The goal of care for a client with COPD is to maintain adequate oxygenation and prevent complications. An oxygen saturation of 95% on room air indicates that the client is receiving enough oxygen without supplemental oxygen therapy.

Incorrect options:

B) Respiratory rate of 28 breaths per minute - This is an abnormal finding, as a normal respiratory rate for an adult is 12 to 20 breaths per minute. A respiratory rate of 28 breaths per minute indicates tachypnea, which may be a sign of respiratory distress or hypoxemia in a client with COPD.

C) Barrel-shaped chest on inspection - This is an abnormal finding, as a normal chest shape is elliptical, with a transverse diameter that is twice the anteroposterior diameter. A barrel-shaped chest, where the chest appears rounded and enlarged, is a result of chronic hyperinflation of the lungs due to COPD. It is not an expected outcome of the client's plan of care.

D) Clubbing of the fingers on palpation - This is an abnormal finding, as normal fingernails have a 160-degree angle between the nail and the nail bed. Clubbing of the fingers, where the angle increases to 180 degrees or more and the nail bed becomes soft and spongy, is a sign of chronic hypoxia due to COPD or other lung diseases. It is not an expected outcome of the client's plan of care.

A hemoglobin A1c test measures the percentage of hemoglobin molecules that have glucose attached to them. Hemoglobin molecules have a lifespan of about 120 days, so this test reflects the average blood glucose level over the past three months. It is used to monitor the long-term glycemic control and effectiveness of diabetes management.

Incorrect options:

B) "It measures your blood glucose level at the time of the test." - This is an incorrect statement, as this describes a random blood glucose test, which measures the blood glucose level at any time of the day, regardless of when the last meal was eaten.

C) "It measures your blood glucose level after fasting for eight hours." - This is an incorrect statement, as this describes a fasting blood glucose test, which measures the blood glucose level after not eating or drinking anything except water for at least eight hours.

D) "It measures your blood glucose level after eating a carbohydrate-rich meal." - This is an incorrect statement, as this describes a postprandial blood glucose test, which measures the blood glucose level one to two hours after eating a meal.

The most reliable and valid method to assess pain intensity is to use a numeric rating scale, where zero means no pain and ten means the worst possible pain. This allows the nurse to quantify and document the client's pain level and monitor changes over time.

Incorrect options:

B) "How does your pain affect your daily activities?" - This is a question that assesses pain interference, which is how pain affects the client's physical, psychological, and social functioning. It does not directly measure pain intensity.

C) "What words would you use to describe your pain?" - This is a question that assesses pain quality, which is how the client perceives and expresses their pain sensation. It does not directly measure pain intensity.

D) "What do you think is causing your pain?" - This is a question that assesses pain etiology, which is the underlying cause or source of the pain. It does not directly measure pain intensity.

The client should be instructed to avoid alcohol while taking methotrexate, as alcohol can increase the risk of liver toxicity and damage. Methotrexate can also impair the immune system and increase the risk of infection, so the client should report any signs of infection, such as fever, sore throat, or cough, to their doctor. Methotrexate can also affect the blood cell counts and kidney function, so the client should have regular blood tests to monitor these parameters. Folic acid supplements can help reduce the side effects of methotrexate, such as nausea, mouth ulcers, and hair loss.

Incorrect options:

A) "I will take folic acid supplements as prescribed by my doctor." - This is a correct statement, as folic acid supplements can help reduce the side effects of methotrexate, such as nausea, mouth ulcers, and hair loss.

C) "I will report any signs of infection to my doctor." - This is a correct statement, as methotrexate can impair the immune system and increase the risk of infection, so the client should report any signs of infection, such as fever, sore throat, or cough, to their doctor.

D) "I will have regular blood tests to monitor my liver and kidney function." - This is a correct statement, as methotrexate can affect the liver and kidney function, so the client should have regular blood tests to monitor these parameters.