A client has a mediastinal chest tube. Which symptom requires the nurse's immediate intervention?

Correct Answer: B

Rationale: The correct answer is B: Tracheal deviation. Tracheal deviation indicates a tension pneumothorax, a life-threatening emergency that requires immediate intervention to prevent respiratory compromise. The other choices are incorrect because: A: Production of pink sputum may indicate bleeding but does not require immediate intervention unless severe. C: Drainage greater than 70 mL/hr may indicate a potential issue with the chest tube, but it does not require immediate intervention unless accompanied by other symptoms. D: Sudden onset of shortness of breath is concerning but not as immediately life-threatening as tracheal deviation in this context.

Correct Answer: B

Rationale: The correct answer is B because it communicates important information to the respiratory therapist regarding the client's readiness for the PFTs. Going down to radiology indicates the client is prepared for the examination, which ensures the test can be conducted smoothly. Rationale: A: Holding the client's morning bronchodilator medication may impact test results, but this information is more relevant for the healthcare provider interpreting the results, not the respiratory therapist conducting the test. C: Physical therapy's statement about running on a treadmill is irrelevant to the PFTs and does not impact the collaboration between the nurse and respiratory therapist. D: Advising the client not to smoke for 6 hours prior to the test is important for accurate results, but this information is more pertinent for the client and healthcare provider interpreting the results, not the respiratory therapist conducting the test.

Correct Answer: A

Rationale: The correct answer is A: Increased anterior-posterior (AP) chest diameter. In COPD, air trapping causes hyperinflation of the lungs, leading to an increase in the AP chest diameter known as barrel chest. This is a classic physical finding in patients with COPD due to chronic airway obstruction. Explanation of other choices: B: Decreased respiratory rate - In COPD, patients typically have an increased respiratory rate due to difficulty breathing. C: Weight gain - Weight gain is not a typical finding in COPD and is more often associated with other medical conditions or lifestyle factors. D: Productive cough with yellow sputum - While a productive cough is common in COPD, yellow sputum is more indicative of a bacterial infection rather than COPD alone.

Correct Answer: A

Rationale: Rationale for Correct Answer A: 1. Shaking the inhaler well before use helps ensure proper mixing of the medication. 2. This action helps to distribute the medication evenly for effective delivery. 3. It prevents clogging and ensures the client receives the correct dose. 4. Shake-and-use approach is essential for optimal therapeutic benefits. Summary of Incorrect Choices: B: Inhaling rapidly may lead to improper medication delivery and increase the risk of side effects. C: Administering medication while lying down may not allow the client to inhale the medication effectively. D: Holding the inhaler too far away can result in decreased medication intake and reduced efficacy.

Correct Answer: C

Rationale: The correct answer is C because daily exercise may exacerbate COPD symptoms in some cases. Individuals with COPD may experience increased shortness of breath and fatigue during physical activity. Therefore, it is crucial to tailor an exercise plan to each client's specific needs and capabilities. Choices A, B, and D are correct as they align with COPD management strategies of smoking cessation, dietary modifications, and hydration to help with mucus clearance, respectively.