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Patient Data

Exhibits

The nurse considers educational needs.
Select which items the nurse should include in the discharge education for client with stable chronic obstructive pulmonary disease (COPD). Select all that apply.

The need to switch to e-cigarettes instead of smoking tobacco cigarettes

Importance of eating a balanced diet

Need for influenza and pneumonia vaccination

Regular exercise

Supplemental oxygen instructions

Smoking cessation

Use of albuterol prior to exercise

How to use a continuous positive airway pressure (CPAP) device at night

Answer and Explanation

Correct Answer : B,C,D,E,F,G

Rationale for Correct Choices

Importance of eating a balanced diet: Clients with COPD require adequate nutrition to maintain energy and prevent muscle wasting, which can worsen respiratory function. Balanced meals support overall health and lung function.
Need for influenza and pneumonia vaccination: Vaccinations reduce the risk of respiratory infections, which can exacerbate COPD and lead to hospitalization. Preventive immunizations are essential for long-term disease management.
Regular exercise: Exercise improves cardiovascular fitness, strengthens respiratory muscles, and enhances overall endurance, helping clients tolerate daily activities despite airflow limitations.
Supplemental oxygen instructions: If prescribed, clients need to know proper oxygen use, flow rates, and safety precautions to maintain adequate oxygen saturation and prevent hypoxemia.
Smoking cessation: Quitting smoking is the single most effective intervention to slow the progression of COPD and reduce exacerbations. Education on cessation strategies and resources is critical.
Use of albuterol prior to exercise: Pre-exercise use of short-acting bronchodilators can reduce exercise-induced bronchospasm, improving tolerance to activity and preventing acute shortness of breath episodes.

Rationale for Incorrect Choices:

The need to switch to e-cigarettes instead of smoking tobacco cigarettes: E-cigarettes are not considered a safe alternative and can still harm the lungs. Advising switching does not reduce COPD progression.
How to use a continuous positive airway pressure (CPAP) device at night: CPAP is used for obstructive sleep apnea, not standard COPD management unless the client has coexisting sleep apnea. It is not routinely included in COPD education.

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Free Nursing Study Resources

Correct Answer is A

Explanation

Rationale:
A. Check under the back for evidence of bleeding: Hypotension, tachycardia, restlessness, and irritability 24 hours post-abdominal surgery suggest possible hypovolemic shock due to internal bleeding. The nurse’s first action is to assess for a source of blood loss to initiate prompt intervention.

B. Ensure the IV solution is infusing at the prescribed rate: Maintaining IV access is important for fluid resuscitation, but identifying the cause of hypotension takes priority. Confirming infusion rate alone does not address potential acute hemorrhage.

C. Notify the healthcare provider of the findings: Reporting the client’s condition is necessary, but immediate assessment of bleeding comes first to provide accurate information and allow timely intervention.

D. Listen to lung sounds: Assessing lung sounds is part of a broader evaluation, but respiratory assessment does not take precedence over identifying life-threatening hemorrhage in a post-surgical client.

A. Daily caloric intake. B. Heart rate and body weight. C. Report of bowel functioning since surgery. D. Number of any missed doses of medication.

Correct Answer is B

Explanation

Rationale:
A. Daily caloric intake: While nutrition affects overall recovery, it is not the most immediate indicator of thyroid hormone replacement effectiveness. Caloric intake provides background information but does not directly reflect therapeutic response.

B. Heart rate and body weight: These are key indicators of thyroid hormone levels and therapeutic effectiveness. Tachycardia, weight loss, or weight gain may signal over- or under-replacement, making this assessment critical for adjusting medication and preventing complications.

C. Report of bowel functioning since surgery: Bowel habits may be influenced by thyroid function, but they are less specific and less immediately critical than vital signs and weight changes in evaluating hormone replacement therapy.

D. Number of any missed doses of medication: Adherence is important, but even with occasional missed doses, the most immediate and objective way to assess therapy effectiveness is through heart rate and body weight monitoring.

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Patient Data Exhibits The nurse considers educational needs. Select which items the nurse should include in the discharge education for client with stable chronic obstructive pulmonary disease (COPD). Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse assesses an adult client 24 hours following abdominal surgery and finds the client's blood pressure is 98/40 mm Hg. The client is tachycardic, restless, and irritable. Which action should the nurse perform first?

Correct Answer is A

Explanation

A client receiving thyroid replacement therapy following a thyroidectomy is seen in the clinic for a 6 weeks postoperative check up. Which assessment is most important for the nurse to obtain?

Correct Answer is B

Explanation

The drainage in the chest tube of a client with emphysema has changed from viscous green to clear watery fluid. Which action is best for the nurse to take?

A client is admitted with heart failure (HF) and left ventricular hypertrophy. Which intervention is most likely to avert development of cardiomegaly and improve myocardial contractility?

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The nurse is preparing a teaching plan for a client taking a prescribed diuretic for edema in the lower extremities. Which instruction should the nurse include in this teaching plan?

A client is receiving a secondary infusion of vancomycin 1,500 mg in 250 mL to be infused over two hours. The IV administration set delivers 15 gtt/mL. How many gtt/min should the nurse regulate the infusion? (Enter numerical value only. If rounding is required, round to the nearest whole number.)

Patient Data

Exhibits

The nurse considers educational needs.
Select which items the nurse should include in the discharge education for client with stable chronic obstructive pulmonary disease (COPD). Select all that apply.