A client with bronchiectasis has a large amount of foul-smelling sputum. What intervention should the nurse prioritize?

Correct Answer: D

Rationale: The correct answer is D because postural drainage therapy helps mobilize and clear secretions from the bronchiectatic areas, reducing the risk of infection from stagnant sputum. It is a priority intervention to improve airway clearance and prevent further lung damage. Encouraging frequent coughing and deep breathing (A) may help clear secretions but may not be as effective as postural drainage. Increasing fluid intake (B) may help liquefy secretions, but without proper clearance, it may not address the underlying issue. Administering antibiotics (C) is important if there is an infection, but it does not directly address the need for sputum clearance in bronchiectasis.

Correct Answer: B

Rationale: The correct answer is B: To remove mucus from the airways. Postural drainage helps mobilize and clear mucus from the bronchiectatic airways, improving ventilation and reducing the risk of infection. This is crucial in bronchiectasis to prevent mucus buildup, which can lead to further lung damage and infections. Incorrect choices: A: To improve oxygen saturation - While postural drainage can indirectly improve oxygenation by clearing mucus, the primary goal is mucus clearance. C: To reduce inflammation in the lungs - Postural drainage primarily focuses on mucus clearance rather than reducing inflammation. D: To prevent respiratory infections - While mucus clearance can help prevent infections, the primary goal of postural drainage is to remove mucus.

Correct Answer: B

Rationale: The correct answer is B: To prevent asthma exacerbations. Montelukast is a leukotriene receptor antagonist that works to reduce inflammation in the airways, preventing asthma symptoms and exacerbations. It is not used for acute bronchospasm relief (choice A) or immediate relief during an attack (choice D). Montelukast does not directly reduce mucus production (choice C) but rather targets the underlying inflammation in asthma.

Correct Answer: C

Rationale: The correct answer is C: Losing weight if overweight. Obesity is a major risk factor for obstructive sleep apnea as excess fat around the neck can obstruct the airway during sleep. Losing weight can help reduce the severity of symptoms by decreasing the amount of tissue that may be blocking the airway. Sleeping in a supine position (A) can actually worsen symptoms by further collapsing the airway. Avoiding CPAP therapy (B) is not recommended as it is a common treatment for sleep apnea. Reducing daily fluid intake (D) may help with nighttime trips to the bathroom but does not directly address the underlying cause of obstructive sleep apnea.

Correct Answer: C

Rationale: Pulmonary fibrosis is characterized by scarring of lung tissue, leading to decreased lung function. Progressive shortness of breath is the most common symptom due to the reduced lung capacity. Unexplained weight loss (A) is not a typical symptom of pulmonary fibrosis. Frequent nosebleeds (B) are not directly associated with the condition. Night sweats and chills (D) are more indicative of infections or other systemic conditions, not specifically pulmonary fibrosis.