An older adult client with a long history of chronic obstructive pulmonary disease (COPD) is admitted with progressive shortness of breath and a persistent cough. The client is anxious and is complaining of a dry mouth. Which intervention should the nurse implement?

Administer a prescribed sedative

Assist client to an upright position.

Encourage client to drink water

Apply a high-flow venturi mask.

Answer and Explanation

The Correct Answer is B

A. Administer a prescribed sedative:
Sedatives may depress the respiratory drive, which can be detrimental in a client with respiratory distress. It is not the appropriate intervention in this case.

B. Assist the client to an upright position.
Positioning the client upright helps improve respiratory mechanics by reducing the pressure on the diaphragm and allowing better lung expansion. This position can enhance the efficiency of breathing and alleviate symptoms of breathlessness.

C. Encourage the client to drink water:
While maintaining hydration is important, it may not directly address the immediate respiratory distress. Addressing the respiratory symptoms with an upright position is more crucial at this moment.

D. Apply a high-flow venturi mask:
While oxygen therapy may be necessary for a client with COPD experiencing respiratory distress, the first step is to assist the client to an upright position to improve respiratory mechanics. Applying a high-flow venturi mask may be a subsequent intervention based on the overall assessment, but positioning is the initial priority.

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Correct Answer is C

Explanation

A. Facial puffiness and periorbital edema:
These are common signs of hypothyroidism but may not require immediate action unless accompanied by severe symptoms.

B. Cold and dry skin:
Cold and dry skin is a characteristic feature of hypothyroidism, but a further decline in the level of consciousness is a more urgent issue.

C. Further decline in the level of consciousness.
A decline in the level of consciousness is a critical sign that requires immediate attention, as it may indicate worsening hypothyroidism, myxedema coma, or other serious complications. Myxedema coma is a life-threatening condition associated with severe hypothyroidism, and it requires prompt medical intervention.

D. Hematocrit of 30% (0.30):
While anemia is a potential complication of hypothyroidism, a hematocrit of 30% alone may not be the most immediate concern compared to a decline in the level of consciousness.

A. Platelet count 40,000 x10/μL (40.000 x109/L). B. White blood cells 9,000/μL (9x109/L) C. Hematocrit 38% (0.38). D. Hemoglobin 12 g/dL (120 g/L).

Correct Answer is A

Explanation

A. Platelet count 40,000 x10/μL (40.000 x109/L):
This is the correct answer. A platelet count of 40,000 x10/μL is significantly below the normal range (usually around 150,000 to 450,000/μL). Low platelet count (thrombocytopenia) can increase the risk of bleeding during and after a surgical procedure. The healthcare provider should be alerted to assess the risk and determine the appropriate management.

B. White blood cells 9,000/μL (9x109/L):
The white blood cell count is within the normal range, and it is not a significant concern for a vertebroplasty procedure.

C. Hematocrit 38% (0.38):
The hematocrit level is within the normal range and is not a significant concern for a vertebroplasty procedure.

D. Hemoglobin 12 g/dL (120 g/L):
The hemoglobin level is within the normal range and is not a significant concern for a vertebroplasty procedure.

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An older adult client with a long history of chronic obstructive pulmonary disease (COPD) is admitted with progressive shortness of breath and a persistent cough. The client is anxious and is complaining of a dry mouth. Which intervention should the nurse implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who has a history of hypothyroidism was initially admitted with lethargy and confusion Which additional finding warrants the most immediate action by the nurse?

Correct Answer is C

Explanation

The nurse is performing the preoperative assessment for a client scheduled for a vertebroplasty of the cervical spine. Which finding should the nurse alert the healthcare provider of prior to the procedure?

Correct Answer is A

Explanation

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An older adult client with a long history of chronic obstructive pulmonary disease (COPD) is admitted with progressive shortness of breath and a persistent cough. The client is anxious and is complaining of a dry mouth. Which intervention should the nurse implement?