the nurse is caring for a client with chronic obstructive pulmonary disease copd who is experiencing shortness of breath what is the priority nursing
Logo

Nursing Elites

HESI LPN

Adult Health Exam 1

1. The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is experiencing shortness of breath. What is the priority nursing intervention?

Correct answer: C

Rationale: The priority nursing intervention for a client with COPD experiencing shortness of breath is to position the client in a high-Fowler's position. This position helps improve lung expansion and ease breathing by maximizing chest expansion and allowing for better airflow. While administering bronchodilator therapy is important, positioning the client for improved breathing takes priority. Inhaling the medication slowly and pressing down on the inhaler is a correct technique for inhaler use but not the priority intervention. Increasing the oxygen flow rate may be needed, but adjusting the client's position to a high-Fowler's position is the priority to address the shortness of breath in COPD.

2. A client with a diagnosis of hypothyroidism is prescribed levothyroxine (Synthroid). What is the most important instruction the nurse should provide?

Correct answer: C

Rationale: The correct answer is C: 'Report any symptoms of hyperthyroidism.' Symptoms of hyperthyroidism, such as palpitations or tremors, may indicate an excessive dose of levothyroxine and should be reported to the healthcare provider for proper adjustment of the medication. Choice A is incorrect because levothyroxine is usually taken in the morning on an empty stomach to maximize absorption. Choice B is incorrect because taking levothyroxine with food can interfere with its absorption. Choice D is incorrect because discontinuing levothyroxine abruptly can lead to a worsening of hypothyroidism symptoms.

3. The nurse is assessing a client with chronic obstructive pulmonary disease (COPD) who is experiencing shortness of breath. What is the priority nursing intervention?

Correct answer: C

Rationale: The priority nursing intervention for a client with COPD experiencing shortness of breath is to position the client in a high-Fowler's position. This position helps improve lung expansion and ease breathing in COPD patients. While administering bronchodilator therapy as prescribed (Choice A) is important, it is not the priority in this scenario. Encouraging deep breathing and coughing exercises (Choice B) can be beneficial but do not take precedence over positioning for improved respiratory function. Increasing the oxygen flow rate (Choice D) can be considered after the initial positioning to relieve respiratory distress, making it a later intervention.

4. A client with cirrhosis is experiencing pruritus. Which intervention should the nurse include in the care plan?

Correct answer: A

Rationale: The correct answer is A: Administer antihistamines as prescribed. Pruritus, or itching, is a common symptom in clients with cirrhosis. Antihistamines can help relieve itching by blocking the effects of histamine. Applying alcohol-based lotions (choice B) can further dry out the skin and exacerbate itching. Encouraging frequent baths with hot water (choice C) can also worsen pruritus by stripping the skin of natural oils. Limiting fluid intake (choice D) is not directly related to managing pruritus in cirrhosis.

5. The client is 4 hours post-operative from a cesarean section and complains of gas pain and bloating. What non-pharmacological intervention can the nurse provide?

Correct answer: A

Rationale: The correct answer is to encourage the client to ambulate. Early ambulation helps alleviate gas pain and bloating by promoting gastrointestinal motility and reducing the accumulation of gas in the abdomen. Applying a heating pad may provide comfort for some types of pain but is not specifically effective for gas pain. Providing a carbonated beverage can actually worsen gas pain due to the introduction of more gas into the digestive system. Teaching relaxation techniques may be beneficial for overall comfort but may not directly address the gas pain and bloating experienced post-cesarean section.

Similar Questions

The wife is observed shaving her husband's beard with a safety razor. What should the nurse do?
A client with asthma is prescribed an albuterol inhaler. Which instruction should the nurse provide?
The nurse is caring for a client who underwent a total knee replacement yesterday. What activity level should the nurse encourage today?
A client with a history of chronic obstructive pulmonary disease (COPD) is admitted with shortness of breath. What is the priority nursing intervention?
What should the nurse prioritize when providing discharge instructions to a client with a new colostomy?

Access More Features

HESI LPN Basic
$69.99/ 30 days

  • 5,000 Questions with answers
  • All HESI courses Coverage
  • 30 days access

HESI LPN Premium
$149.99/ 90 days

  • 5,000 Questions with answers
  • All HESI courses Coverage
  • 30 days access

Other Courses