A client with COPD reports difficulty breathing while lying flat. What intervention should the nurse implement?

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Encourage the use of a recliner chair. This intervention helps alleviate difficulty breathing while lying flat in a client with COPD by allowing them to sit in a more upright position, which reduces the pressure on the diaphragm and lungs. Option A) Teach diaphragmatic breathing techniques, while beneficial for COPD management, does not directly address the immediate issue of difficulty breathing while lying flat. Option C) Elevate the head of the bed to 30 degrees is a common intervention for clients with respiratory issues, but a recliner chair provides better support and comfort for clients with COPD experiencing difficulty breathing in a lying position. Option D) Administer bronchodilators before bedtime is not directly related to the positional discomfort experienced by the client, and it may not effectively address the immediate issue of difficulty breathing while lying flat. Educationally, understanding the rationale behind choosing a recliner chair for clients with COPD can help nurses provide appropriate care tailored to the individual's needs, promoting optimal comfort and respiratory function. It is essential for nurses to be knowledgeable about positioning interventions to manage respiratory symptoms effectively in clients with COPD.

Correct Answer: B

Rationale: The correct answer is B: "I can sleep with my pet as long as I vacuum regularly." This statement indicates a need for further teaching because pet dander is a common trigger for asthma symptoms. Even with regular vacuuming, the pet dander can still be present in the environment and can exacerbate asthma symptoms. It is important for individuals with asthma to avoid exposure to pet dander to help manage their condition effectively. Option A is correct as individuals with asthma should avoid cleaning products with strong odors as these can trigger asthma symptoms. Strong odors can irritate the airways and lead to breathing difficulties for individuals with asthma. Option C is correct as outdoor exercise during high pollen seasons can expose individuals with asthma to allergens that can trigger asthma symptoms. It is recommended for individuals with asthma to exercise indoors or during times when pollen levels are lower. Option D is correct as using air conditioning can help reduce indoor humidity levels, which can create a more comfortable environment for individuals with asthma. High humidity levels can promote the growth of mold and dust mites, which are common asthma triggers. In an educational context, it is important for nurses to provide detailed and accurate information to clients with asthma to help them effectively manage their condition. Teaching about asthma triggers and how to avoid them is crucial in empowering clients to take control of their health and prevent asthma exacerbations.

Correct Answer: B

Rationale: In this question, the correct answer is option B) Oxygen saturation improved to 94%. This finding indicates improvement in a client with COPD who is being treated with a bronchodilator. The rationale behind this is that in COPD, impaired gas exchange is a common problem due to airway obstruction and decreased lung function. By improving oxygen saturation, the bronchodilator is effectively helping the client to oxygenate better, which is a critical goal in managing COPD. Option A) Heart rate increased to 100 beats per minute is incorrect because an increased heart rate may indicate tachycardia, which could be a sign of distress or inadequate response to the medication. Option C) Client reports mild dizziness is incorrect as dizziness is not a typical sign of improvement in COPD with bronchodilator therapy. Option D) Respiratory rate increased to 24 breaths per minute is incorrect because an increased respiratory rate may suggest respiratory distress rather than improvement in oxygenation status. Educationally, understanding the expected outcomes of bronchodilator therapy in COPD is crucial for nurses caring for these patients. Monitoring oxygen saturation levels is a key assessment parameter to evaluate the effectiveness of treatment and ensure optimal patient outcomes.

Correct Answer: C

Rationale: In this scenario, option C, "Disconnection of the chest tube from the drainage system," requires immediate action. This is because a disconnected chest tube can lead to air entering the pleural space, causing a pneumothorax or a collapsed lung, which is a life-threatening emergency. Immediate intervention is crucial to prevent complications and ensure the client's safety and well-being. Option A, "Drainage of 75 mL in the past hour," is within the expected range for a chest tube output and does not require immediate action. It is important to monitor drainage, but this amount alone does not indicate a critical issue. Option B, "Absence of bubbling in the water seal chamber," indicates that the system is intact and functioning correctly, which is a normal finding. Absence of bubbling can be an expected observation in certain phases of chest tube management and does not warrant immediate action. Option D, "Fluctuation in the water seal chamber with respiration," is a normal finding indicating proper functioning of the chest tube system. Fluctuation with respiration indicates that the system is maintaining appropriate pressure differentials and is not a cause for concern. In an educational context, understanding the significance of each observation in the management of a client with a chest tube is essential for providing safe and effective care. Nurses must be able to differentiate between normal and abnormal findings to intervene promptly and prevent complications in clients with chest tubes. This question highlights the critical thinking skills required in assessing and managing clients with complex respiratory conditions, such as those needing chest tube management.

Correct Answer: B

Rationale: In the context of managing asthma with inhaled corticosteroids, option B, "Rinse your mouth after each use of the inhaler," is the correct teaching point that the nurse should emphasize. This is because inhaled corticosteroids can lead to oral thrush or fungal infections in the mouth due to their local effects on mucous membranes. Rinsing the mouth after each use helps to minimize this risk and maintain oral health. Option A, "Use the corticosteroid only during an asthma attack," is incorrect because inhaled corticosteroids are typically used on a daily basis as maintenance therapy to reduce airway inflammation and prevent asthma attacks. Using them only during an attack would not provide the intended long-term benefits. Option C, "Shake the inhaler and exhale quickly before using," is incorrect as shaking the inhaler is typically necessary for metered-dose inhalers (MDIs) but not specifically for inhaled corticosteroids. Exhaling quickly before using the inhaler is also not a standard instruction for inhaled corticosteroids. Option D, "Use the corticosteroid before the bronchodilator," is incorrect because inhaled corticosteroids are usually recommended to be used before bronchodilators to allow for better penetration of the corticosteroid into the airways and optimize their effectiveness in reducing inflammation. In an educational context, emphasizing the importance of rinsing the mouth after using inhaled corticosteroids helps to prevent potential side effects and complications, promoting adherence to the prescribed treatment regimen and overall better outcomes in managing asthma. It is crucial for nurses to provide clear and accurate teaching points to empower patients in self-management and promote their understanding of asthma therapy.