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 A

Explanation

Choice A reason: Beginning a weight loss program can help reduce the severity of OSA, which is a condition that causes repeated episodes of breathing cessation during sleep due to upper airway obstruction. Excess weight can contribute to OSA by increasing the fat deposits around the neck and throat, which can narrow the airway and make it more prone to collapse. Losing weight can help improve the airflow and reduce the need for CPAP therapy.

Choice B reason: Drinking 1 to 2 glasses of wine at bedtime can worsen OSA, which is a condition that requires adequate oxygenation and ventilation during sleep. Alcohol can relax the muscles of the throat and tongue, which can increase the risk of airway obstruction and apnea. Alcohol can also disrupt the sleep cycle and quality, which can affect the overall health and well-being of the client.

Choice C reason: Taking sedatives prior to sleep can also worsen OSA, which is a condition that requires alertness and arousal during sleep to resume breathing after an apneic episode. Sedatives can depress the central nervous system and the respiratory drive, which can reduce the responsiveness and the ability to overcome the airway obstruction. Sedatives can also have adverse effects, such as drowsiness, confusion, and dependency.

Choice D reason: Sleeping with the head of the bed flat can also worsen OSA, which is a condition that requires optimal positioning and alignment during sleep to prevent the airway obstruction. Sleeping with the head of the bed flat can cause the tongue and the soft palate to fall back and block the airway, especially when lying on the back. Sleeping with the head of the bed elevated can help open the airway and reduce the snoring and the apnea.

A. Whole milk and daily servings of ice cream. B. Citrus fruit and melon with a salt substitute. C. Pasta with herbal butter and no meat sauce. D. Canned vegetables with additional table salt.

Correct Answer is A

Explanation

Choice A reason: Whole milk and ice cream are high in fat, which can trigger the inflammation of the gallbladder (cholecystitis) and the formation of gallstones. The client should avoid foods that are high in fat, such as fried foods, cheese, butter, cream, and fatty meats.

Choice B reason: Citrus fruit and melon with a salt substitute are not a problem for a client with cholecystitis, unless they have other conditions that require dietary modifications, such as diabetes or kidney disease. The client should eat a balanced diet that includes fruits, vegetables, grains, and lean proteins.

Choice C reason: Pasta with herbal butter and no meat sauce is also acceptable for a client with cholecystitis, as long as the butter is used sparingly and the pasta is not cooked with oil or cheese. The client should limit the intake of refined carbohydrates, such as white bread, rice, and sugar, and choose whole grains instead.

Choice D reason: Canned vegetables with additional table salt are not recommended for a client with cholecystitis, because they are high in sodium, which can increase the risk of fluid retention and hypertension. The client should reduce the intake of salt and processed foods, such as canned soups, sauces, and snacks, and use herbs and spices to flavor the food.

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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

A client with obstructive sleep apnea (OSA) calls the clinic to report difficulty wearing the continuous positive air pressure (CPAP) mask because it is uncomfortable. The client asks the nurse for an alternative way to manage sleep apnea. Which recommendation should the nurse provide?

Correct Answer is A

Explanation

After teaching a client newly diagnosed with cholecystitis about recommended diet changes, the nurse evaluates the client's learning. Which food choices eliminated by the client indicate to the nurse that teaching has been successful?

Correct Answer is A

Explanation

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The nurse is caring for a client who had an appendectomy 4 hours ago. Which finding requires immediate action by the nurse?

After teaching a client newly diagnosed with cholecystitis about recommended diet changes, the nurse evaluates the client's learning. Which food choices eliminated by the client indicate to the nurse that teaching has been successful?

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