A nurse is caring for a client who has COPD.

Nurses' Notes

Vital Signs

Medication

Home health nurse admission note:

Client discharged from healthcare facility yesterday following a 4-day stay for exacerbation of COPD. Lives alone; alert and oriented to person, place, and time. Lung fields with scattered rhonchi throughout, cough productive for thick white sputum, dyspnea with minimal exertion.

Clubbing is noted on fingers, chest is barrel-shaped. Supplemental oxygen at 2L/min via nasal cannula.

Home Health Nurse Note 3 days following discharge from health care facility: Client sleeping in recliner with nasal canula on their lap; awakens easily and is oriented to person but disoriented to place and time.

Lung sounds with scattered rhonchi, cough productive for thick, yellow secretions. 2+pitting edema bilateral in ankles and feet.

Re-oriented client. Client states "I don't remember if I did that breathing machine thing you told me about."

Instructed client on oxygen use, safety, and nebulizer treatments. Elevated lower extremities.

Select the 5 findings that require follow-up.

Disorientation

Barrel-shaped chest

Yellow sputum

Nebulizer use

Ankle edema SaO2 92% Clubbing of fingers

Lives alone

Answer and Explanation

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

- Disorientation may indicate hypoxia, infection, or medication side effects. - Yellow sputum may indicate a bacterial infection that requires antibiotics. - Nebulizer use may indicate that the client is not using it correctly or regularly as prescribed, which can affect their lung function and oxygenation. - Ankle edema may indicate fluid overload or heart failure, which can worsen COPD symptoms and increase the risk of complications.

- Living alone may pose safety risks for the client, especially if they are disoriented or have difficulty managing their oxygen and nebulizer treatments. The nurse should assess the client's support system and refer them to community resources if needed.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

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

Explanation

Hepatitis A is an acute viral infection that affects the liver and is transmitted by fecal-oral route. It can be spread by contaminated food or water, or by close contact with an infected person. Practicing effective hand hygiene can reduce the risk of ingesting or spreading the virus. Avoiding serving raw foods, especially shellfish, can prevent exposure to contaminated food sources.

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

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

Explanation

This is because these medications are antimycobacterial agents that inhibit the growth and replication of Mycobacterium tuberculosis, the bacterium that causes tuberculosis. Acyclovir is an antiviral medication that is used to treat herpes simplex virus infections, and montelukast is a leukotriene receptor antagonist that is used to prevent asthma attacks.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has hepatitis A about preventing transmission of the disease. Which is included in the teaching?

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

Explanation

A nurse is teaching a client who has tuberculosis and is to start combination drug therapy. Which of the following medications should the w plan to administer? (Select all that apply.)

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

Explanation

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