A client with chronic obstructive lung disease who is receiving oxygen at 1.5 L/minute by nasal cannula, is currently short of breath. Which action should the nurse take?

Have the client breathe into a paper bag.

Ask the client to take short, rapid breaths.

Instruct the client in pursed lip breathing.

Increase oxygen to three L/minute.

Answer and Explanation

The Correct Answer is C

A.   Having the client breathe into a paper bag is a technique sometimes used for anxiety-induced hyperventilation but is not appropriate for a client with chronic obstructive lung disease
experiencing shortness of breath. It can lead to a buildup of carbon dioxide, worsening the client's condition.
B.   Asking the client to take short, rapid breaths may exacerbate hyperventilation and increase the client's anxiety. This breathing pattern can lead to further respiratory distress in a client with
chronic obstructive lung disease.
C.   Instructing the client in pursed lip breathing is the most appropriate action. Pursed lip breathing helps to prolong exhalation, reduce air trapping, and improve gas exchange in clients with chronic obstructive lung disease. It can help alleviate shortness of breath and promote
relaxation.
D.   Increasing oxygen to three L/minute may not be necessary and could potentially lead to oxygen toxicity. The priority is to help the client manage their shortness of breath effectively through breathing techniques.

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Correct Answer is ["B","D"]

Explanation

SCDs are effective for preventing DVT but are not directly related to infection prevention. The focus here is more on preventing respiratory and urinary infections.

B. Teaching the client to use an incentive spirometer every 2 hours while awake helps prevent
atelectasis and pneumonia by promoting deep breathing and lung expansion, reducing the risk of respiratory infections.
C. Assessing pain level and medicating PRN as prescribed is important for postoperative comfort but is not directly related to reducing the risk of infection.
D. Removing the urinary catheter as soon as possible and encouraging voiding helps reduce the risk of urinary tract infections, which are common in clients with prolonged catheter use.
E. Low molecular weight heparin helps prevent blood clots, reducing the risk of thrombosis, which can increase the risk of postoperative complications, including infections.

A. Client's healthcare power of attorney. B. Currently prescribed medications. C. Increasing confusion of the client. D. Fall at home as reason for admission.

Correct Answer is C

Explanation

A. The client's healthcare power of attorney is important information but may not be immediately relevant to the client's current clinical status and need for medical intervention.
B. Currently prescribed medications are important to know but should not take precedence over the client's acute change in mental status, which requires immediate attention.
C. Increasing confusion of the client is the most critical information to report first as it indicates a change in the client's condition and may require urgent evaluation and intervention by the
healthcare provider.
D. The fall at home as the reason for admission is important background information but should be provided after the current assessment of the client's condition, which includes the increasing confusion.

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A client with chronic obstructive lung disease who is receiving oxygen at 1.5 L/minute by nasal cannula, is currently short of breath. Which action should the nurse take?

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Naxlex Comprehensive Predictor Exams

An older adult client is admitted for repair of a broken hip. To reduce the risk for infection in the postoperative period, what nursing care intervention(s) should the nurse include in the client's plan of care? Select all that apply.

Correct Answer is ["B","D"]

Explanation

Correct Answer is C

Explanation

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