A nurse is contributing to the plan of care for a client who has COPD. Which of the following interventions should the nurse include in the plan of care?

Instruct the client to use pursed-lip breathing.

Plan to have the client lay down for 1 hr after meals.

Restrict the client’s fluid intake to less than 1 L/day.

Encourage the client to use the upper chest for respiration.

Answer and Explanation

The Correct Answer is A

Pursed-lip breathing is a technique that helps to slow down the breathing rate and keep the airways open longer. This improves gas exchange and reduces the work of breathing. Pursed-lip breathing also helps to prevent air trapping and hyperinflation of the lungs, which are common complications of COPD.

Choice B is wrong because laying down for 1 hour after meals can increase the pressure on the diaphragm and make breathing more difficult. It can also increase the risk of aspiration and reflux.

Choice C is wrong because restricting the client’s fluid intake to less than 1 L/day can lead to dehydration and thickening of secretions, which can obstruct the airways and impair gas exchange. Fluid intake should be adequate to maintain hydration and thin secretions.

Choice D is wrong because using the upper chest for respiration is a sign of inefficient breathing and respiratory distress.

It can increase the oxygen demand and cause fatigue. The client should be encouraged to use the diaphragm and abdominal muscles for respiration, which are more efficient and reduce the work of breathing.

Normal ranges for oxygen saturation are 95% to 100%, for arterial blood gas pH are 7.35 to 7.45, for PaCO2 are 35 to 45 mmHg, for PaO2 are 80 to 100 mmHg, and for HCO3 are 22 to 26 mEq/L.

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Correct Answer is A

Explanation

Urinary catheterization is a common cause of health care-associated infections (HAIs), which are infections that patients get while receiving medical treatment in a health care facility. Urinary catheterization involves inserting a tube into the bladder to drain urine, which can introduce bacteria into the urinary tract and cause infections.

Choice B is wrong because malnutrition is not a direct cause of HAIs, although it can weaken the immune system and increase the risk of infections.

Choice C is wrong because multiple caregivers are not a direct cause of HAIs, although they can increase the exposure to different pathogens and cross contamination if they do not follow proper hygiene and infection control practices.

Choice D is wrong because chlorhexidine washes are not a cause of HAIs, but rather a preventive measure to reduce the risk of HAIs by disinfecting the skin and mucous membranes.

A. Nonmaleficence. B. Fidelity. C. Justice. D. Autonomy.

Correct Answer is A

Explanation

Nonmaleficence is the ethical principle of doing no harm or preventing harm to a client. It is based on the Hippocratic oath of “primum non nocere” or “first, do no harm”. It means that the nurse should act in the best interest of the client and avoid any actions that could cause injury or suffering.

Choice B. Fidelity is the ethical principle of being faithful and loyal to a client.

It means that the nurse should keep promises, respect confidentiality, and maintain trust.

Choice C. Justice is the ethical principle of treating clients fairly and equally.

It means that the nurse should distribute resources and services based on the client’s needs and not on personal biases.

Choice D. Autonomy is the ethical principle of respecting a client’s right to make their own decisions.

It means that the nurse should inform the client of their options and support their choices, as long as they do not harm others.

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A nurse is contributing to the plan of care for a client who has COPD. Which of the following interventions should the nurse include in the plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

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