A nurse collaborates with a respiratory therapist to complete pulmonary function tests (PFTs) for a client. Which statements should the nurse include in communications with the respiratory therapist prior to the tests? (SATA)

Correct Answer: B

Rationale: Pulmonary function tests (PFTs) are diagnostic procedures that evaluate lung function, requiring precise coordination between the nurse and respiratory therapist to ensure accurate results. The correct answer is **B: "The client is ready to go down to radiology for this examination,"** because PFTs are typically performed in a specialized pulmonary function lab or respiratory therapy department, not radiology. This miscommunication could lead to delays or confusion, as radiology is not the correct location for PFTs. The nurse should verify the correct testing location with the respiratory therapist to ensure the client is directed appropriately. **Why the other options are incorrect:** **A: "I held the client's morning bronchodilator medication."** Holding bronchodilators before PFTs is often necessary because these medications can artificially improve lung function, skewing test results. However, this statement is not directly relevant to pre-test communication with the respiratory therapist. The therapist does not need this information to perform the test—instead, it is part of the nurse's responsibility to follow pre-test protocols. The respiratory therapist focuses on administering the test, not medication management. **C: "Physical therapy states the client can run on a treadmill."** While some PFTs (such as cardiopulmonary exercise testing) may involve treadmill use, standard spirometry or diffusion capacity tests do not. This statement is irrelevant unless the specific PFT requires exercise, which is uncommon in basic assessments. Including unnecessary details may confuse the therapist or imply an incorrect test type. The nurse should clarify the exact PFT being performed before relaying unrelated physical therapy clearance. **D: "I advised the client not to smoke for 6 hours prior to the test."** Smoking before PFTs can affect results by irritating airways and altering lung function. However, this is another pre-test nursing responsibility, not a critical communication point for the respiratory therapist. The therapist expects the client to arrive prepared; their role is to conduct the test, not verify smoking cessation. The nurse should document this instruction in the client's chart rather than report it to the therapist. In summary, effective communication before PFTs should focus on logistical coordination (e.g., correct testing location) rather than reiterating pre-test instructions that are the nurse's duty. Misplaced statements (A, D) or irrelevant details (C) distract from ensuring the procedure is performed efficiently. The priority is confirming the client is in the right place at the right time with the necessary preparations already completed.

Correct Answer: B

Rationale: The correct answer is B: Notify Rapid Response Team. Continuous cyanosis despite oxygen therapy after benzocaine spray indicates possible methemoglobinemia, a life-threatening condition. Rapid Response Team can provide immediate intervention and transfer to a higher level of care. Administering albuterol (A) is not indicated for methemoglobinemia. Assessing peripheral pulses (C) may not address the underlying issue. Obtaining blood and sputum cultures (D) is not the priority in this acute situation.

Correct Answer: A

Rationale: The correct answer is A: Document findings. This is important because the harsh hollow sound over the trachea and larynx could indicate a potential emergency or serious condition like an airway obstruction or laryngeal edema. Documenting findings helps in providing clear communication to other healthcare professionals and ensures proper follow-up care. Administering O2 therapy (B) or albuterol (D) without a clear understanding of the underlying issue could be harmful. Positioning the client in high-Fowler's position (C) may not directly address the potential emergency at hand.

Correct Answer: D

Rationale: The correct answer is D because tracheal deviation indicates a potential tension pneumothorax, a life-threatening emergency requiring immediate intervention. Tracheal deviation occurs when there is a significant shift in the mediastinum due to increased pressure in the pleural space. This can compromise respiratory function and lead to respiratory failure. Options A, B, and C are not as urgent as tracheal deviation. Pain at 5/10 is expected post-thoracentesis, a small amount of drainage is common, and a pulse oximetry reading of 93% on low oxygen is concerning but not immediately life-threatening.

Correct Answer: C

Rationale: The correct answer is C: Assess the client's gag reflex before giving any food or water. After a bronchoscopy, the client may have an impaired gag reflex due to the numbing agent used during the procedure. Assessing the gag reflex is crucial to prevent aspiration and ensure the client can safely swallow without the risk of choking or inhaling fluids. This step is essential before offering any food or water to the client. Option A is incorrect because calling the healthcare provider for a prescription is unnecessary at this point. Option B is incorrect because ice chips can still pose a risk if the client's gag reflex is impaired. Option D is incorrect as allowing the client to have a sip without assessing the gag reflex first could lead to complications if the client is unable to swallow properly.