A client who has chronic heart failure tells the nurse 'I was fine when I went to bed but I woke up in the middle of the night feeling like I was suffocating!' How should the nurse document this finding?

Correct Answer: C

Rationale: The correct answer is C: Paroxysmal nocturnal dyspnea. This finding describes the sudden onset of severe shortness of breath at night, commonly seen in patients with chronic heart failure due to fluid redistribution when lying down. Orthopnea (A) is difficulty breathing when lying flat, not specifically at night. Pulsus alternans (B) is a regular rhythm with alternating strong and weak pulses, not related to this patient's symptom. Acute bilateral pleural effusion (D) is a buildup of fluid in the lungs, not a sudden onset symptom like in this case.

Correct Answer: B

Rationale: The correct answer is B: 1 gram of pure Hb can combine with 1.34 - 1.39 ml of oxygen. This is correct because each gram of hemoglobin can bind with approximately 1.34 - 1.39 ml of oxygen, facilitating efficient oxygen transport in the blood. A is incorrect because while a small amount of oxygen is transported as dissolved oxygen, the majority is transported bound to hemoglobin. C is incorrect because arterial pO2 reflects the oxygen content in the blood, not just the hemoglobin levels. D is incorrect because CO2 is actually 20 times more soluble than oxygen, not 200 times.

Correct Answer: C

Rationale: The correct answer is C: Using a high-flow venturi mask to deliver oxygen as prescribed. This is the best option as it directly addresses the issue of promoting adequate gas exchange in a patient with advanced COPD. The high-flow venturi mask delivers oxygen at a precise concentration, ensuring optimal oxygenation. Encouraging the patient to drink fluids (A) is important for overall health but does not directly address gas exchange. Keeping the patient in semi-Fowler's position (B) can help with breathing but is not as effective as providing supplemental oxygen. Administering a sedative (D) can further depress the respiratory system and worsen gas exchange, making it an inappropriate choice.

Correct Answer: C

Rationale: The correct answer is C: Tidal volume. Tidal volume refers to the volume of air inspired and expired during a normal breath. It represents the amount of air moved into or out of the lungs during each respiratory cycle, which typically ranges from 500 to 700 milliliters in adults. Total lung capacity (A) is the maximum volume of air the lungs can hold, including residual volume. Forced vital capacity (B) is the maximum amount of air that can be forcefully exhaled after a maximum inhalation, not related to a normal breath. Residual volume (D) is the volume of air remaining in the lungs after a maximal exhalation and is not part of a normal breath cycle.

Correct Answer: D

Rationale: The correct answer is D, sitting on the side of the bed and leaning on an overbed table. This position promotes maximum expansion of the thorax, allowing for improved lung ventilation. Leaning forward helps reduce the work of breathing and facilitates better airflow. Options A and C do not provide the same level of thoracic expansion and may not be as effective. Option B may not provide the necessary support for the client to lean forward and optimize breathing.