A patient recovering from thoracotomy reports shortness of breath and chest pain. What should the nurse do first?

Correct Answer: B

Rationale: The correct answer is B: Assess for tracheal deviation. This is the priority because it can indicate a pneumothorax, a potentially life-threatening complication of thoracotomy. Tracheal deviation could suggest a tension pneumothorax, which requires immediate intervention to prevent respiratory distress and cardiac compromise. Administering analgesics (A) may be necessary but not the first priority. Encouraging the use of an incentive spirometer (C) and positioning the patient in semi-Fowler's position (D) can help improve lung function but are not as urgent as assessing for tracheal deviation.

Correct Answer: B

Rationale: The correct answer is B: Rinse your mouth after using the inhaler. This is important because corticosteroid inhalers can cause oral thrush, a fungal infection in the mouth. Rinsing the mouth after use helps prevent this side effect. Choice A is incorrect because corticosteroid inhalers are used for long-term control, not during acute attacks. Choice C is incorrect as corticosteroid inhalers are usually taken on an empty stomach. Choice D is incorrect as using a spacer with the inhaler can actually improve drug delivery and effectiveness.

Correct Answer: B

Rationale: The correct interpretation is B: Metabolic acidosis. The low pH indicates acidosis. The low HCO3- level (<22 mEq/L) indicates a primary metabolic acidosis. The PaCO2 level is not elevated, ruling out respiratory compensation. Choice A is incorrect because the primary disturbance is metabolic, not respiratory alkalosis. Choice C is incorrect as it suggests both acidosis and alkalosis, which is not the case. Choice D is incorrect because the PaCO2 is not elevated, ruling out respiratory acidosis.

Correct Answer: B

Rationale: The correct answer is B: Respiratory acidosis. The pH is below the normal range (7.35-7.45), indicating acidosis. The PaCO2 is elevated (normal range 35-45 mm Hg), suggesting respiratory acidosis. The HCO3 is within the normal range, indicating that compensation has not occurred. This scenario is consistent with uncompensated respiratory acidosis. A: Metabolic alkalosis - Incorrect. HCO3 is within the normal range, not elevated as seen in metabolic alkalosis. C: Compensated respiratory acidosis - Incorrect. The HCO3 is not elevated, indicating incomplete compensation. D: Uncompensated metabolic acidosis - Incorrect. The PaCO2 is elevated, indicating a respiratory issue rather than a metabolic one.

Correct Answer: C

Rationale: The correct answer is C because eating smaller, more frequent meals can help reduce the feeling of breathlessness in COPD patients by avoiding large meals that may put pressure on the diaphragm. This approach can also help maintain energy levels and prevent overeating, which can lead to bloating and increased pressure on the lungs. A is incorrect because limiting physical activity can worsen COPD symptoms by leading to muscle weakness and reduced exercise tolerance. B is incorrect because using a rescue inhaler before every meal is not a standard COPD management practice and may lead to overuse of the medication. D is incorrect because adjusting oxygen flow rate without medical guidance can be dangerous and may result in oxygen levels being too high or too low, which can be harmful to the patient.