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Which discharge instruction is most appropriate for reducing the client's fatigue and shortness of breath during mealtimes?
- A. Eat simple carbohydrates for quick energy.
- B. Eat fatty foods to get maximum caloric intake.
- C. Eat frequent, small meals to reduce energy use.
- D. Eat the largest meal late at night before sleep.
Correct Answer: C
Rationale: Frequent, small meals reduce the energy required for digestion, minimizing fatigue and shortness of breath in COPD clients.
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Which nursing action is most appropriate immediately after the chest tube is removed from the client?
- A. Apply a sterile dressing and tape it securely.
- B. Request a chest X-ray to assess lung fields.
- C. Administer oxygen by nasal cannula.
- D. Encourage the client to cough vigorously.
Correct Answer: A
Rationale: Applying a sterile dressing taped securely prevents air entry into the pleural space and promotes healing post-chest tube removal.
The nurse and an unlicensed assistive personnel (UAP) are caring for a group of clients on a medical unit. Which information provided by the UAP warrants immediate intervention by the nurse?
- A. The client diagnosed with cancer of the lung has a small amount of blood in the sputum collection cup.
- B. The client diagnosed with chronic emphysema is sitting on the side of the bed and leaning over the bedside table.
- C. The client receiving Procrit, a biologic response modifier, has a T 99.2°F, P 68, R 24, and BP of 198/102.
- D. The client receiving prednisone, a steroid, is complaining of an upset stomach after eating breakfast.
Correct Answer: C
Rationale: Hypertension (198/102) with Procrit (C) suggests a serious side effect, requiring immediate intervention. Hemoptysis (A), tripod position (B), and stomach upset (D) are expected or less urgent.
The nurse is preparing the plan of care for the client who had a pleurodesis. Which collaborative intervention should the nurse include?
- A. Monitor the amount and color of drainage from the chest tube.
- B. Perform a complete respiratory assessment every two (2) hours.
- C. Administer morphine sulfate, an opioid analgesic, intravenously.
- D. Keep a sterile dressing and bottle of sterile normal saline at the bedside.
Correct Answer: A
Rationale: Pleurodesis involves sclerosing the pleural space to prevent fluid reaccumulation, often requiring a chest tube. Monitoring drainage amount and color (A) is a collaborative intervention to assess procedure success and detect complications. Respiratory assessment (B) and morphine administration (C) are nursing or medical orders, not collaborative. Keeping sterile supplies (D) is preparatory, not a primary intervention.
Because of this client's impaired speech, which nursing action facilitates communication?
- A. Discourage the client's attempts at communication.
- B. Inform the client to speak slowly when talking.
- C. Listen attentively to the client's vocalizations.
- D. Provide the client with paper and pencil.
Correct Answer: D
Rationale: Providing paper and pencil allows the client with impaired speech post-laryngectomy to communicate effectively through writing.
A patient is taking Streptomycin. Which finding below requires the nurse to notify the physician?
- A. Patient reports a change in vision.
- B. Patient reports a metallic taste in the mouth.
- C. The patient has ringing in their ears.
- D. The patient has a persistent dry cough.
Correct Answer: C
Rationale: Streptomycin can cause ototoxicity, leading to symptoms like ringing in the ears (tinnitus). This requires immediate physician notification to prevent further hearing damage.