distress is contraindicated as it can further depress respiratory drive.
C. Ipratropium is a bronchodilator and is appropriate for COPD exacerbations.
D. Hydromorphone is an opioid analgesic. Opioids can depress respiratory drive, which is especially dangerous for patients with respiratory compromise such as COPD.
E. Oxygen is essential for patients with COPD exacerbations.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","E"]
Explanation
A. As the heart's ability to pump blood is compromised, blood pressure decreases.
B. Bounding pulses are associated with increased cardiac output, which is opposite to what occurs in cardiac tamponade.
C. Beck's Triad: This classic triad includes hypotension, muffled heart sounds, and jugular venous distention, all indicative of cardiac tamponade.
D. Muffled heart sounds are a characteristic of cardiac tamponade due to the fluid accumulation around the heart.
E. Jugular veins are distended: The increased pressure in the right atrium due to impaired ventricular filling leads to distended jugular veins.
Correct Answer is C
Explanation
A. Pink skin is characteristic of emphysema. Unlike chronic bronchitis, patients with emphysema often maintain adequate oxygen levels until the disease is very advanced.
B. Barrel chest is a classic sign of emphysema due to air trapping in the lungs, causing the chest to become hyperinflated.
C. Cyanotic skin tone is more common in chronic bronchitis due to chronic hypoxia.
D. Pursed-lip breathing is a common technique used by patients with emphysema to help them exhale more completely.
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