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. Irrigating the catheter manually:
Manually irrigating the catheter without an order may disrupt the clotting process and increase the risk of bleeding. It is not a routine nursing intervention post-TURP without specific orders.

B. Monitoring catheter drainage.
It is not within the nurse's scope of practice to manually irrigate the catheter without a healthcare provider's order, especially in the context of post-TURP care. The dark, pink-tinged outflow with blood clots indicates some expected bleeding following the procedure. The nurse should closely monitor the catheter drainage for the amount, color, and presence of clots.

C. Discontinuing infusing solution:
Discontinuing the normal saline irrigation may lead to clot formation and obstruction, potentially worsening the situation. The continuous bladder irrigation is often used to prevent clot formation and maintain catheter patency post-TURP.

D. Decreasing the flow rate:
The flow rate is typically set by the healthcare provider to maintain catheter patency and prevent clot formation. Decreasing the flow rate without specific orders may not be appropriate in this situation.

A. Blood pH level. B. Platelet count. C. Hematocrit D. White blood cell (WBC) count.

Correct Answer is D

Explanation

A. Blood pH level:
The blood pH level is important for assessing the acid-base balance in the body. However, in the context of purulent drainage from a wound, it is not the primary laboratory value to review for signs of infection.

B. Platelet count:
Platelet count is important for assessing blood clotting ability. While it is a valuable parameter in overall care, it may not be directly related to the observation of purulent drainage from a wound, which typically suggests infection rather than a clotting issue.

C. Hematocrit:
Hematocrit measures the proportion of blood that is cellular. Like platelet count, it is important for assessing overall blood composition and oxygen-carrying capacity. However, it may not be the first parameter to review when evaluating signs of infection.

D. White blood cell (WBC) count:
The WBC count is a crucial parameter when assessing for infection. An elevated WBC count is a common response to infection as the body mobilizes its immune defenses. Reviewing the WBC count is particularly relevant when purulent drainage is observed, as it may indicate an inflammatory response to infection.

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

While caring for a client with a full thickness burn covering 40% of the body, the nurse observes purulent drainage at the wound. Before reporting this finding to the healthcare provider, the nurse should review which of the client's laboratory values?

Correct Answer is D

Explanation

While caring for a client with Amyotrophic Lateral Sclerosis (ALS), the nurse performs a neurological assessment every four hours. Which assessment finding warrants immediate intervention by the nurse?

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