A patient with chronic obstructive pulmonary disease (COPD) has been eating very little and has lost weight. Which intervention would be most appropriate for the nurse to include in the plan of care?

Correct Answer: C

Rationale: The correct answer is C, offering high-calorie protein snacks between meals and at bedtime. This intervention is most appropriate for a COPD patient who has lost weight due to poor intake. Proteins are essential for muscle maintenance and repair, and high-calorie snacks can help meet energy needs. Whole grains (A) may not provide enough calories, fruits and fruit juices (B) may not be calorie-dense, and foods with high vegetable content (D) may not provide sufficient protein or calories. In summary, option C addresses both the protein and calorie needs of the patient, making it the most suitable intervention.

Correct Answer: C

Rationale: The correct answer is C. When the patient uses albuterol for peak flows in the yellow zone, it indicates successful teaching because the yellow zone signifies caution, where the patient should take action to prevent worsening asthma symptoms. Using albuterol at this stage helps to manage symptoms before they escalate. Choice A is incorrect because inhaling rapidly through the peak flowmeter mouthpiece is not a correct technique and may lead to inaccurate results. Choice B is incorrect because montelukast is a controller medication and not used for immediate relief during asthma exacerbations. Choice D is incorrect because calling the healthcare provider when the peak flow is in the green zone is unnecessary as it indicates good lung function.

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: A

Rationale: The correct answer is A: 02 saturation is >90%. This is the best indicator because it directly measures the amount of oxygen in the blood, reflecting the effectiveness of the treatment in improving ventilation and oxygenation. - Choice B: No wheezes are audible. Wheezes can persist even after treatment, so absence of wheezes does not always indicate effectiveness. - Choice C: Respiratory rate is 16 breaths/min. While a normal respiratory rate is a good sign, it may not necessarily indicate the full effectiveness of the treatment. - Choice D: Accessory muscle use has decreased. Although a decrease in accessory muscle use is positive, it may not always correlate directly with improved oxygenation and ventilation.

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.