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 A

Explanation

A. Discuss approaches to chronic pain control with the client:
This is the correct answer. Heberden's nodes are bony enlargements that can occur in osteoarthritis, particularly in the joints of the fingers. These nodes can be associated with pain. Discussing approaches to chronic pain control with the client is an appropriate nursing intervention to address the client's pain and improve quality of life.

B. Review the client's dietary intake of high-protein foods:
Dietary intake of high-protein foods is not directly related to the management of Heberden's nodes in degenerative joint disease. Pain control and joint protection measures are more relevant.

C. Notify the healthcare provider of the finding immediately:
While it's important to communicate significant findings to the healthcare provider, the presence of Heberden's nodes in degenerative joint disease may not require immediate notification unless there are other concerning symptoms or complications.

D. Assess the client's radial pulses and capillary refill time:
Assessing radial pulses and capillary refill time is not directly related to managing Heberden's nodes in degenerative joint disease. These nodes are primarily a result of joint changes in osteoarthritis.

A. Instruct the client to avoid foods with gluten, such as wheat bread. B. Explain that the need to restrict fluids is the primary limitation. C. Advise the client to limit foods that are high in calcium and iron. D. Describe the use of an elimination diet to find trigger foods

Correct Answer is D

Explanation

A. Instruct the client to avoid foods with gluten, such as wheat bread.
While some individuals with Crohn's disease may experience improvement by avoiding certain types of carbohydrates, including gluten, this recommendation is not universally applicable to all individuals with Crohn's disease. Gluten restriction is more relevant for those with gluten sensitivity or celiac disease.

B. Explain that the need to restrict fluids is the primary limitation.
This statement is not accurate. Fluid restriction is not a primary dietary limitation for individuals with Crohn's disease. In fact, maintaining adequate hydration is generally important for overall health. Restricting fluids is not a standard dietary recommendation for managing Crohn's disease.

C. Advise the client to limit foods that are high in calcium and iron.
Limiting foods high in calcium and iron is not a standard recommendation for Crohn's disease. In fact, adequate intake of essential nutrients, including calcium and iron, is important for overall health. Limiting these nutrients could lead to nutritional deficiencies.

D. Describe the use of an elimination diet to find trigger foods.
This is the most appropriate response. Crohn's disease symptoms can vary among individuals, and identifying trigger foods through an elimination diet can help personalize dietary recommendations. By systematically eliminating and reintroducing foods, individuals can identify which specific foods may exacerbate their symptoms.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

While assessing a client with degenerative joint disease, the nurse observes Heberden's nodes, large prominences on the client's fingers that are reddened. The client reports that the nodes are painful. Which action should the nurse take?

Correct Answer is A

Explanation

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

Correct Answer is D

Explanation

A female college student comes to the school's health clinic complaining of urinary frequency and burning with right lower back pain. Which intervention should the nurse implement first?

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