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When developing a discharge plan to manage the care of a client with chronic obstructive pulmonary disease (COPD), the nurse should advise the client to expect to:
- A. Develop respiratory infections easily.
- B. Maintain current status.
- C. Require less supplemental oxygen.
- D. Show permanent improvement.
Correct Answer: A
Rationale: COPD clients are prone to respiratory infections due to impaired lung defenses. Maintaining status is possible but not an expectation. Oxygen needs may increase, and COPD is progressive, not permanently improved.
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Before a client's discharge after mitral valve replacement surgery, the nurse should evaluate the client's understanding of postsurgery activity restrictions. Which of the following should the client not engage in until after the 1-month postdischarge appointment with the surgeon?
- A. Showering.
- B. Lifting anything heavier than 10 lb.
- C. A program of gradually progressive walking.
- D. Light housework.
Correct Answer: B
Rationale: Lifting heavy objects (>10 lb) risks sternal dehiscence post-mitral valve replacement, so it is restricted until surgeon approval.
A client with renal calculi is prescribed tamsulosin. The nurse explains it:
- A. Dissolves stones.
- B. Relaxes ureter muscles.
- C. Reduces urine output.
- D. Prevents infection.
Correct Answer: B
Rationale: Tamsulosin relaxes ureter muscles, aiding stone passage.
The client is ready for discharge after surgery for a deviated septum. Which of the following discharge instructions would be appropriate?
- A. Avoid activities that elicit Valsalva's maneuver.
- B. Take aspirin to control nasal discomfort.
- C. Avoid brushing the teeth until the nasal packing is removed.
- D. Apply heat to the nasal area to control swelling.
Correct Answer: A
Rationale: Avoiding Valsalva's maneuver (e.g., straining, heavy lifting) prevents increased pressure that could cause bleeding or disrupt the surgical site.
The nurse's assignment consists of the following four clients. From highest to lowest priority, in which order should the nurse assess the clients after receiving morning report?
- A. The client with cirrhosis who became confused and disoriented during the night.
- B. The client with acute pancreatitis who is requesting pain medication.
- C. The client who is 1 day postoperative following a cholecystectomy and has a T-tube inserted.
- D. The client with hepatitis B who has questions about his discharge instructions.
Correct Answer: A,B,C,D
Rationale: Confusion in cirrhosis (A) indicates possible hepatic encephalopathy, a priority. Pain in pancreatitis (B) requires prompt relief. Postoperative T-tube monitoring (C) is next. Discharge teaching (D) is lowest priority.
A client is to be discharged from same-day surgery 7 hours after his inguinal hernia repair. Which of the following indicates this client is ready to be discharged?
- A. The client voids 500 mL of urine.
- B. The client tolerates eating a hamburger.
- C. The client is pain-free.
- D. The client walks in the hallway unassisted.
Correct Answer: A
Rationale: Voiding 500 mL indicates normal bladder function, a key discharge criterion after hernia repair, ensuring no urinary retention from anesthesia or surgery.