A nurses assessment reveals that a client with COPD may be experiencing bronchospasm. What assessment finding would suggest that the patient is experiencing bronchospasm?

Correct Answer: B

Rationale: Bronchospasm in COPD, a sudden airway narrowing from smooth muscle contraction, is suggested by wheezes or diminished breath sounds on auscultation. Wheezing a high-pitched sound from turbulent airflow through constricted passages is classic, while diminished sounds reflect reduced air entry, both audible in acute exacerbation. Crackles (fine or coarse) indicate fluid or mucus, typical in pneumonia or heart failure, not bronchospasm's dry obstruction. Reduced respiratory rate or lethargy suggests severe hypoxia or fatigue, not specific to bronchospasm COPD patients often show tachypnea. Slow, deliberate respirations may be compensatory but aren't diagnostic. The nurse's detection of wheezes or diminished sounds confirmed by stethoscope prompts bronchodilator use, aligning with COPD exacerbation management to reverse this reversible component.

Correct Answer: B

Rationale: A pillow during coughing splints the abdominal incision, supporting it to reduce strain on sutures and tissues cut through surgery. Coughing stresses the incision, risking dehiscence or pain from nerve irritation; splinting with a pillow or hands minimizes this pull, enhancing comfort and safety. It doesn't directly relieve pain analgesics do nor distract, as focus remains on coughing. Anxiety may lessen indirectly via comfort, but splinting's primary role is mechanical support. The nurse's use of this technique ensures effective airway clearance without compromising the incision, aligning with postoperative care to prevent complications like wound disruption.

Correct Answer: A

Rationale: Ascertaining the surgical site is correctly marked per universal protocol with indelible ink prevents wrong-site surgery, a critical error with severe consequences, making it most important. Marking the right great toe ensures surgical precision, mandated for all invasive procedures. Family location aids communication but isn't safety-critical. A clean gown and removing hairpins/cosmetics are standard but less urgent than site verification. The nurse's focus on this step upholds patient safety, aligning with Joint Commission standards to eliminate procedural mistakes.

Correct Answer: C

Rationale: Continued nausea and vomiting post-ambulatory surgery may need medication, so connecting the patient with the physician for relief (e.g., antiemetics) is key. Deep breaths or ginger ale/crackers may help mildly but fail for persistent symptoms. The ER is excessive unless dehydration worsens. This review ensures timely medical input, aligning with ambulatory care follow-up to manage common postoperative issues effectively.

Correct Answer: D

Rationale: A healthy carrier is someone who harbors and can transmit an infectious agent without showing symptoms, including during the incubation period before illness manifests. 'Healthy carrier,' is correct because it fits this description, as seen with typhoid carriers like Mary Mallon, who spread disease unknowingly. 'Convalescent carrier,' refers to someone recovering from illness who still sheds pathogens, not during incubation. 'Precocious carrier,' is not a standard term in epidemiology. 'Contact carrier,' is also not recognized; it might imply transmission via contact but lacks specificity to incubation. The healthy carrier's asymptomatic yet infectious state during incubation aligns with the question, supported by public health definitions from the CDC, distinguishing D as the accurate answer over less applicable or nonexistent terms.