A nurse is participating in a health and wellness event at the local community center. A woman approaches and relates that she is worried that her widowed father is becoming more functionally impaired and may need to move in with her. The nurse inquires about his ability to complete activities of daily living (ADLs). ADLs include independence with: (Select all that apply.)

Correct Answer: B

Rationale: The correct answer is B: Toileting. ADLs are essential self-care activities that individuals perform daily to maintain their well-being. Toileting is one of the basic ADLs and refers to the ability to use the toilet independently. This is crucial for maintaining hygiene and overall health. The other choices are incorrect because: A: Driving is not typically considered an ADL. It falls under the category of instrumental activities of daily living (IADLs), which are more complex tasks related to independent living. C: Bathing is a fundamental ADL, but the question asks for activities that are included in ADLs and not for all possible ADLs. D: Daily exercise is important for overall health but is not specifically categorized as an ADL. It falls under the category of health-promoting activities.

Correct Answer: B

Rationale: In pulmonary fibrosis, the thickened alveolar walls impair gas exchange, leading to diffusion limitation. This restricts oxygen transfer across the alveolar-capillary membrane, causing hypoxemia. Anatomic shunt (A) involves blood bypassing ventilated lung areas, not seen in pulmonary fibrosis. Intrapulmonary shunt (C) refers to blood flow through unventilated lung regions, not a characteristic of pulmonary fibrosis. V/Q mismatch ratio of less than 1 (D) indicates a ventilation-perfusion mismatch, not typically associated with pulmonary fibrosis.

Correct Answer: B

Rationale: The correct answer is B: Assess for fluid overload and manage diuresis if indicated. In ARDS, increasing CVP and oxygen requirements may indicate fluid overload contributing to the respiratory distress. Diuresis can help reduce fluid volume, improve oxygenation, and decrease the workload on the heart. Increasing oxygen flow rate (A) may help temporarily but doesn't address the underlying issue of fluid overload. Notifying the physician about worsening hypoxemia (C) is important but addressing fluid overload is the immediate priority. Immediate intubation (D) may be necessary in severe cases, but addressing fluid overload should be attempted first.

Correct Answer: A

Rationale: The correct action is to check for kinks or obstructions in the ventilator tubing first because a high-pressure alarm indicates a potential issue with airflow, which can lead to decreased oxygenation and ventilation. By ensuring the tubing is clear, the nurse can address the immediate problem and potentially prevent further complications. Auscultating lung sounds for a pneumothorax can be important but is not the priority in this situation. Suctioning the endotracheal tube for secretions may help in some cases but should not be the first action when a high-pressure alarm occurs. Notifying the respiratory therapist is important, but resolving the potential obstruction in the ventilator tubing should be the initial step to ensure the patient's safety and optimal ventilation.

Correct Answer: B

Rationale: The correct answer is B: Use of permissive hypercapnia. In ARDS, permissive hypercapnia allows for lower tidal volumes and pressures, reducing the risk of barotrauma. Decreasing PEEP (A) can worsen oxygenation. Increasing tidal volume (C) can exacerbate lung injury. Positive pressure ventilation (D) is necessary but can lead to barotrauma if not carefully managed.