The nurse is assessing the client diagnosed with COPD. Which of the following would require immediate attention by the nurse?

Use of accessory muscles during inspiration.

Large amounts of thick white sputum

Presence of a barrel chest and clubbing

Oxygen flowmeter set on 8 LPM

Answer and Explanation

The Correct Answer is D

A. Use of accessory muscles during inspiration is common in COPD as clients work harder to breathe. While this indicates respiratory distress, it is not necessarily an immediate emergency.
B. Large amounts of thick white sputum can indicate mucus production, which is common in COPD. If the sputum were yellow or green, it could suggest infection, requiring further assessment.
C. A barrel chest and clubbing are chronic changes in COPD due to prolonged air trapping and hypoxia. These findings do not require immediate intervention.
D. Oxygen flowmeter set on 8 LPM is correct. High-flow oxygen can suppress the hypoxic drive in COPD clients, leading to respiratory depression. The nurse should immediately lower the oxygen to a safer level (typically 1-3 LPM) and monitor the client’s respiratory status.

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Correct Answer is B

Explanation

A. Taking 4 tablets over 20 minutes exceeds the recommended limit of 3 doses in 15 minutes and can dangerously delay emergency care if the pain is due to a heart attack.

B. The correct teaching is to take 1 sublingual nitroglycerin tablet at the onset of angina and, if pain persists after 5 minutes, activate emergency services while taking up to 2 additional tablets at 5-minute intervals. This ensures rapid symptom relief while promptly initiating emergency care if the angina does not resolve.

C. Calling 911 before taking any nitroglycerin delays immediate treatment of angina. Sublingual nitroglycerin is meant to relieve pain quickly, so contacting emergency services comes after assessing response to the first dose.

D. Waiting until all 3 tablets are taken before calling 911 can dangerously delay care if the angina is progressing to myocardial infarction. Early activation after the first dose ensures patient safety and timely intervention.

Correct Answer is ["120"]

Explanation

 Convert pounds to kilograms:

176 pounds / 2.2 pounds/kg = 80 kg

 Calculate the enoxaparin dose:

80 kg 1.5 mg/kg = 120 mg

 Round to the nearest whole number:

120 mg

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The nurse is assessing the client diagnosed with COPD. Which of the following would require immediate attention by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client who has angina pectoris and a new prescription for nitroglycerin sublingual tablets. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is B

Explanation

A nurse is caring for a client who has a pulmonary embolism and has a new order for enoxaparin 1.5 mg/kg/dose to be administered subcutaneously every 12 hours. The client weighs 176 pounds. How many mg should the nurse administer per dose? (Round to the nearest whole number)

Correct Answer is ["120"]

Explanation

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