The nurse is observing a patient using a metered-dose inhaler (MDI) to aid in the management of chronic obstructive pulmonary disease (COPD). Which of the following actions, performed by the patient, indicate that further instruction is needed?

The patient shakes the MDI before using

The patient exhales before starting to use the MDI

The patient inspires rapidly when dispensing the medication from the MDI

The patient holds their breath for 10 seconds after inhaling from the MDI

Answer and Explanation

The Correct Answer is C

Choice A reason: Shaking the MDI before use is correct technique as it ensures that the medication is properly mixed.

Choice B reason: Exhaling before using the MDI is proper technique as it prepares the lungs for inhalation of the medication.

Choice C reason: Inspiring rapidly when dispensing the medication is incorrect because it can cause the medication to deposit in the mouth or throat rather than reaching the lungs.

Choice D reason: Holding the breath for 10 seconds after inhaling the medication is correct technique as it allows the medication to settle in the lungs.

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Correct Answer is B

Explanation

Choice A reason: The lab results pH 7.46, PaCO2 30, HCO3 24 suggest a slightly alkaline state with normal bicarbonate levels, which could indicate respiratory alkalosis with compensation. However, for a patient with a small bowel obstruction and nasogastric suction, this is less likely.

Choice B reason: The lab results pH 7.48, PaCO2 42, HCO3 29 indicate metabolic alkalosis. This is a common finding in patients with small bowel obstruction who have been on nasogastric suction, which removes stomach acids and leads to an increase in bicarbonate levels. The elevated pH and bicarbonate levels are consistent with this condition.

Choice C reason: The lab results pH 7.31, PaCO2 34, HCO3 18 indicate metabolic acidosis. This finding is inconsistent with the expected results for a patient with small bowel obstruction and nasogastric suction, which typically leads to metabolic alkalosis due to loss of gastric acid.

A. Encourage the patient to rest in bed for most of the day. B. Administer a high-protein diet including caffeinated beverages to increase energy levels. C. Assist the patient with activities of daily living (ADLs) and encourage frequent rest periods. D. Provide supplemental oxygen via face mask during vigorous exercises.

Correct Answer is C

Explanation

Choice A reason: Encouraging the patient to rest in bed for most of the day may lead to further deconditioning and muscle weakness. While rest is important, balancing activity and rest is more beneficial for managing fatigue in chronic anemia.

Choice B reason: Administering a high-protein diet including caffeinated beverages to increase energy levels is not recommended. While a high-protein diet can support energy and muscle strength, caffeine may cause jitteriness and disrupt sleep, which can exacerbate fatigue.

Choice C reason: Assisting the patient with ADLs and encouraging frequent rest periods is appropriate for managing fatigue, weakness, and activity intolerance in chronic anemia. This approach helps the patient conserve energy while maintaining some level of activity to prevent deconditioning.

Choice D reason: Providing supplemental oxygen via face mask during vigorous exercises is not appropriate. Patients with chronic anemia should avoid vigorous exercises that could exacerbate fatigue and weakness. The focus should be on moderate, manageable activities with adequate rest.

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The nurse is observing a patient using a metered-dose inhaler (MDI) to aid in the management of chronic obstructive pulmonary disease (COPD). Which of the following actions, performed by the patient, indicate that further instruction is needed?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient diagnosed with small bowel obstruction. A nasogastric tube with low continuous suction has been in place for 72 hours. Upon reviewing the blood work, which lab results will the nurse expect to see?

Correct Answer is B

Explanation

The nurse is caring for a patient admitted to the hospital with chronic anemia. The patient reports persistent fatigue, weakness, and activity intolerance. Which intervention will the nurse implement for these manifestations?

Correct Answer is C

Explanation

The nurse is caring for a patient who presents with metabolic alkalosis. Upon assessing the patient, which clinical manifestation will the nurse expect to find?

The nurse is caring for a patient diagnosed with small bowel obstruction. A nasogastric tube with low continuous suction has been in place for 72 hours. Upon reviewing the blood work, which lab results will the nurse expect to see?

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