A client seen in the emergency department reports fever,fatigue and dry cough but no other upper respiratory symptoms. A chest x-ray reveals mediastinal widening. What action by the nurse is best?

Correct Answer: B

Rationale: The correct answer is B: Inform the client that oral antibiotics will be needed for 60 days. This is the best action because the client is showing symptoms consistent with tuberculosis, such as fever, fatigue, dry cough, and mediastinal widening on chest x-ray. Treatment for tuberculosis typically involves a combination of oral antibiotics for a prolonged period, usually 6-9 months. Collecting a sputum sample for culture by deep suctioning (A) may be necessary to confirm the diagnosis but is not the priority at this moment. Placing the client on Airborne Precautions immediately (C) is important once the diagnosis is confirmed, not the initial action. Directly observed therapy (D) is a method to ensure adherence to medication but is not the immediate next step.

Correct Answer: B

Rationale: In this scenario, the correct answer is option B: Continuous bubbling in the water seal chamber. This finding indicates an air leak, which can lead to complications like pneumothorax. It is crucial to address this immediately to prevent respiratory compromise. Option A is incorrect as chest tube drainage of 10-15 mL per hour is within the expected range. Option C, complaints of pain at the chest tube site, while important to address, may not be as urgent as an air leak. Option D, a chest tube dressing dated yesterday, is not an immediate concern unless there are signs of infection or loosening. Educationally, this question tests the student's understanding of potential complications post-thoracotomy and the importance of prompt intervention in managing chest tubes. It reinforces the significance of recognizing and responding to critical findings in real-time patient care situations.

Correct Answer: B

Rationale: In the context of preparing for a thoracentesis procedure, the correct answer is B) Obtain the supplies that will be used. This is the first step the nurse should take before assisting the physician with the procedure. Obtaining the supplies ensures that everything needed for the thoracentesis is readily available, promoting efficiency and patient safety. Option A) Verify breath sounds in all fields, although important in respiratory assessment, is not the immediate priority when preparing for a thoracentesis. This step can be done after the supplies are gathered. Option C) Sending labeled specimen containers to the lab is a step that occurs after the thoracentesis procedure is completed, not before. Option D) Directing family members to the waiting room is important for maintaining patient privacy during the procedure, but it is not the first step in preparing for the thoracentesis. In an educational context, understanding the sequential steps involved in a procedure like thoracentesis is crucial for nurses to provide safe and effective patient care. By prioritizing tasks and following a systematic approach, healthcare professionals can ensure that procedures are conducted smoothly and with attention to detail.

Correct Answer: B

Rationale: In the context of patients with COPD, the correct dietary modification to meet their nutritional needs is to avoid foods that require a lot of chewing, which is option B. This is because COPD can lead to shortness of breath and fatigue, making it difficult for patients to chew and swallow food that requires significant effort. Choosing softer, easier-to-eat foods can help patients conserve energy during meals and prevent them from becoming too fatigued to finish their meals. Option A, eating a high-carbohydrate, low-fat diet, is not the most appropriate choice for patients with COPD. While a balanced diet is essential for overall health, the focus for COPD patients should be on foods that are easy to eat and digest to prevent them from becoming too tired during meals. Option C, preparing most foods of the diet to be eaten hot, does not directly address the issue of ease of chewing and swallowing, which is crucial for patients with COPD. While warm foods can be soothing and easier to digest for some individuals, it is not as critical as choosing foods that are easy to chew. Option D, drinking fluids with meals to promote digestion, is not the most relevant choice for patients with COPD in terms of meeting their nutritional needs. While proper hydration is important for overall health, the focus of dietary modifications for COPD patients should be on the ease of food consumption rather than the promotion of digestion through fluids. Educationally, understanding the specific dietary needs of patients with COPD is crucial for healthcare professionals working with this population. Providing appropriate dietary guidance can help improve patients' nutritional status, overall well-being, and quality of life. By recognizing the challenges that COPD patients face during meals and recommending dietary modifications that address these issues, healthcare providers can better support their patients in managing their condition effectively.