A nurse is caring for a patient preparing for discharge from the hospital the next day. The patient does not read. His family caregiver will be visiting before discharge. What can the nurse do to facilitate the patient's understanding of his discharge instructions? (Select all that apply.)

Correct Answer: B

Rationale: The correct answer is B: Sit facing the patient so he is able to watch your lip movements and facial expressions. This approach enhances communication by allowing the patient to visually observe the nurse's non-verbal cues, which can aid in understanding despite the patient's inability to read. By facing the patient directly, the nurse can convey empathy and provide a visual connection that can facilitate comprehension. This method promotes effective communication and patient engagement. Rationales for why the other choices are incorrect: A: Yelling is not an appropriate or effective communication strategy, as it can be perceived as aggressive or disrespectful. C: While presenting one idea or concept at a time can be helpful, it does not address the visual communication aspect necessary for a non-reader. D: Sending a written copy of the instructions home is not helpful for a patient who cannot read. Additionally, relying solely on the family caregiver to review the instructions may not ensure the patient's full understanding.

Correct Answer: C

Rationale: The correct answer is C: Inadequate gas exchange to meet the metabolic needs of the body. This is the accurate description of respiratory failure as it reflects the core issue of the condition - the lungs' inability to effectively exchange oxygen and carbon dioxide to support the body's metabolic needs. Explanation for why the other choices are incorrect: A: The absence of ventilation - This is too simplistic and does not encompass the full spectrum of respiratory failure, which involves both ventilation and gas exchange. B: Any episode in which part of the airway is obstructed - This describes airway obstruction, not respiratory failure, which involves broader issues with gas exchange. D: An episode of acute hypoxemia caused by a pulmonary dysfunction - This choice focuses only on hypoxemia and pulmonary dysfunction, which are components of respiratory failure but do not fully capture the complexity of the condition.

Correct Answer: B

Rationale: The correct answer is B (pH 7.45, PaCO2 30 mm Hg, PaO2 55 mm Hg) as it indicates early-stage ARDS. In ARDS, there is hypoxemia, resulting in low PaO2 levels. The low PaO2 can lead to respiratory alkalosis, hence the high pH (normal or slightly alkalotic). The low PaCO2 (hypocapnia) is a compensatory mechanism to maintain pH. Choices A, C, and D do not reflect the typical ABG findings in early-stage ARDS. A (pH 7.30, PaCO2 50 mm Hg, PaO2 60 mm Hg) shows respiratory acidosis and lower PaO2. C (pH 7.38, PaCO2 40 mm Hg, PaO2 92 mm Hg) indicates better oxygenation and less likely to be early ARDS. D (

Correct Answer: A

Rationale: The correct answer is A: Increased PaO2 with decreased oxygen requirements. Prone therapy improves oxygenation in ARDS by optimizing ventilation-perfusion matching. When the patient's PaO2 increases and oxygen requirements decrease, it indicates improved oxygenation efficiency. Reduced chest expansion and decreased lung compliance (B) would suggest worsening lung function. Improved respiratory rate with increased tidal volumes (C) could indicate compensatory mechanisms, not necessarily improved oxygenation. Decreased blood pressure and heart rate (D) are more indicative of hemodynamic changes rather than the effectiveness of prone therapy in ARDS.

Correct Answer: B

Rationale: The correct answer is B: Obtain oxygen saturation using pulse oximetry. In a patient with sepsis, it is crucial to assess oxygen saturation to evaluate respiratory status and tissue perfusion. The patient's vital signs indicate signs of respiratory distress (elevated temperature, increased respirations) and potential hypoperfusion (low blood pressure). Oxygen saturation will provide critical information on the patient's oxygenation status. A: Notifying the healthcare provider may be necessary but addressing the immediate respiratory concern is the priority. C: Documenting and monitoring are important, but immediate intervention is needed due to the patient's critical condition. D: Administering acetaminophen is not appropriate at this time as the priority is to assess and address respiratory distress and potential hypoperfusion.