A client with COPD is receiving oxygen at 2 L/min via nasal cannula. The client reports drowsiness and confusion. What is the nurse's priority action?

Correct Answer: B

Rationale: The correct answer is B. Assessing the client's oxygen saturation and respiratory status is the priority. Drowsiness and confusion may indicate oxygen overdose, so assessing these parameters will help determine if the client is experiencing oxygen toxicity. Increasing the oxygen flow rate (choice A) could worsen the symptoms. Discontinuing oxygen therapy (choice C) without assessment could lead to hypoxia. Notifying the healthcare provider (choice D) can be done after the initial assessment.

Correct Answer: D

Rationale: The correct answer is D because using an albuterol inhaler for peak flows in the yellow zone indicates that the patient understands how to respond to worsening symptoms. Albuterol is a rescue inhaler used to manage asthma exacerbations, which are typically indicated by peak flows in the yellow zone. Inhaling rapidly through the peak flow meter (A) is not the correct technique and can lead to inaccurate readings. Taking montelukast (B) is a daily controller medication and not indicated for immediate symptom relief. Calling the healthcare provider when in the green zone (C) is unnecessary as the green zone signifies good lung function.

Correct Answer: A

Rationale: The correct answer is A: Administer anticoagulant medication. This is the priority intervention because anticoagulants help prevent the existing clot from getting larger and reduce the risk of new clots forming. Administering anticoagulant medication promptly is essential to prevent complications like worsening of the pulmonary embolism or development of new clots. B: Positioning the patient flat may worsen the condition by reducing blood flow to the lungs. C: Encouraging ambulation may dislodge the clot and lead to a life-threatening situation. D: Chest physiotherapy may not address the underlying cause of the pulmonary embolism and could potentially dislodge the clot. In summary, administering anticoagulant medication is the priority intervention as it directly addresses the pathophysiology of the condition and reduces the risk of complications.

Correct Answer: B

Rationale: Correct Answer: B - "I should sleep on my back for better airflow." Rationale: 1. Sleeping on the back can worsen obstructive sleep apnea by causing the tongue and soft tissues to block the airway. 2. The optimal sleeping position for CPAP therapy is usually on the side to maintain open airways. 3. Choices A, C, and D are correct as consistent CPAP usage, regular cleaning, and weight loss can improve sleep apnea symptoms.

Correct Answer: D

Rationale: The correct answer is D because assessing the patient's reported exertional dyspnea directly evaluates the symptom that the patient is experiencing. Improvement in exertional dyspnea indicates that the treatment is effective in managing the patient's condition. It is essential to focus on the patient's subjective experience to determine treatment effectiveness. Choices A, B, and C are incorrect because: A: Heart rate below 100 beats per minute may or may not be relevant to assessing exertional dyspnea improvement. It does not directly evaluate the patient's reported symptom. B: Improved lung fields on a chest x-ray may suggest some improvement but do not directly correlate with the patient's symptom of exertional dyspnea. C: Stable blood pressure is important but does not directly assess the patient's reported symptom of exertional dyspnea.