An adult client, a smoker, has had chronic obstructive pulmonary disease (COPD) for twelve years. When conducting discharge teaching, what should the nurse advise the client to avoid in order to prevent exacerbation of COPD?

Exposure to persons with pneumonia or chickenpox.

Excessive physical exertion and respiratory tract infections.

Overdose of albuterol and alcohol consumption.

Excessive bedrest and lack of exercise.

Answer and Explanation

The Correct Answer is B

Choice A reason: Exposure to persons with pneumonia or chickenpox is not a good idea for anyone, but it is not the main factor that can worsen COPD. COPD is a chronic inflammatory condition that affects the airways and the lungs, and it is mainly caused by smoking or other environmental irritants. Pneumonia and chickenpox are acute infections that can affect the respiratory system, but they are not the primary cause of COPD exacerbation.

Choice B reason: Excessive physical exertion and respiratory tract infections are the most common triggers that can lead to COPD exacerbation, which is a sudden worsening of symptoms, such as shortness of breath, cough, and mucus production. Physical exertion can increase the oxygen demand and the work of breathing, while respiratory infections can cause inflammation and mucus obstruction in the airways. Therefore, the nurse should advise the client to avoid these factors and to seek medical attention if they occur.

Choice C reason: Overdose of albuterol and alcohol consumption are not recommended for anyone, but they are not the main factors that can aggravate COPD. Albuterol is a bronchodilator that can help relax the muscles around the airways and improve breathing, but it can also cause side effects, such as palpitations, tremors, and anxiety, if taken in excess. Alcohol consumption can impair the immune system and the liver function, but it does not directly affect the lungs or the airways.

Choice D reason: Excessive bedrest and lack of exercise are not beneficial for anyone, but they are not the main factors that can exacerbate COPD. Bedrest can lead to muscle weakness and deconditioning, while lack of exercise can reduce the cardiovascular and respiratory fitness. However, these factors do not cause inflammation or obstruction in the airways, which are the main features of COPD. The nurse should encourage the client to maintain a moderate level of physical activity and to follow a pulmonary rehabilitation program if available.

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Correct Answer is B

Explanation

Choice A reason: Corticosteroid cream was applied to eczema is not a useful information in determining the possible cause of the symptoms, because it is a treatment that can reduce the inflammation and itching of eczema, not a trigger that can worsen it. Corticosteroid cream should be used as prescribed by the doctor, and the nurse should instruct the client on how to apply it correctly and safely.

Choice B reason: A grandson and his new dog recently visited is a useful information in determining the possible cause of the symptoms, because it can indicate that the client was exposed to an allergen or an irritant that can trigger an eczema flare-up. Some people with eczema may have allergic reactions to animal dander, saliva, or fur, which can cause skin inflammation, redness, and itching. The nurse should ask the client about their history of allergies and their contact with the dog, and advise them to avoid or minimize exposure to potential allergens.

Choice C reason: An old friend with eczema came for a visit is not a useful information in determining the possible cause of the symptoms, because eczema is not a contagious condition that can be transmitted from person to person. Eczema is a chronic skin disorder that causes dry, itchy, and inflamed skin, and it is influenced by genetic, environmental, and immune factors. The nurse should reassure the client that eczema is not infectious and that they can maintain social relationships with other people with eczema.

Choice D reason: Recently received an influenza immunization is not a useful information in determining the possible cause of the symptoms, because there is no evidence that influenza immunization can cause or worsen eczema. Influenza immunization is a preventive measure that can protect the client from getting the flu, which can be a serious and sometimes fatal illness, especially for people with chronic conditions, such as eczema. The nurse should encourage the client to get vaccinated for influenza and other diseases, as recommended by the doctor.

A. Wears clothing to cover the radiation site. B. Washes the radiation site with antibacterial soap and water. C. Applies prescribed lotions to the radiation site. D. Dries the area with patting motions after taking a shower.

Correct Answer is B

Explanation

Choice A reason: Wearing clothing to cover the radiation site is a correct action, as it can protect the skin from sun exposure, irritation, and infection. The clothing should be loose-fitting, soft, and made of natural fibers, such as cotton or linen. The clothing should also be changed daily and washed separately from other clothes.

Choice B reason: Washing the radiation site with antibacterial soap and water is an incorrect action, as it can dry out, damage, or inflame the skin. The skin in the radiation site is more sensitive and vulnerable to injury and infection. The client should use mild, unscented soap and water to gently cleanse the area once a day, and avoid rubbing or scrubbing the skin.

Choice C reason: Applying prescribed lotions to the radiation site is a correct action, as it can moisturize, soothe, and heal the skin. The client should use only the lotions that are recommended by the health care provider, and avoid any products that contain alcohol, perfume, or other irritants. The client should also apply the lotions at least one hour before or after the radiation treatment, and not during the treatment.

Choice D reason: Drying the area with patting motions after taking a shower is a correct action, as it can prevent friction and trauma to the skin. The client should use a soft, clean towel to gently pat the skin dry, and avoid rubbing or pulling the skin. The client should also avoid using hair dryers, heating pads, or ice packs on the radiation site.

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An adult client, a smoker, has had chronic obstructive pulmonary disease (COPD) for twelve years. When conducting discharge teaching, what should the nurse advise the client to avoid in order to prevent exacerbation of COPD?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During a home visit, the nurse assesses the skin of a client with eczema who reports that an exacerbation of symptoms has occurred during the last week. Which information is most useful in determining the possible cause of the symptoms?

Correct Answer is B

Explanation

The nurse is teaching a client with cancer about skin care for the portal site receiving external beam radiation. Which client action about skin care indicates a need for further teaching?

Correct Answer is B

Explanation

A client taking antibiotics for three days to treat a Streptococcal throat infection returns to the clinic reporting a feel itchy rash across the chest and arms. The nurse auscultates pulmonary wheezing and an elevated heart rate. Which action should the nurse implement?

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