The nurse is teaching a patient with chronic obstructive pulmonary disease (COPD) about huff coughing to clear secretions.

During the patient’s return demonstration, the patient exhales using pursed lips. What should the nurse do next?

Advise the patient that the procedure is being performed correctly.

Tell the patient to take several shallow breaths before the next exhalation.

Instruct the patient to inhale deeply and then quickly and forcefully exhale 2 to 3 times.

Position the patient in the semi-Fowler’s position and apply oxygen.

Answer and Explanation

The Correct Answer is C

Choice A rationale
Huff coughing is a method that forces mucus up your throat by breathing it in, holding it, and actively exhaling. It’s different from a typical cough and more effective in clearing mucus from the lungs. Pursed-lip breathing, which the patient is doing, is not part of the huff coughing technique.
Choice B rationale
Taking several shallow breaths before the next exhalation is not part of the huff coughing technique. The technique involves taking a slow and deep breath until your lungs are about 75% full, holding your breath for two to three seconds, and then exhaling slowly but strongly.
Choice C rationale
Instructing the patient to inhale deeply and then quickly and forcefully exhale 2 to 3 times is the correct method for huff coughing. This technique helps to move mucus from the smaller airways to the larger ones, making it easier to cough up and out.
Choice D rationale
Positioning the patient in the semi-Fowler’s position and applying oxygen is not part of the huff coughing technique. While oxygen therapy can be beneficial for patients with COPD, it does not directly aid in the huff coughing technique.

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Correct Answer is A

Explanation

Choice A rationale
Encouraging the client to continue their walking routine is a supportive and positive response. This acknowledges the client’s desire to stay active and engage in activities they enjoy despite their osteoarthritis. It promotes a sense of empowerment and independence, which can be important for overall well-being.
Choice B rationale
Advising less weight-bearing to prevent joint destruction may seem logical, but it is not the best advice. Regular exercise, including walking, can actually help manage osteoarthritis by strengthening the muscles around the joints, improving flexibility, and reducing pain.
Choice C rationale
Recommending walking indoors for improved stability and safety might be helpful in some cases, but it is not necessarily the best response. The client has expressed a desire to continue walking in the park with friends, which also has social and mental health benefits.
Choice D rationale
Suggesting a calcium supplement along with continued walking is not the best advice. While calcium is important for bone health, osteoarthritis is not caused by a lack of calcium. It’s a degenerative joint disease that involves the breakdown of cartilage in the joints.

A. The patient exclusively consumes lactose-free dairy products. B. The patient meticulously cleans and peels all fresh fruits and vegetables. C. The patient enjoys fat-free yogurt as an occasional snack. D. The patient has eliminated grains from their diet.

Correct Answer is C

Explanation

Choice A rationale
Exclusively consuming lactose-free dairy products is not a specific characteristic of the DASH diet. While the DASH diet recommends low-fat or fat-free dairy products, it does not specifically require them to be lactose-free.
Choice B rationale
Meticulously cleaning and peeling all fresh fruits and vegetables is a good practice for food safety, but it is not specific to the DASH diet.
Choice C rationale
Enjoying fat-free yogurt as an occasional snack aligns with the DASH diet’s emphasis on low-fat dairy products.
Choice D rationale
Eliminating grains from the diet is not recommended in the DASH diet. On the contrary, the DASH diet encourages the consumption of whole grains.

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The nurse is teaching a patient with chronic obstructive pulmonary disease (COPD) about huff coughing to clear secretions. During the patient’s return demonstration, the patient exhales using pursed lips. What should the nurse do next?

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A young adult client with osteoarthritis of both knees expresses the desire to continue daily walks in the park with friends. How should the nurse respond?

Correct Answer is A

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Correct Answer is C

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The nurse is teaching a patient with chronic obstructive pulmonary disease (COPD) about huff coughing to clear secretions.

During the patient’s return demonstration, the patient exhales using pursed lips. What should the nurse do next?