Patient Data

History and Physical

A 34-year-old male client presents to the emergency department (ED) for an acute asthma attack which began after jogging through a local park. The client is able to answer questions, pausing every few words to catch his breath. The client reports using a rescue inhaler three times, but he just couldn't catch his breath. The client reports that symptoms seem worse when outdoors and when exercising and that episodes like this make him extremely nervous. The client reports that it has been a couple of months since he had an asthma attack, and he came to the ED today because he noticed that his inhaler was expired and was worried the medication was not working.
The nurse reviews the client's history of the presenting illness in the electronic medical record.

Click to highlight the two pieces of key subjective data which indicate the client is in need of health interventions.

The client reports using a rescue inhaler three times, but he just couldn't catch his breath

The client reports that symptoms seem worse when outdoors and when exercising

episodes like this make him extremely nervous

it has been a couple of months since he had an asthma attack

noticed that his inhaler was expired and was worried the medication was not working

Answer and Explanation

The Correct Answer is ["A"]

Subjective data refers to the symptoms reported by the client while objective data refers to the information collected on assessment of the client. During asthmatic attack, the client reports of shortness of breath, audible wheezing, inability to speak in complete sentences and a feeling of nervousness.

The use of a reliever without relief during an asthmatic attack indicates the severity of the attack. This requires intervention including the introduction of inhaled corticosteroids to reduce airway inflammation and remodeling.

The recurrence of symptoms on exposure to exercise requires the need for further advise to avoid triggers and recurrence of symptoms.

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Free Nursing Study Resources

Correct Answer is D

Explanation

D. A high fiber diet is recommended for individuals with diverticulosis to help maintain bowel regularity and prevent constipation, which can contribute to diverticular symptoms and complications. Increasing fluid intake is also important to support the passage of fiber through the digestive tract and prevent dehydration. Adequate hydration is essential for softening stool and reducing the risk of fecal impaction or exacerbation of diverticular symptoms.
A. A soft diet is not typically recommended for diverticulosis, as it may lack adequate fiber and contribute to constipation. While milk and milk products are sources of calcium and protein, they do not provide the necessary fiber to promote bowel regularity and prevent diverticulosis- related complications.
B. Eating small, frequent meals and sitting up for a period after eating can help reduce symptoms of gastroesophageal reflux disease (GERD), but these measures are not specifically indicated for diverticulosis management. While maintaining an upright position after meals may help prevent GERD symptoms, it is not the most important diet instruction for diverticulosis.
C. A bland diet may be recommended for certain gastrointestinal conditions, but it is not typically indicated for diverticulosis. Avoiding spicy foods may help reduce symptoms in some individuals with gastrointestinal issues, but it is not the primary dietary intervention for managing diverticulosis.

A. Remain upright following meals. B. Avoid wearing tight fitting clothes. C. Minimize intake of spicy foods. D. Begin a smoking cessation program.

Correct Answer is A

Explanation

A. Remaining upright following meals helps prevent gastric contents from refluxing into the esophagus by promoting gravity-assisted emptying of the stomach and reducing intra- abdominal pressure. This can help alleviate symptoms of GERD such as heartburn and regurgitation.
B. Wearing tight fitting clothes can contribute to increased pressure on the abdomen, which may worsen symptoms of GERD by further compressing the stomach and promoting reflux. While avoiding tight fitting clothes is important for minimizing discomfort, it is not as critical as remaining upright following meals in managing GERD symptoms.
C. Spicy foods can exacerbate symptoms of GERD in some individuals by irritating the esophagus and increasing gastric acid secretion. While minimizing intake of spicy foods is advisable for many people with GERD, it may not be as universally important as the instruction to remain upright following meals.
D. Quitting smoking is important for overall health and can help improve symptoms of GERD. However, while smoking cessation is beneficial, it may not directly address the immediate need to minimize symptoms following meals as the instruction to remain upright does.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When conducting discharge teaching for a client diagnosed with diverticulosis, which diet instruction should the nurse include?

Correct Answer is D

Explanation

The nurse reviews discharge instructions with a client who has gastroesophageal reflux disease (GERD). Which instruction is most important for the nurse to emphasize?

Correct Answer is A

Explanation

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