A nurse is providing discharge teaching for a client who requires home oxygen therapy. Which of the following statements should the nurse identify as an indication that the client needs further teaching?

"I will wear synthetic clothing and woolen socks when using my oxygen.”

"I will make sure my visitors smoke outside.”

"I will be able to tell how much oxygen I'm getting by looking at the flowmeter.”

"I should call my doctor if I find it harder to concentrate.”

Answer and Explanation

The Correct Answer is A

Choice A rationale:

This statement indicates a need for further teaching. Synthetic clothing and woolen socks can generate static electricity, which poses a risk around oxygen due to its flammable nature. The client should be advised to wear cotton clothing and avoid synthetic fabrics to prevent static-related accidents.

Choice B rationale:

This statement is correct. Oxygen supports combustion, so ensuring visitors don't smoke near the client is crucial. However, it does not indicate a need for further teaching.

Choice C rationale:

This statement is incorrect. The client cannot determine the oxygen flow rate by visual inspection of the flowmeter. The flow rate should be set based on the healthcare provider's instructions, and this information should have been covered in the teaching.

Choice D rationale:

This statement indicates the client understands the potential cognitive effects of oxygen therapy and when to seek medical assistance. It does not necessarily indicate a need for further teaching.

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Correct Answer is A

Explanation

Choice A rationale:

Unequal chest expansion is the correct choice. In a patient with chronic obstructive pulmonary disease (COPD), the airways are often narrowed and obstructed, leading to difficulty in moving air in and out of the lungs. This can result in unequal chest expansion during breathing, where one side of the chest expands less than the other. This finding is commonly observed in patients with COPD due to the imbalance in lung function between different areas of the lungs.

Choice B rationale:

Atrophied neck and trapezius muscle is not a typical finding in COPD. Muscle atrophy can occur in conditions of prolonged disuse or immobility, but it is not a characteristic manifestation of COPD itself.

Choice C rationale:

Increased tactile fremitus refers to increased vibrations felt on the chest wall during speech. This finding is more commonly associated with conditions that cause lung consolidation, such as pneumonia. In COPD, there is often air trapping and hyperinflation of the lungs, which would not lead to increased tactile fremitus.

Choice D rationale:

An anterior-to-posterior chest diameter ratio of 1:1 is not a typical finding in a healthy individual, let alone in a patient with COPD. In COPD, there is often an increase in the anterior-to-posterior chest diameter ratio, giving the chest a barrel-like appearance. This is due to the trapped air and hyperinflation of the lungs, which is characteristic of the disease.

A. Clean the wound by scrubbing the site with gauze. B. Massage reddened areas with dressing changes. C. Reposition the client at least every 2 hours. D. Apply a heat lamp twice a day.

Correct Answer is C

Explanation

Choice A rationale:

Cleaning the wound by scrubbing the site with gauze is not an appropriate intervention for a stage 3 pressure ulcer. Scrubbing can damage the fragile tissue, increase the risk of infection, and delay wound healing. Gentle cleaning with a mild solution and avoiding trauma to the wound bed are recommended.

Choice B rationale:

Massaging reddened areas with dressing changes is contraindicated for pressure ulcers, especially stage 3 ulcers. Massaging can cause further damage to the tissues and disrupt the healing process. Dressing changes should focus on maintaining a clean and moist environment to promote healing.

Choice C rationale:

(Correct Choice) Repositioning the client at least every 2 hours is a crucial intervention to prevent further pressure ulcers and facilitate wound healing. Regular repositioning helps relieve pressure on specific areas and improves blood circulation, reducing the risk of tissue breakdown and the development of new ulcers.

Choice D rationale:

Applying a heat lamp twice a day is not recommended for stage 3 pressure ulcers. Heat can increase blood flow to the area, potentially exacerbating inflammation and delaying healing. Pressure ulcers require a clean and moist environment for optimal healing.

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A nurse is providing discharge teaching for a client who requires home oxygen therapy. Which of the following statements should the nurse identify as an indication that the client needs further teaching?

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Correct Answer is C

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