A patient is having difficulty weaning from mechanical ve ntilation. The nurse assesses the patient and notes what potential cause of this difficult weaning?

Correct Answer: B

Rationale: The correct answer is B: Hemoglobin of 8 g/dL. Low hemoglobin levels can lead to inadequate oxygen delivery to tissues, causing respiratory distress and difficulty weaning from mechanical ventilation. This is due to reduced oxygen-carrying capacity leading to increased work of breathing. A: Cardiac output of 6 L/min is within normal range and not directly related to difficulty weaning from mechanical ventilation. C: Negative sputum culture and sensitivity indicate absence of respiratory infection but not a direct cause of difficulty weaning. D: White blood cell count of 8000 is within normal range and not a direct cause of difficulty weaning.

Correct Answer: C

Rationale: Step-by-step rationale for why choice C is correct: 1. Going to the patient’s bedside is the priority as it allows the nurse to assess the patient's condition directly. 2. By being at the bedside, the nurse can quickly evaluate the patient's breathing, vital signs, and other indicators for immediate action. 3. Direct assessment enables timely intervention and avoids delays in addressing potential life-threatening situations. 4. Checking for possible causes of the alarm and reconnection to the ventilator can follow, but assessing the patient's immediate needs takes precedence. In summary, choice C is correct because direct patient assessment is the fundamental step in responding to a ventilator alarm to ensure patient safety and timely intervention. Choices A, B, and D are incorrect as they focus on troubleshooting and technical aspects before directly assessing the patient's condition.

Correct Answer: A

Rationale: The correct answer is A: Alveoli collapse and atelectasis occurs. When fluid is present in the alveoli, it impairs the surface tension necessary for the alveoli to remain open, leading to collapse and atelectasis. This prevents proper gas exchange, resulting in hypoxemia. Choice B is incorrect because impaired gas diffusion typically occurs with conditions affecting the alveolar-capillary membrane, not fluid in the alveoli. Choice C is incorrect as hypoventilation refers to decreased ventilation, not specifically related to fluid in the alveoli. Choice D is incorrect as fluid in the alveoli is not a direct indicator of heart failure.

Correct Answer: B

Rationale: The correct answer is B: Inhaled bronchodilators and intravenous corticosteroids. Bronchodilators help to quickly open up the airways during an asthma exacerbation, providing immediate relief. Intravenous corticosteroids help reduce airway inflammation and prevent further worsening of symptoms. Corticosteroids by mouth (Choice A) are not as effective as intravenous administration during an acute exacerbation. Prone positioning or continuous lateral rotation (Choice C) is not a recommended treatment for asthma exacerbation. Sedation and inhaled bronchodilators (Choice D) are not appropriate as sedation can depress respiratory function and worsen the condition.

Correct Answer: A

Rationale: The correct answer is A because PE should be suspected in patients with unexplained cardiorespiratory complaints and risk factors for VTE. This is important because PE can present with nonspecific symptoms, making it crucial to consider it in the differential diagnosis. Explanation: 1. PE can present with various symptoms, including dyspnea, chest pain, and hemoptysis, but these are not present in all patients. 2. Bradycardia and hyperventilation are not classic symptoms of PE, as it can present with tachycardia and other respiratory findings. 3. Critically ill patients are actually at higher risk for VTE and PE, so prophylaxis is typically recommended. In summary, choice A is correct because it emphasizes the importance of considering PE in patients with cardiorespiratory complaints and risk factors for VTE, while the other choices contain inaccuracies or incomplete information.