A patient hospitalized with community-acquired pneumonia has a temperature of 101.6° F, a frequent cough, and severe pleuritic chest pain. Which prescribed medication should the nurse give first?

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Piperacillin/tazobactam (Zosyn). When a patient with community-acquired pneumonia presents with a high fever, severe chest pain, and cough, these symptoms indicate a potentially serious infection that requires prompt antibiotic therapy. Piperacillin/tazobactam is a broad-spectrum antibiotic that covers a wide range of pathogens commonly associated with pneumonia, making it the priority medication to address the underlying infection. The other options are not the best choices in this situation: A) Codeine: Codeine is a cough suppressant and would not address the underlying infection causing the pneumonia. B) Guaifenesin: Guaifenesin is an expectorant used to help loosen mucus in the airways but would not treat the infection. C) Acetaminophen (Tylenol): Acetaminophen is a fever reducer and pain reliever, which may provide symptomatic relief but does not address the infection itself. In an educational context, this question highlights the importance of prioritizing patient care based on assessment findings and understanding the rationale behind the prescribed treatments. Nurses need to recognize the urgency of treating infections like pneumonia promptly to prevent complications and improve patient outcomes. This question also emphasizes the need for nurses to have a strong foundation in pharmacology to make appropriate medication decisions in acute care settings.

Correct Answer: A

Rationale: The correct answer is option A: "I will blow into the meter as hard and fast as possible." This statement indicates effective learning because using a peak flow meter requires the patient to forcefully exhale to get an accurate reading of their peak expiratory flow rate, which is crucial in monitoring asthma symptoms and determining the effectiveness of treatment. Option B is incorrect because inhaling deeply before exhaling into the peak flow meter can affect the accuracy of the reading. The patient should exhale normally and forcefully to obtain the correct measurement. Option C is incorrect because peak flow meters are used for regular monitoring of asthma symptoms, not just when the patient feels short of breath. Regular use helps in identifying early signs of worsening asthma and adjusting treatment accordingly. Option D is incorrect because holding the breath after using the peak flow meter is not necessary and does not contribute to obtaining an accurate reading. It is important for the patient to exhale forcefully into the meter and then record the value without holding their breath. In an educational context, it is vital for patients with asthma to understand how to correctly use a peak flow meter to monitor their lung function. By providing clear instructions and ensuring that patients demonstrate the correct technique, nurses can empower patients to actively manage their asthma and seek timely medical intervention when necessary.

Correct Answer: B

Rationale: The most appropriate intervention for a patient with a tracheostomy experiencing thick respiratory secretions is to suction the tracheostomy as needed using sterile technique (Option B). This is because suctioning helps remove the secretions that can obstruct the airway and impede effective breathing. It is a standard nursing intervention for maintaining airway patency in patients with tracheostomies. Option A, encouraging the patient to drink more fluids, may not effectively address the immediate issue of thick secretions in the airway. While hydration is important for overall respiratory health, it may not provide immediate relief. Option C, instilling sterile saline into the tracheostomy to thin secretions, can potentially introduce infection risk and is not a recommended practice unless specifically ordered by a healthcare provider. Option D, administering a mucolytic agent prescribed by the healthcare provider, may be appropriate in some cases, but as an immediate intervention, suctioning is more effective in clearing the airway promptly. In an educational context, understanding the rationale behind each option enhances critical thinking skills and clinical reasoning in nursing practice. It is crucial for nurses to prioritize interventions based on the patient's immediate needs and evidence-based practices to ensure optimal patient outcomes.

Correct Answer: C

Rationale: In this scenario, the nurse's priority action should be to apply oxygen therapy (Option C) for the patient suspected of having a pulmonary embolism (PE). Oxygen therapy is crucial in the management of PE because it helps improve oxygenation and prevent hypoxia, which can be life-threatening in this condition. Administering anticoagulant therapy (Option A) is an important intervention for PE, but oxygen therapy takes precedence as it addresses the immediate need for oxygenation. Notifying the healthcare provider (Option B) is also important, but it is not the priority over ensuring the patient has adequate oxygen supply. Elevating the patient's legs (Option D) is not indicated in the management of PE and would not address the immediate need for oxygenation in this situation. Educationally, understanding the priority actions in managing a patient with a suspected PE is crucial for nurses to provide safe and effective care. Prioritizing interventions based on the patient's condition and immediate needs is a fundamental aspect of nursing practice.

Correct Answer: B

Rationale: In this scenario, the correct answer is option B, which is an oxygen saturation of 86%. Oxygen saturation represents the amount of oxygen carried by hemoglobin in the blood. A saturation level of 86% is considered critically low and requires immediate intervention to prevent hypoxia, which can lead to serious complications like organ damage or failure. Option A, dryness around the nostrils, is not an immediate concern and can be addressed with simple interventions like humidification. Option C, a respiratory rate of 20 breaths per minute, falls within the normal range and does not indicate an urgent issue. Option D, occasional nasal bleeding, while concerning, is not as critical as the low oxygen saturation level and can be managed while addressing the oxygenation problem. Educationally, understanding the importance of monitoring oxygen saturation levels is crucial for healthcare professionals, especially in patients receiving oxygen therapy. This knowledge helps in early identification of hypoxia and prompt intervention to ensure patient safety and well-being. It also highlights the significance of prioritizing interventions based on the severity of the patient's condition.