A nurse is reinforcing discharge teaching with a client who has COPD and reports problems with maintaining adequate nutrition. Which of the following instructions should the nurse include?

"Self-administer oxygen through your nasal cannula at 6 milliliters per minute during meals."

"Drink at least 240 milliliters of water during each meal."

"Perform pulmonary hygiene 1 hour before meals."

"Lie down for 30 minutes after eating."

Answer and Explanation

The Correct Answer is C

A. "Self-administer oxygen through your nasal cannula at 6 milliliters per minute during meals." is incorrect. Oxygen should not typically be increased during meals unless specifically prescribed by the provider. If the client has difficulty eating due to breathlessness, a more individualized plan is needed.

B. "Drink at least 240 milliliters of water during each meal." is incorrect. Clients with COPD may have difficulty breathing when consuming large amounts of fluids during meals. Overhydration could also worsen fluid retention in some cases. The amount of fluid should be tailored to the client’s needs and prescribed by the healthcare provider.

C. "Perform pulmonary hygiene 1 hour before meals." is correct. Pulmonary hygiene (such as postural drainage, coughing techniques, and deep breathing exercises) should be performed before meals to clear the airways and improve the ability to breathe while eating, preventing aspiration and difficulty breathing.

D. "Lie down for 30 minutes after eating." is incorrect. Lying down after eating can increase the risk of aspiration, especially in clients with COPD who may already have a compromised respiratory system. The client should be advised to remain upright after meals to prevent reflux and aspiration.

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Correct Answer is B

Explanation

A. Family history of cardiovascular disease: This is a non-modifiable risk factor. Family history can increase the likelihood of cardiovascular disease, but it cannot be changed.

B. Cholesterol 240 mg/dL: This is a modifiable risk factor. High cholesterol levels, particularly above 200 mg/dL, increase the risk of cardiovascular disease, and they can be managed through lifestyle changes, diet, and medication.

C. Sex: This is a non-modifiable risk factor. Men are generally at higher risk for cardiovascular disease at a younger age, while the risk increases for women after menopause.

D. Age 65: This is a non-modifiable risk factor. As people age, their risk for cardiovascular disease increases.

A. Encouraging the client to write about her feelings in a journal each day. B. Demonstrating a nonjudgmental attitude toward the client when providing care for her surgical wounds. C. Identifying the client's perception of the changes in her physical appearance. D. Providing the client with information on community resources that will strengthen her coping skills.

Correct Answer is C

Explanation

A. Encouraging the client to write about her feelings in a journal each day.: While journaling can be therapeutic, it may not be the best immediate intervention. The client may first need support and validation of her feelings before engaging in such an activity.

B. Demonstrating a nonjudgmental attitude toward the client when providing care for her surgical wounds.: This is important for maintaining therapeutic communication, but it does not address the emotional distress the client is currently experiencing.

C. Identifying the client's perception of the changes in her physical appearance.: The client is likely struggling with body image changes following a bilateral mastectomy. The priority should be to assess the client’s emotional response to her altered appearance and to offer emotional support. This provides the foundation for helping the client process her feelings.

D. Providing the client with information on community resources that will strengthen her coping skills.: While community resources can be helpful later on, the immediate priority is understanding the client’s emotional response to her surgery. Once the nurse has established the client's emotional needs, then providing resources may be more appropriate.

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A nurse is reinforcing discharge teaching with a client who has COPD and reports problems with maintaining adequate nutrition. Which of the following instructions should the nurse include?

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Naxlex Comprehensive Predictor Exams

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