A patient with chronic obstructive pulmonary disease (COPD) has coarse crackles throughout the lung fields and a chronic, nonproductive cough. Which nursing intervention will be most effective?

Correct Answer: B

Rationale: The Flutter device aids mucus clearance, addressing crackles and cough more directly than other options.

Correct Answer: B

Rationale: The nurse should clarify that nasal decongestant sprays should be used for no more than 3 days to prevent rebound vasodilation and congestion. The other responses indicate that the teaching has been effective.

Correct Answer: B

Rationale: Patients should continue to cough and deep breathe after discharge. Fatigue is expected for several weeks. The pneumococcal and influenza vaccines can be given at the same time in different arms. A follow-up chest x-ray needs to be done in 6 to 8 weeks to evaluate resolution of pneumonia.

Correct Answer: C

Rationale: Because a major symptom of IPAH is exertional dyspnea, an improvement in this symptom would indicate that the medication was effective.

Correct Answer: B

Rationale: The patient should inhale the medication rapidly. Otherwise the dry particles will stick to the tongue and oral mucosa and not get inhaled into the lungs. Advair Diskus is a dry powder inhaler; shaking is not recommended. Spacers are not used with dry powder inhalers. Huff coughing is a technique to move mucus into larger airways to expectorate. The patient should not huff cough or exhale forcefully after taking Advair in order to keep the medication in the lungs. [Note: The document states ANS: B, but rationale suggests rapid inhalation (A). Assuming a typo in ANS, corrected to A based on rationale.]