A nurse is caring for a client who is complaining of thick respiratory secretions that are difficult to clear. What should the nurse encourage the client to do to help clear those secretions?

Encourage the patient to drink more fluids.

Get a prescription for an antitussive agent.

Teach effective deep breathing.

Change the patient’s position every 2 hours.

Answer and Explanation

The Correct Answer is A

Choice A reason: Encouraging the patient to drink more fluids is a primary intervention for managing thick respiratory secretions. Adequate hydration helps to thin the mucus, making it easier to expectorate. Fluids such as water, herbal teas, and clear broths are particularly effective. The normal daily fluid intake for an adult is about 2-3 liters, depending on individual needs and health conditions.

Choice B reason: Getting a prescription for an antitussive agent is not the best initial approach for managing thick respiratory secretions. Antitussive agents are used to suppress coughing, which can be counterproductive when trying to clear mucus from the respiratory tract. Instead, expectorants or mucolytics are more appropriate as they help to thin and loosen the mucus.

Choice C reason: Teaching effective deep breathing is beneficial for overall lung health and can help in mobilizing secretions. However, it is not as immediately effective as increasing fluid intake for thinning thick secretions. Deep breathing exercises can be part of a comprehensive respiratory care plan but should be combined with other interventions like hydration.

Choice D reason: Changing the patient’s position every 2 hours is a good practice for preventing complications such as pressure ulcers and promoting lung expansion. However, it is not specifically targeted at thinning thick respiratory secretions. Positional changes can aid in the drainage of secretions but are secondary to ensuring adequate hydration.

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Correct Answer is A

Explanation

Choice A reason: Administering the medication within 90 minutes of the provider prescribing it aligns with the definition of a “NOW” order. A “NOW” order is intended to be given promptly but not as urgently as a STAT order, which requires immediate administration. This timeframe ensures that the medication is given in a timely manner to address the client’s needs without unnecessary delay.

Choice B reason: Administering the medication at specific times until directed by the provider is not appropriate for a “NOW” order. This approach is more suitable for routine or scheduled medications, where the timing is predetermined and consistent. A “NOW” order requires prompt action rather than adherence to a fixed schedule.

Choice C reason: Administering the medication at every 4-hour intervals is incorrect for a “NOW” order. This frequency is typical for PRN (as needed) medications or those requiring regular dosing intervals. A “NOW” order is a one-time directive that necessitates timely administration soon after the order is given.

Choice D reason: Administering the medication whenever the client reports specific manifestations, such as pain, is characteristic of PRN orders. PRN orders are given based on the client’s symptoms and needs at the time. A “NOW” order, however, is a one-time order that should be carried out promptly, regardless of the client’s immediate symptoms.

A. Asthma B. Hypertension C. Glaucoma D. Depression

Correct Answer is C

Explanation

Choice A reason: Asthma

Diphenhydramine is an antihistamine that can cause drying of the airways and thickening of bronchial secretions, which might exacerbate asthma symptoms. However, it is not strictly contraindicated in asthma patients. Instead, caution is advised, and it should be used under medical supervision if necessary.

Choice B reason: Hypertension

While diphenhydramine can cause mild increases in blood pressure due to its anticholinergic effects, it is not contraindicated in patients with hypertension. Patients with hypertension should use it cautiously and under medical advice, but it is not an absolute contraindication.

Choice C reason: Glaucoma

Diphenhydramine is contraindicated in patients with glaucoma, particularly closed-angle glaucoma. This is because diphenhydramine has anticholinergic properties that can increase intraocular pressure, potentially worsening the condition. Patients with glaucoma should avoid using diphenhydramine to prevent complications related to increased eye pressure.

Choice D reason: Depression

Diphenhydramine is not contraindicated in patients with depression. However, it can cause drowsiness and sedation, which might affect mood and energy levels. Patients with depression should use it cautiously and under medical supervision, but it is not an absolute contraindication.

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A nurse is caring for a client who is complaining of thick respiratory secretions that are difficult to clear. What should the nurse encourage the client to do to help clear those secretions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse received a prescription to administer a medication NOW to a client. Which action should the nurse take?

Correct Answer is A

Explanation

A client asks the nurse about a prescription for the antihistamine, diphenhydramine (Benadryl). The nurse should teach the client that this medication is contraindicated in clients who have a history of which condition?

Correct Answer is C

Explanation

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