A client has developed atelectasis postoperatively. Which of the following findings should the nurse expect?

Correct Answer: B

Rationale: The correct answer is B: Increasing dyspnea. Atelectasis is a condition where the lung tissue collapses, leading to decreased oxygen exchange and resulting in symptoms like dyspnea (difficulty breathing). This occurs because the collapsed lung tissue reduces the surface area available for gas exchange, leading to decreased oxygen saturation and increased work of breathing. Facial flushing (choice A) is not typically associated with atelectasis. Decreasing respiratory rate (choice C) may not be a reliable indicator as the body may compensate by increasing respiratory rate to maintain oxygenation. Friction rub (choice D) is more commonly associated with conditions like pleurisy or pneumonia, not atelectasis.

Correct Answer: A

Rationale: In the context of pharmacology and medical-surgical nursing, understanding the relationship between decreased plasma volume and cardiac output is crucial. The correct answer is A) Flattened neck veins when the client is in a supine position. This finding supports the nursing diagnosis of Decreased Cardiac Output because decreased plasma volume leads to reduced preload, resulting in decreased venous return to the heart. In the supine position, flattened neck veins indicate decreased venous return and impaired filling of the right side of the heart, ultimately leading to decreased cardiac output. Option B) Full and bounding pedal and post-tibial pulses is incorrect because this finding is more indicative of increased cardiac output or volume overload rather than decreased cardiac output related to decreased plasma volume. Option C) Pitting edema located in feet, ankles, and calves is incorrect as it is a sign of fluid retention, typically seen in conditions like heart failure where there is an excess of fluid volume, not decreased plasma volume. Option D) Shallow respirations with crackles on auscultation is more indicative of respiratory issues such as pulmonary edema rather than decreased cardiac output related to decreased plasma volume. Understanding these clinical findings in the context of pharmacology helps nurses make accurate assessments and diagnose alterations in cardiac function promptly, leading to appropriate interventions to improve patient outcomes.

Correct Answer: A

Rationale: In this scenario, the correct action that can be delegated to the nursing assistant is to provide oral care every 3-4 hours (Option A). This task is within the scope of practice for a nursing assistant and helps maintain the client's oral hygiene, which is important in preventing infections and promoting comfort. Monitoring for indications of dehydration (Option B) and administering 0.45% saline by IV line (Option C) are tasks that require a higher level of clinical judgment and understanding of the client's condition, which should be performed by a registered nurse. Assessing daily weights for trends (Option D) is also a critical nursing responsibility that involves interpreting and analyzing data to monitor the client's fluid status accurately. Educationally, understanding the principles of delegation is crucial for newly graduated RNs. Delegating tasks effectively involves considering the complexity of the task, the stability of the client, and the competency of the healthcare team members. By delegating appropriate tasks, RNs can optimize client care outcomes and promote teamwork within the healthcare setting.

Correct Answer: A

Rationale: In the scenario of a client with respiratory failure experiencing respiratory acidosis while on mechanical ventilation, increasing the ventilator rate from 6 to 10 per minute is the correct action to take. Respiratory acidosis occurs when the lungs cannot remove enough carbon dioxide, leading to an increase in carbonic acid in the blood and a decrease in blood pH. By increasing the ventilator rate, you can enhance the removal of carbon dioxide, helping to correct the acidosis. Option B, decreasing the ventilator rate from 10 to 6 per minute, would further decrease the efficiency of carbon dioxide removal, exacerbating the respiratory acidosis. Option C, increasing the oxygen concentration from 30% to 40%, does not directly address the underlying cause of respiratory acidosis, which is inadequate carbon dioxide elimination. Option D, decreasing the oxygen concentration from 40% to 30%, also does not address the root cause of respiratory acidosis and may lead to hypoxemia without improving the acidosis. Understanding the principles of mechanical ventilation and the management of respiratory acidosis is crucial for nurses caring for patients with respiratory failure. Adjusting ventilator settings based on the patient's ABG results is a key aspect of providing effective respiratory care.

Correct Answer: B

Rationale: In this scenario, the most desirable fluid to avoid dehydration when increasing running mileage is option B) Ice-cold mineral water. Mineral water contains essential electrolytes such as sodium, potassium, and magnesium, which are crucial for maintaining proper hydration levels during physical activity. These electrolytes help in replenishing the salts lost through sweating during exercise, aiding in proper muscle function and overall hydration status. Options A, C, and D are not as desirable as mineral water for hydration during increased physical activity. A) Tomato juice contains natural sugars and some electrolytes, but its high fiber content can cause gastrointestinal distress during exercise. C) Beer is not a suitable choice for hydration as it acts as a diuretic, increasing urine output and potentially exacerbating dehydration. D) Lemonade, while containing some vitamin C, is high in sugar which can lead to a rapid rise and subsequent drop in blood sugar levels, affecting energy levels and hydration status negatively during exercise. For medical-surgical nursing practice, understanding the importance of proper hydration and electrolyte balance during physical activity is crucial for patient care. Educating patients on selecting appropriate fluids, such as mineral water, can help prevent dehydration-related complications and support overall health and well-being during exercise.