A client with chronic obstructive pulmonary disease (COPD) who has been receiving oxygen therapy at 2 L/min now has a respiratory rate of 10 breaths/min. What action should the nurse take first?

Correct Answer: D

Rationale: The correct answer is D, assessing the client's mental status and level of consciousness. This is the first action to take because a respiratory rate of 10 breaths/min in a COPD client receiving oxygen therapy may indicate respiratory depression or impending respiratory failure. Assessing mental status and level of consciousness can help determine if the client is experiencing hypoxia. Increasing oxygen flow rate (A) without assessing the client first can be dangerous if the client is retaining carbon dioxide. Administering a bronchodilator (B) may not address the underlying issue of respiratory depression. Encouraging deep breaths (C) may not be appropriate if the client is in respiratory distress.

Correct Answer: C

Rationale: The correct answer is C because excessive alcohol consumption can raise blood pressure. Step 1: Alcohol can lead to hypertension. Step 2: Limiting alcohol intake is crucial in managing hypertension. Step 3: Choices A, B, and D promote healthy behaviors that help control blood pressure. Summary: Choice C is incorrect as it goes against hypertension management, while choices A, B, and D align with lifestyle modifications for hypertension.

Correct Answer: D

Rationale: The correct answer is D: Assess the client for any allergies, especially to iodine or shellfish. This is crucial because contrast dye containing iodine is commonly used during cardiac catheterization, and a client with allergies to iodine or shellfish can have a severe allergic reaction. It is essential to identify allergies beforehand to prevent any potential adverse reactions during the procedure. A: Ensuring NPO status is important for some procedures, but assessing for allergies is more critical to prevent life-threatening reactions. B: Administering pre-procedure medications is important, but assessing for allergies takes precedence to avoid allergic reactions. C: While obtaining informed consent is necessary, assessing for allergies is a crucial safety measure to prevent allergic reactions during the procedure.

Correct Answer: C

Rationale: The correct answer is C: Assessing for chest pain. The priority assessment for a client post-MI is to monitor for any signs of recurrent chest pain or angina, as it could indicate ongoing cardiac ischemia or a new infarction. Prompt intervention is crucial in these situations to prevent further damage to the heart muscle. Monitoring urine output (A) and electrolyte levels (D) are important assessments but do not take precedence over assessing for chest pain. Checking blood glucose levels (B) is relevant for diabetic clients but is not the priority in this case.

Correct Answer: A

Rationale: The correct answer is A: Take prescribed antihypertensive medications regularly. This is the most important instruction for preventing another stroke because hypertension is a major risk factor for strokes. By controlling blood pressure with antihypertensive medications, the patient can significantly reduce the risk of another stroke. Engaging in physical therapy exercises (choice B) can be beneficial for overall recovery but is not as critical for stroke prevention as managing blood pressure. Following a low-fat, low-cholesterol diet (choice C) is important for heart health but not the most crucial for stroke prevention. Attending regular follow-up appointments (choice D) is essential for monitoring progress and adjusting treatment but does not directly prevent another stroke like managing hypertension does.