A client with chronic obstructive pulmonary disease (COPD) smokes two packs of cigarettes per day and is admitted to the hospital for a respiratory infection. The client reports difficulty controlling respiratory distress at home when using the rescue inhaler. Which comment from the client indicates to the nurse that the client is not using the inhaler properly?

"I have a hard time inhaling and holding my breath after I squeeze the inhaler, but I do my best."

"I never use the inhaler unless I am feeling really short of breath."

"After I squeeze the inhaler and swallow, I always feel a slight wave of nausea, but it goes away."

"I always shake the inhaler several times before I start."

Answer and Explanation

The Correct Answer is C

Rationale

A. This comment suggests that the client is aware of the correct technique (inhaling and holding breath) but finds it difficult to execute properly. It indicates a partial understanding of the inhaler technique but potential difficulty in coordination.

B. This comment indicates a misunderstanding of the purpose of a rescue inhaler. Rescue inhalers are intended to be used promptly at the onset of symptoms to relieve acute shortness of breath. Delaying use until symptoms are severe may result in inadequate relief and worsening of respiratory distress.

C. This comment suggests that the client may be swallowing the medication instead of inhaling it into the lungs. Inhalers are meant to deliver medication directly into the lungs through inhalation, not swallowing. Swallowing the medication can lead to gastrointestinal side effects like nausea.

D. Shaking the inhaler before use is a correct step to ensure proper dispersion of the medication. This comment indicates the client understands and follows this part of the inhaler technique correctly.

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

Explanation

Rationale

The client is experiencing significant psychological distress characterized by intrusive thoughts and memories related to the traumatic event (house collapsing during a hurricane). These thoughts are causing her difficulty in falling asleep and impacting her emotional well-being. Her statement about feeling unable to get out of a "funk" suggests that she may be experiencing symptoms of acute stress or post-traumatic stress disorder (PTSD). It's crucial to address her psychological distress promptly to provide support and prevent exacerbation of her symptoms.

Sleep Difficulties: The client requests sleeping medication due to her difficulty in falling asleep. Sleep disturbances are common after experiencing a traumatic event and can further contribute to emotional distress and hinder recovery. It's important to assess her sleep patterns and consider appropriate interventions, such as pharmacological sleep aids under medical supervision, to help her achieve adequate restorative sleep.

Environment: The client expresses a preference for a quieter area of the unit away from constant noise (talking and alarms). Hospital environments can be noisy and disruptive, which can exacerbate anxiety and sleep difficulties. Ensuring she is in a quieter environment or making adjustments to minimize noise near her can improve her comfort and facilitate better sleep, which is essential for recovery and emotional well-being.

A. Names 3 home safety hazards to be resolved immediately. B. Identifies 2 treatments for constipation due to immobility. C. States 4 risk factors for the development of osteoporosis. D. Lists 5 calcium-rich foods to be added to the daily diet.

Correct Answer is A

Explanation

Rationale

A. This is because preventing falls and injuries is crucial for individuals with osteoporosis, as their bones are more fragile and susceptible to fractures. Creating a safe environment by identifying and resolving home safety hazards can significantly reduce the risk of falls, which is essential for the well-being of someone with osteoporosis.

B. Constipation can be a concern for older adults, especially those with limited mobility. While addressing constipation is important for overall comfort and well-being, it is not directly related to osteoporosis management.

C. Understanding risk factors for osteoporosis is important for prevention and management but not of immediate concern.

D. Adequate calcium intake helps maintain bone density and reduce the risk of fractures in individuals with osteoporosis. However, this is not a priority.

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Naxlex Comprehensive Predictor Exams

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

Explanation

The nurse is preparing a teaching plan for an older adult client diagnosed with osteoporosis. Which expected outcome has the highest priority for this client?

Correct Answer is A

Explanation

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