A nurse is caring for a client who has COPD and is 5 kg (11 lb) below her ideal body weight. The client experiences shortness of breath when eating. Which of the following actions should the nurse take?

Administer a bronchodilator following meals.

Limit the client's food consumption between meals.

Arrange for a low-protein diet.

Request non-gas-forming foods from the dietary department.

Answer and Explanation

The Correct Answer is D

Rationale:

A. Administer a bronchodilator following meals: Bronchodilators should be administered before meals, not after, to help relieve shortness of breath and improve the client’s ability to eat without fatigue or dyspnea. Giving them afterward does not assist with eating difficulties.

B. Limit the client's food consumption between meals: Restricting food intake between meals would reduce overall caloric intake, which is counterproductive for a client who is underweight and experiencing nutritional deficits due to COPD. Frequent small meals are usually recommended.

C. Arrange for a low-protein diet: Clients with COPD who are underweight often need adequate protein to maintain muscle mass and respiratory function. A low-protein diet could worsen malnutrition and impair recovery.

D. Request non-gas-forming foods from the dietary department: Non-gas-forming foods reduce bloating and abdominal discomfort, which can make eating easier for clients with COPD who experience dyspnea. This intervention supports improved caloric intake and minimizes respiratory compromise during meals.

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Correct Answer is D

Explanation

Rationale:

A. "Why did you start drinking alcohol?": This question explores motivations or personal history but is not part of the standardized Alcohol Use Disorders Identification Test (AUDIT). The AUDIT focuses on quantity, frequency, and consequences of alcohol use rather than reasons for drinking.

B. "Does anyone else in your family have a drinking problem?": Family history of alcohol use may be relevant for overall assessment but is not included in the AUDIT, which is designed to screen the client’s own drinking behaviors and risks.

C. "How old were you when you started to drink alcohol?": Age of initiation provides background information but is not a question within the AUDIT. The test is concerned with current patterns and consequences of alcohol consumption.

D. "How often do you drink alcohol?": This question is a standard component of the AUDIT and assesses the frequency of alcohol consumption. It helps identify patterns of use and potential risk for alcohol-related problems, making it appropriate for inclusion in the screening.

A. Prime the infusion tubing with 0.45% sodium chloride. B. Assess the client's lung sounds prior to the infusion. C. Verify with another nurse that the unit of blood is compatible with the client's blood type. D. Don sterile gloves to prepare the blood administration setup. E. Infuse the blood over 4 hr.

Correct Answer is ["B","C","E"]

Explanation

Rationale:

A. Prime the infusion tubing with 0.45% sodium chloride.: Blood products should never be primed with hypotonic solutions like 0.45% sodium chloride because it can cause hemolysis of the RBCs. Only 0.9% sodium chloride (normal saline) is safe for priming and flushing blood administration tubing.

B. Assess the client's lung sounds prior to the infusion.: Older adults are at increased risk for fluid overload during transfusions. Assessing lung sounds before starting the infusion provides a baseline and helps detect early signs of pulmonary edema or transfusion-associated circulatory overload.

C. Verify with another nurse that the unit of blood is compatible with the client's blood type.: Performing a second verification with another nurse is a critical safety measure to prevent transfusion reactions. Confirming blood type and crossmatch ensures compatibility and patient safety.

D. Don sterile gloves to prepare the blood administration setup.: Sterile gloves are not required for blood administration. Standard clean technique with non-sterile gloves is sufficient to prevent infection, as the IV setup does not require sterility.

E. Infuse the blood over 4 hr.: Red blood cells should be infused within 4 hours to minimize the risk of bacterial growth and ensure product viability. Infusing too slowly can increase infection risk, and infusing too quickly can cause fluid overload, especially in older adults.

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A nurse is caring for a client who has COPD and is 5 kg (11 lb) below her ideal body weight. The client experiences shortness of breath when eating. Which of the following actions should the nurse take?

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