An obese client with emphysema who smokes at least a pack of cigarettes daily is admitted after experiencing a sudden increase in dyspnea and activity intolerance. Oxygen therapy is initiated and it is determined that the client will be discharged with oxygen. Which information is most important for the nurse to emphasize in the discharge teaching plan?

Guidelines for oxygen use.

Methods for weight loss.

Approaches to conserve energy.

Strategies for smoking cessation.

Answer and Explanation

The Correct Answer is D

A. Guidelines for oxygen use:
While guidelines for oxygen use are important, addressing the root cause of the respiratory condition, which includes smoking cessation, is crucial for long-term management.

B. Methods for weight loss:
Obesity can contribute to respiratory issues, but in the immediate context of emphysema exacerbation and the need for oxygen therapy, smoking cessation is a more urgent concern.

C. Approaches to conserve energy:
Conserving energy is important for clients with emphysema, but addressing the impact of smoking on respiratory function is a more immediate priority.

D. Strategies for smoking cessation.
Smoking is a major contributor to the progression of emphysema and exacerbation of respiratory symptoms. Addressing smoking cessation is crucial in improving the client's respiratory function and overall health. Continuing to smoke can exacerbate emphysema and compromise the effectiveness of other interventions, including oxygen therapy.

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Correct Answer is B

Explanation

A. Keep the room at a comfortable temperature:
While maintaining a comfortable room temperature is important for the overall well-being of the client, it is not the most essential intervention during a seizure. The priority during a seizure is to ensure the client's safety, particularly focusing on airway management.

B. Ensure oral suction is available:
This is the most essential intervention. During a seizure, the client may produce excessive saliva, and having oral suction readily available helps prevent airway obstruction and ensures a clear airway. It is crucial for the safety and well-being of the client.

C. Provide frequent mouth care:
Mouth care is important for the overall hygiene of the unconscious client, but it may not be the most immediate priority during a seizure. The focus during a seizure is on preventing complications such as aspiration or airway obstruction.

D. Maintain the client in a semi-Fowler's position:
Positioning is important for the comfort and safety of the unconscious client, but maintaining a semi-Fowler's position may not be the primary concern during an active seizure. The immediate focus is on airway management and preventing injury.

A. Hyperaldosteronism causing an increased sodium reabsorption in renal tubules. B. Decreased renin-angiotensin response related to an increase in renal blood flow. C. Decreased portacaval pressure with greater collateral circulation. D. Hypoalbuminemia that results in a decreased colloidal oncotic pressure

Correct Answer is D

Explanation

A. Hyperaldosteronism causing an increased sodium reabsorption in renal tubules.
Hyperaldosteronism is characterized by an excess of aldosterone, a hormone that regulates sodium and water balance. In cirrhosis, however, sodium retention is often related to other mechanisms such as portal hypertension and hypoalbuminemia, rather than hyperaldosteronism.

B. Decreased renin-angiotensin response related to an increase in renal blood flow.
Cirrhosis is more commonly associated with an activated renin-angiotensin-aldosterone system, leading to increased sodium and water retention. The increased renin-angiotensin response is a compensatory mechanism to maintain perfusion in the setting of cirrhosis and does not contribute to decreased renal blood flow.

C. Decreased portacaval pressure with greater collateral circulation.
This statement is not accurate. In cirrhosis, there is typically increased portacaval pressure due to portal hypertension, which can lead to the development of collateral circulation. However, this does not explain the edema and ascites seen in cirrhosis.

D. Hypoalbuminemia that results in a decreased colloidal oncotic pressure.
This is the correct choice. In cirrhosis, liver damage leads to decreased synthesis of albumin. Albumin plays a crucial role in maintaining colloidal oncotic pressure, and when it is decreased (hypoalbuminemia), fluid is more likely to leak out of blood vessels, resulting in edema. The same mechanism contributes to the development of ascites in the abdominal cavity.

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Naxlex Comprehensive Predictor Exams

When providing care for an unconscious client who has seizures, which nursing intervention is most essential?

Correct Answer is B

Explanation

The nurse assesses a client with cirrhosis and finds 4+ pitting edema of the feet and legs, and massive ascites. Which mechanism contributes to edema and ascites in clients with cirrhosis?

Correct Answer is D

Explanation

A client with newly diagnosed Crohn's disease asks the nurse about dietary restrictions. How should the nurse respond?

The nurse is caring for a client with human immunodeficiency virus (HIV) who has developed oral thrush and is experiencing burning and soreness in the mouth. Which intervention should the nurse implement first?

After falling down the basement steps, a client is brought to the emergency room. X-rays confirms that the client's right leg is fractured. Following application of a leg cast, which assessment finding warrants immediate intervention by the nurse?

The nurse reports that a client is at risk for a brain attack (stroke) based on which assessment finding?

The nurse is caring for a client with chronic pancreatitis who reports persistent gnawing abdominal pain. To help the client manage the pain, which assessment data is most important for the nurse to obtain?

A client with multiple sclerosis has urinary retention related to sensorimotor deficits. Which action should the nurse include in the client's plan of care?

The nurse is caring for a client diagnosed with psoriasis vulgaris who is receiving a psoralen and ultraviolet A light (PUVA) treatment. Which assessment finding indicates that the client has been overexposed to the treatment?