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A nurse is caring for a client who has COPD.

Medication

Indacaterol 75 mcg, one inhalation daily

Acetylcysteine 20% solution 3 to 5 ml nebulizer every 6 to 8 hr while awake

Select the 5 findings that require follow-up.

Disorientation

Barrel-shaped chest

Yellow sputum

Nebulizer use

Ankle edema

SaO2 92%

Clubbing of fingers

Answer and Explanation

Correct Answer : A,B,C,E,F

A. Disorientation:

This may indicate a neurological or cognitive issue and requires further assessment.

B. Barrel-shaped chest:

This is a characteristic finding in COPD, but any change or worsening may need evaluation.

C. Yellow sputum:

Yellow or greenish sputum may indicate an infection, and follow-up is needed.

D. Nebulizer use:

Nebulizer use is part of the prescribed treatment.

E. Ankle edema:

Edema can be a sign of heart failure or other cardiovascular issues and should be investigated.

F. SaO2 92%:

Oxygen saturation of 92% is below the normal range. It may indicate respiratory compromise and needs attention.

G. Clubbing of fingers:

While clubbing can be associated with chronic respiratory conditions, it is not an immediate concern.

H. Lives alone:

Living alone may impact the client's support system but does not require immediate medical attention.

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Correct Answer is A

Explanation

A. Cabbage: This is the correct answer. Cabbage is a food high in vitamin K, which can antagonize the effects of warfarin. Warfarin is an anticoagulant that works by inhibiting vitamin K-dependent clotting factors. Consistent intake of vitamin K-rich foods, such as cabbage, can affect the stability of the client's international normalized ratio (INR).

B. Green beans: Green beans are not particularly high in vitamin K, and their consumption is not usually restricted for clients taking warfarin.

C. White beans: White beans are not particularly high in vitamin K, and their consumption is not usually restricted for clients taking warfarin.

D. Cantaloupe: Cantaloupe is not high in vitamin K, and its consumption is not usually restricted for clients taking warfarin.

A. Montelukast B. Rifampin C. Acyclovir D. Isoniazid E. Pyrazinamide

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

Explanation

A. Montelukast: Montelukast is a leukotriene receptor antagonist commonly used in the management of asthma and allergic rhinitis. It is not part of the standard tuberculosis treatment regimen.

B. Rifampin: Rifampin is a key component of tuberculosis treatment and is effective against both active and latent tuberculosis.

C. Acyclovir is an antiviral medication primarily used for herpes simplex virus infections and is not part of the standard treatment for tuberculosis.

D. Isoniazid: Isoniazid is another essential drug in the treatment of tuberculosis, particularly for the prevention of latent tuberculosis progression to active disease.

E. Pyrazinamide: Pyrazinamide is part of the standard combination therapy for tuberculosis.

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A nurse is caring for a client who has COPD. Medication Indacaterol 75 mcg, one inhalation daily Acetylcysteine 20% solution 3 to 5 ml nebulizer every 6 to 8 hr while awake Select the 5 findings that require follow-up.

Nursing Test Bank

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Correct Answer is A

Explanation

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

Explanation

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A nurse is caring for a client who has COPD.

Medication

Indacaterol 75 mcg, one inhalation daily

Acetylcysteine 20% solution 3 to 5 ml nebulizer every 6 to 8 hr while awake

Select the 5 findings that require follow-up.