The nurse is reviewing the recommended preventative care for clients with asthma, chronic bronchitis, and emphysema. Which health care measure is most important for the nurse to recommend to these clients?

Ensure supplemental oxygen and respiratory medications are available at all times.

Use nasal or cough tissues followed by handwashing at all times.

Avoid large crowded areas during the colder months of the year.

Get annual flu and Pneumococcal vaccine polyvalent (PPSV23) vaccines.

Answer and Explanation

The Correct Answer is D

Choice A reason: Ensuring oxygen and medications manages exacerbations in asthma, bronchitis, and emphysema, where airway inflammation obstructs breathing. These treat symptoms, not prevent infections. Vaccines reduce influenza and pneumococcus, major exacerbation triggers, providing specific immunity to prevent severe respiratory infections, making them a higher priority.

Choice B reason: Using tissues and handwashing reduces infection spread but is less effective than vaccines for preventing exacerbations in chronic lung diseases. Influenza and pneumococcus trigger severe bronchoconstriction or inflammation. Vaccines offer targeted protection against these pathogens, prioritizing prevention over general hygiene in high-risk clients.

Choice C reason: Avoiding crowded areas in colder months reduces viral exposure, which can exacerbate asthma or COPD via inflammation. Vaccines are more effective, providing specific immunity against influenza and pneumococcus, the most common triggers of severe exacerbations, making this less critical than vaccination for preventing respiratory complications.

Choice D reason: Annual flu and PPSV23 vaccines are critical for asthma, bronchitis, and emphysema, as these conditions increase severe infection risk. Influenza and pneumococcus trigger exacerbations via airway inflammation, risking hospitalization. Vaccines stimulate antibody production, reducing infection severity, making them the top preventive measure for chronic lung disease management.

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Correct Answer is C

Explanation

Choice A reason: Thick, dry, dark areas on heels suggest chronic skin changes, not early pressure ulcers. Persistent redness over bone is the earliest sign (Stage 1). This indicates later damage, per pressure injury staging and prevention protocols in nursing care for immobile clients.

Choice B reason: Broken skin indicates a Stage 2 pressure ulcer, beyond the earliest stage. Persistent redness (Stage 1) signals initial tissue compromise. Broken skin requires intervention but is not the earliest sign, per pressure ulcer assessment and prevention standards in nursing practice.

Choice C reason: Persistent redness over bone is the earliest sign of a Stage 1 pressure ulcer, indicating tissue compromise due to pressure. Early intervention prevents progression in bedrest clients with heart failure, per pressure injury prevention and skin assessment protocols in nursing care.

Choice D reason: A superficial sacral ulcer (Stage 2) is more advanced than persistent redness (Stage 1), the earliest sign. Redness allows earlier intervention to prevent ulceration. Ulcers indicate progression, per pressure ulcer staging and prevention guidelines for immobile clients in nursing.

A. Use a heating pad at night to keep feet warm. B. Wear gloves when removing packages from freezer. C. Wear knee-high support stockings during the day. D. Walk regularly to increase circulation.

Correct Answer is B

Explanation

Choice A reason: Using a heating pad is contraindicated in Raynaud’s, as reduced sensation from vasospasm risks burns. Raynaud’s involves cold-triggered arteriolar constriction, reducing blood flow. Heat does not address vasospasm’s pathophysiology and may cause tissue damage, making this instruction inappropriate compared to cold protection strategies.

Choice B reason: Wearing gloves when handling cold items prevents vasospasm in Raynaud’s, where cold triggers arteriolar constriction, causing ischemia and pain. Protecting extremities maintains blood flow, preventing episodes. This directly addresses the disease’s pathophysiological trigger, making it the most effective instruction for managing Raynaud’s symptoms.

Choice C reason: Knee-high support stockings improve venous return, relevant for venous insufficiency, not Raynaud’s arterial vasospasm. Stockings do not prevent cold-induced vasoconstriction, the primary trigger. Gloves for cold exposure directly mitigate vasospastic episodes, making this instruction less effective for Raynaud’s disease management.

Choice D reason: Regular walking improves overall circulation but does not prevent Raynaud’s vasospastic episodes, triggered by cold or stress. While exercise supports vascular health, avoiding cold exposure with gloves is more targeted, directly reducing arteriolar constriction and ischemic symptoms, making walking a secondary recommendation.

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The nurse is reviewing the recommended preventative care for clients with asthma, chronic bronchitis, and emphysema. Which health care measure is most important for the nurse to recommend to these clients?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who has been hospitalized with an exacerbation of heart failure experiences severe dyspnea with activity and remains on bedrest. Which assessment finding provides the nurse with the earliest indication that the client is developing a pressure ulcer?

Correct Answer is C

Explanation

Which instruction should the nurse provide a client who was recently diagnosed with Raynaud’s disease?

Correct Answer is B

Explanation

The CAGE questionnaire asks four questions and is a widely used tool to screen for alcoholism. Which of the four questions included in the CAGE questionnaire is most indicative of alcoholism?

An older adult client, who is insulin-dependent, arrives at the diabetic clinic with concerns of thick, crusty, and long toenails that are piercing the adjacent toes. Which action should the nurse take?

A female client engages in repeated checks of door and window locks and behavior that prevents her from arriving on time and interfering with her ability to function effectively. Which action should the nurse take?

A client has a prescription for the insertion of a nasogastric tube to low intermittent suction. When inserting the nasogastric tube, the nurse observes an immediate return of “coffee ground” drainage. Which action should the nurse implement?

A client is admitted to the hospital with suicidal ideation. When completing the health history and admission assessment interview, which client comment is most important for the nurse to document?

Prior to initiating digital removal of a fecal impaction, it is most important for the nurse to perform which client assessment?

During a home visit, the nurse assesses the skin of a client with eczema who reports that an exacerbation of symptoms has occurred during the last week. Which information is most useful in determining the possible cause of the symptoms?