A patient with COPD complains of worsening fatigue and dyspnea. Which assessment finding requires immediate attention?

Correct Answer: B

Rationale: The correct answer is B: Oxygen saturation of 82% on room air. This finding indicates severe hypoxemia in a patient with COPD, necessitating immediate attention to prevent complications like respiratory failure. Clubbing of the fingers (choice A) is a sign of chronic hypoxia but does not require immediate attention. Increased anterior-posterior chest diameter (choice C) and barrel chest appearance (choice D) are common in COPD but do not indicate an acute issue requiring immediate intervention. Oxygen saturation is a crucial parameter to monitor in COPD patients as it directly reflects their respiratory status.

Correct Answer: A

Rationale: The correct answer is A because pursed-lip breathing is a technique commonly used by patients with COPD to improve breathing efficiency by slowing down exhalation and keeping airways open. This helps to reduce air trapping and improve oxygen exchange. Option B is incorrect because pursed-lip breathing is not primarily used for anxiety reduction. Option C is incorrect as it doesn't directly relate to pursed-lip breathing. Option D is incorrect because pursed-lip breathing is a preventive technique rather than a response to acute shortness of breath.

Correct Answer: B

Rationale: The correct answer is B: Standard four-drug therapy for TB. In this scenario, the nurse has a positive TB skin test but no symptoms or chest x-ray findings. This suggests latent TB infection. The standard treatment for latent TB infection is a four-drug therapy regimen to prevent the progression to active TB. It is essential for the occupational health nurse to educate the staff nurse about this treatment to prevent the development of active TB disease. Choice A (Use and side effects of isoniazid) is incorrect because while isoniazid is part of the treatment regimen for latent TB infection, the nurse needs to be educated about the full four-drug therapy regimen, not just one drug. Choice C (Need for annual repeat TB skin testing) is incorrect as the positive TB skin test already indicates latent TB infection, so repeat skin testing annually is not necessary. Choice D (Reasons for annual sputum cytology testing) is incorrect because sputum cytology testing is not

Correct Answer: C

Rationale: The correct answer is C: Monitor the patient's respiratory rate. This is the priority nursing intervention because anticoagulant therapy can lead to potential bleeding complications, such as pulmonary embolism. Monitoring the patient's respiratory rate helps assess for signs of bleeding or clot formation in the lungs, which are critical to address promptly. A: Monitoring INR levels is important but not the priority over assessing for immediate complications. B: Increasing fluid intake may be beneficial for some conditions but is not the priority in this case. D: Administering an antifungal medication is unrelated to anticoagulant therapy and not a priority intervention.

Correct Answer: A

Rationale: The correct answer is A: Administer a bronchodilator. This is the priority intervention because wheezing indicates airway constriction in asthma, requiring immediate relief to improve breathing. Bronchodilators help dilate the airways, providing quick relief. Administering an inhaled corticosteroid (B) is important for long-term control, not immediate relief. Administering an IV analgesic (C) is not necessary for wheezing in asthma. Performing a neurological assessment (D) is not relevant and does not address the immediate respiratory issue.