A nurse teaches a client who has chronic obstructive pulmonary disease. Which statements related to nutrition would the nurse include in this client’s teaching? (Select all that do not apply.)

Correct Answer: D

Rationale: The correct answer is D because consuming high-fiber foods can actually slow down gastric emptying and exacerbate symptoms of bloating and gas in individuals with COPD. The other choices are relevant to nutrition in COPD management. A: Fluid restriction before meals helps prevent feeling too full and can aid in breathing efficiency. B: Resting before meals can reduce dyspnea during eating. C: Having smaller, more frequent meals can help maintain energy levels and prevent feeling too full, which can improve breathing.

Correct Answer: C

Rationale: The correct answer is C. The client statement "I took all my meds including warfarin and atenolol with a sip of water this morning" needs immediate follow-up because warfarin is a blood thinner and atenolol is a beta-blocker, both of which can have implications for surgery. Warfarin increases the risk of bleeding during surgery and atenolol can affect heart function. The nurse needs to assess the timing of medication intake and coordinate with the healthcare team to manage these medications appropriately before surgery to prevent complications. Choice A is not the most immediate concern since it is common practice to fast before surgery to reduce the risk of aspiration. Choice B, while important, does not require immediate follow-up as long as the donation meets the facility's guidelines. Choice D, bringing a health care directive, is important but not as urgent as addressing medication intake that can directly impact the surgery.

Correct Answer: D

Rationale: The correct answer is D: Check the insertion site. This is the priority intervention because sneezing can increase pressure in the femoral artery, potentially causing bleeding or dislodging the catheter. Checking the insertion site allows the nurse to assess for any signs of bleeding, hematoma, or catheter migration. Palpating pedal pulses (choice A) may be important but not as immediate as ensuring catheter site integrity. Measuring vital signs (choice B) is important but not the priority in this scenario. Assessing for urticaria (choice C) is not relevant to the immediate risk associated with sneezing post-catheterization.

Correct Answer: B

Rationale: Step 1: Documenting the assessment is appropriate as redness and warmth around the incision on the first postoperative day are common signs of normal inflammation. Step 2: This action allows for tracking changes in the wound over time. Step 3: It provides a baseline for comparison in case the condition worsens. Step 4: Obtaining wound cultures (A) is premature as it is not indicated for initial signs of inflammation. Step 5: Notifying the health care provider (C) may be necessary if the condition worsens, but it is not the first step. Step 6: Assessing the wound every 2 hours (D) is excessive and unnecessary unless there are other concerning symptoms.

Correct Answer: D

Rationale: The correct answer is D because beta blockers lower heart rate by blocking the effects of adrenaline on the heart. This results in a decreased pulse rate. Choice A is incorrect because beta blockers typically lower blood pressure. Choice B is incorrect as beta blockers do not directly affect respiratory rate. Choice C is incorrect because beta blockers do not affect oxygen saturation directly. Overall, the expected assessment after administering a beta blocker would be a decrease in heart rate (pulse).