A patient with a massive hemothorax and pneumothorax has absent breath sounds in the right lung. To promote improved V/Q matching, how should the nurse position the patient?

Correct Answer: A

Rationale: The correct answer is A: On the left side. Placing the patient on the left side helps to improve ventilation-perfusion (V/Q) matching by allowing the unaffected left lung to expand fully. This position can help redistribute blood flow to the functioning lung, improving oxygenation. Choice B: On the right side would not be appropriate as it would further compromise the affected right lung. Choice C: In a reclining chair bed may not be ideal for promoting optimal lung expansion and V/Q matching. Choice D: Supine with the head of the bed elevated may not be as effective in improving V/Q matching compared to positioning on the left side.

Correct Answer: C

Rationale: Step-by-step rationale for the correct answer (C): 1. Urinary tract infection (UTI) triggers a systemic inflammatory response. 2. Systemic inflammation can lead to a condition called sepsis. 3. Sepsis can cause widespread inflammation in the body, including the lungs. 4. This generalized inflammation can result in damage to the lung tissue, leading to acute respiratory distress syndrome (ARDS). Summary of why other choices are incorrect: A: Incorrect because UTI does not directly spread to the lungs through circulation. B: Incorrect because toxins produced by UTI typically affect the urinary system, not the lungs. D: Incorrect because fever associated with infection does not directly cause scar tissue formation in the lungs.

Correct Answer: D

Rationale: The correct answer is D because in acute respiratory failure, the goal is to maintain adequate oxygenation while avoiding oxygen toxicity. Keeping PaO2 at ≥60 mm Hg ensures tissue oxygenation without causing harm. Low-flow devices like nasal cannula (A) may not provide sufficient oxygen. Correcting PaO2 to normal levels quickly (B) can lead to oxygen toxicity. Positive-pressure ventilation (C) is indicated in severe respiratory failure, not for all patients in acute respiratory failure.

Correct Answer: C

Rationale: The student nurse should first check the level of suction on the wall because the absence of bubbling in the suction control chamber indicates a potential issue with the suction level. Checking the suction setting ensures that the chest tube is functioning properly. Documenting this as normal (choice A) is incorrect because it could lead to overlooking a problem. Encouraging the patient to cough and deep breathe (choice B) is not relevant to addressing the issue with the chest tube. Clamping the chest tube and calling for help (choice D) is dangerous and could compromise the patient's condition. Therefore, checking the suction level on the wall (choice C) is the appropriate initial action to take.

Correct Answer: A

Rationale: The correct answer is A. The staff nurse should first directly address the inappropriate behavior with the hiring manager. By clearly stating that the conduct causes discomfort and requesting it to stop immediately, the nurse sets clear boundaries and asserts their rights. This action establishes a record of the nurse's response to the misconduct and gives the hiring manager the opportunity to rectify the situation. It also empowers the nurse to advocate for themselves in a professional manner. Summary: - B: Reporting to the nurse manager can be done after addressing the hiring manager directly. - C: Creating a written document can be important but should follow direct communication. - D: Seeking help from a friend can provide support but should not replace direct confrontation with the hiring manager.