A patient who has a history of chronic obstructive pulmonary disease (COPD) was hospitalized for increasing shortness of breath and chronic hypoxemia (SaO2 levels of 89% to 90%). In planning for discharge, which action by the nurse will be most effective in improving compliance with discharge teaching?

Correct Answer: C

Rationale: The correct answer is C: Arrange for the patient's caregiver to be present during the teaching. Rationale: 1. Involving the patient's caregiver promotes better understanding and support for the patient's care at home. 2. Caregivers can assist in reinforcing teaching, ensuring the patient follows instructions. 3. Caregivers can help monitor the patient for any signs of worsening condition or noncompliance. 4. This approach is effective in addressing potential barriers to compliance and continuity of care. Summary of other choices: A: Having the patient repeat instructions may not guarantee understanding or retention of information. B: Teaching just before discharge may not allow enough time for the patient and caregiver to fully grasp and prepare for home care. D: Starting teaching during admission may overwhelm the patient and may not address the need for ongoing support at home.

Correct Answer: A

Rationale: The correct answer is A: Administer oxygen therapy. In COPD exacerbation, there is inadequate oxygenation due to impaired lung function. Administering oxygen therapy is the priority to improve oxygen levels and prevent hypoxia. Oxygen therapy helps reduce the work of breathing and decrease the workload on the heart. It is crucial to address hypoxemia promptly to prevent further complications. Summary: - Option B: Administering a bronchodilator can help improve airflow but is not the priority in a COPD exacerbation. - Option C: Administering fluids and electrolytes may be needed, but oxygen therapy takes precedence in improving oxygenation. - Option D: Encouraging deep breathing exercises is beneficial but not as urgent as providing oxygen therapy to address hypoxemia.

Correct Answer: D

Rationale: The correct answer is D: Administer analgesics. The priority nursing intervention for a postoperative patient experiencing severe pain is to address the pain first to ensure patient comfort and improve recovery. Administering analgesics will help alleviate the patient's pain and promote their well-being. IV fluids (choice B) may be necessary but addressing pain takes precedence. Antiemetics (choice C) may be needed if the patient is experiencing nausea or vomiting, but pain management is the immediate priority. Administering analgesics (choice A) is the most appropriate and urgent intervention to prioritize the patient's comfort and recovery.

Correct Answer: A

Rationale: The correct answer is A: Place the patient on NPO status. This is crucial to prevent aspiration during surgery. NPO status ensures the patient's stomach is empty, reducing the risk of vomiting and aspiration of stomach contents during anesthesia induction. Explanation (B) and (C) are important but not the immediate priority. Performing a preoperative assessment (D) is also important but not as critical as ensuring the patient is NPO to prevent complications during surgery.

Correct Answer: D

Rationale: The correct answer is D: Administer oral antihypertensives. The priority action for a patient with hypertension experiencing dizziness and headache is to address the underlying cause of the symptoms, which is likely elevated blood pressure. Administering oral antihypertensives will help lower the patient's blood pressure and alleviate the symptoms. Explanation: 1. Assess the patient's vital signs to confirm hypertension. 2. Administering oral antihypertensives is a quick and effective way to lower blood pressure. 3. Monitoring the patient's response to the medication is crucial. 4. Administering oxygen therapy (Choice C) is not the priority as the symptoms are likely due to hypertension, not hypoxia. 5. Administering antihypertensive medication (Choice A) or a beta-blocker (Choice B) via other routes may not be as quick or effective as oral medications.