Correct Answer: A

Rationale: Impaired Gas Exchange is the nursing diagnosis that should take the highest priority for implementing client education in a client with chronic obstructive pulmonary disease (COPD). Since COPD directly affects the ability of the lungs to take in oxygen and eliminate carbon dioxide, impaired gas exchange is a critical concern for these patients. By educating the client on proper breathing techniques, medication adherence, smoking cessation, and environmental triggers, the nurse can help in improving gas exchange and overall respiratory function. Addressing Impaired Gas Exchange as a priority can significantly impact the client's quality of life and prevent respiratory complications.

Correct Answer: B

Rationale: B. Coach in nonpharmacologic pain management techniques: The client's vital signs indicate they may be experiencing pain as evidenced by an elevated heart rate (P 119), which can be addressed initially with nonpharmacologic pain management techniques. This approach can help reduce pain and anxiety without the immediate need for medication.

Correct Answer: B

Rationale: A decreased urinary output from 50 mL/hour to 40 mL/hour indicates a worsening of the client's condition with preeclampsia. A decreased urinary output can be a sign of reduced kidney function, which is a serious complication in preeclampsia. Monitoring urinary output is crucial in assessing kidney function and overall fluid balance in clients with preeclampsia. It is important to promptly address any reduction in urinary output to prevent further deterioration in the client's condition. The other options do not specifically indicate a worsening of the condition in this context.

Correct Answer: A

Rationale: 1. Tachycardia: Disseminated intravascular coagulation (DIC) can lead to widespread clotting within the blood vessels, which can result in tissue ischemia and subsequent compensatory mechanisms such as tachycardia to increase cardiac output and maintain perfusion.

Correct Answer: C

Rationale: Hyperthyroidism is a noncardiac risk factor for heart failure because it can lead to increased heart rate, palpitations, and ultimately strain on the heart. When a person has hyperthyroidism, the thyroid gland produces too much thyroid hormone, which can impact the cardiovascular system by affecting heart function. This increased workload on the heart can contribute to the development of heart failure. It is important for the nurse to recognize hyperthyroidism as a potential risk factor for heart failure during the assessment of the client.