A male patient is admitted to the healthcare facility for treatment of chronic obstructive pulmonary disease. Which nursing diagnosis is most important for this patient?

Correct Answer: D

Rationale: The correct answer is D: Impaired gas exchange related to airflow obstruction. This is the most important nursing diagnosis for a patient with chronic obstructive pulmonary disease because impaired gas exchange directly impacts the patient's ability to breathe and obtain oxygen. Addressing this issue is crucial in managing the patient's condition and preventing further complications. A: Activity intolerance related to fatigue may be a concern for the patient, but it is secondary to the primary issue of impaired gas exchange. B: Anxiety related to actual threat to health status is important to address, but it is not the most critical nursing diagnosis for this patient. C: Risk for infection related to retained secretions is a valid concern, but it is not as immediate and directly life-threatening as impaired gas exchange in a patient with chronic obstructive pulmonary disease.

Correct Answer: B

Rationale: The correct answer is B: Flail chest. Flail chest is characterized by paradoxical movement of a segment of the chest wall due to multiple rib fractures. In this case, the left chest wall moving in during inspiration and out during expiration indicates this paradoxical movement. This leads to ineffective breathing, causing dyspnea and anxiety. Hemothorax (A) is accumulation of blood in the pleural cavity, not associated with chest wall movement. Atelectasis (C) is collapse of lung tissue, not associated with chest wall movement. Pleural effusion (D) is accumulation of fluid in the pleural space, also not associated with paradoxical chest wall movement.

Correct Answer: A

Rationale: The correct answer is A: High Fowler's position. This position promotes optimal lung expansion by maximizing chest expansion and allowing for improved airflow. The upright position reduces pressure on the diaphragm, making it easier for the client to breathe. Left and right side-lying positions may restrict lung expansion and worsen breathing difficulties. The supine position with pillows under each arm does not provide the same benefits as the High Fowler's position in terms of respiratory support. Overall, High Fowler's is the most effective position for a client experiencing an asthmatic attack as it facilitates better oxygenation and ventilation.

Correct Answer: D

Rationale: The correct answer is D: diffusion. Oxygen and carbon dioxide move in and out of cells through simple diffusion, which is the passive movement of molecules from an area of high concentration to an area of low concentration. This process occurs due to the concentration gradient of these gases. Osmosis (Choice C) is the movement of water across a selectively permeable membrane, not gases like oxygen and carbon dioxide. Exocytosis and endocytosis (Choice A) involve the transport of larger molecules and particles in and out of cells, not gases. Bulk flow (Choice B) involves the movement of fluids in response to pressure differences, not the specific movement of oxygen and carbon dioxide molecules. Therefore, diffusion is the correct mechanism for the movement of oxygen and carbon dioxide in the body due to their small molecular size and the concentration gradient present.

Correct Answer: D

Rationale: The correct answer is D because hypoxia, which is a condition of low oxygen levels in the body, can indeed lead to hyperventilation, as the body tries to compensate. It can also cause symptoms like headaches, nausea, and lethargy due to the lack of oxygen reaching the brain and other organs. Severe hypoxia can lead to loss of consciousness and even death if oxygen levels are not restored promptly. Therefore, all the statements in choices A, B, and C are true in relation to hypoxia, making option D the correct choice.