The nurse is teaching the client about incentive spirometry in the preoperative unit. Which statement regarding incentive spirometry should the nurse include with preoperative teaching?
"Failure to keep your lungs working may result in pneumonia after surgery which could, in turn, result in death."
"Incentive spirometry is conducted routinely after surgery and will be demonstrated when you return from surgery."
"You will use the incentive spirometer for the first postoperative day until deep breathing and coughing can be done comfortably."
"Deep breathing exercises are encouraged to maintain lung capacity and to strengthen respiratory muscles, which will help prevent complications."
The Correct Answer is D
Choice A reason: While it is important to communicate the risks of not using the incentive spirometer, this statement is overly alarming and may cause unnecessary anxiety for the client. It is better to focus on positive outcomes and preventive measures.
Choice B reason: This statement informs the client that incentive spirometry is routine and will be demonstrated postoperatively, but it does not provide specific details about its benefits or importance.
Choice C reason: This statement explains the use of the incentive spirometer on the first postoperative day, but it does not address the overall goal of preventing complications through lung exercises.
Choice D reason: This statement effectively explains the purpose and benefits of deep breathing exercises, including using the incentive spirometer. It emphasizes the importance of maintaining lung capacity and strengthening respiratory muscles to prevent complications, providing a clear rationale for the intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Lethargy and lack of appetite are symptoms that might indicate hypothyroidism or an insufficient dosage of levothyroxine. These symptoms are not typically associated with a dosage that is too high.
Choice B reason: Bradycardia and constipation are also indicative of hypothyroidism or an inadequate dosage of levothyroxine. These symptoms suggest a need for a higher dosage rather than indicating that the current dosage is too high.
Choice C reason: Muscle cramping and dry, flushed skin can be associated with electrolyte imbalances or dehydration, but they are not specific symptoms of an excessive dosage of levothyroxine.
Choice D reason: Palpitations and shortness of breath are signs of hyperthyroidism, which can occur if the dosage of levothyroxine is too high. These symptoms indicate that the client's metabolism is excessively stimulated, leading to cardiovascular strain and respiratory distress. It is crucial for the nurse to monitor these symptoms and adjust the medication dosage accordingly.
Correct Answer is B
Explanation
Choice A reason: Alopecia, or hair loss, is a common symptom of systemic lupus erythematosus but does not require immediate follow-up. It is not life-threatening and can be managed as part of the overall treatment plan.
Choice B reason: Haematuria, or blood in the urine, requires immediate follow-up because it can indicate serious renal involvement or a possible flare-up of lupus nephritis. Kidney complications in lupus can lead to severe outcomes if not addressed promptly.
Choice C reason: Fatigue is a common symptom of lupus and while it can significantly impact the client's quality of life, it does not usually require urgent intervention. It is managed through ongoing treatment and lifestyle adjustments.
Choice D reason: Joint pain is another common symptom of lupus. Although it can be debilitating, it is not an emergency and can be managed through standard treatments for lupus.
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