A patient with idiopathic pulmonary arterial hypertension (IPAH) reports a decrease in exertional dyspnea. What should the nurse assess to evaluate treatment effectiveness?

Correct Answer: D

Rationale: The correct answer is D because assessing the patient's reported exertional dyspnea directly evaluates the symptom that the patient is experiencing. Improvement in exertional dyspnea indicates that the treatment is effective in managing the patient's condition. It is essential to focus on the patient's subjective experience to determine treatment effectiveness. Choices A, B, and C are incorrect because: A: Heart rate below 100 beats per minute may or may not be relevant to assessing exertional dyspnea improvement. It does not directly evaluate the patient's reported symptom. B: Improved lung fields on a chest x-ray may suggest some improvement but do not directly correlate with the patient's symptom of exertional dyspnea. C: Stable blood pressure is important but does not directly assess the patient's reported symptom of exertional dyspnea.

Correct Answer: C

Rationale: The correct answer is C. This statement is incorrect because stopping tuberculosis medications prematurely can lead to treatment failure and the development of drug-resistant strains. Patients must complete the full course of treatment to ensure the infection is completely eradicated. Wearing a mask to prevent spreading the infection, taking medication for at least 6 months as prescribed, and scheduling regular follow-up appointments are all essential steps in managing tuberculosis effectively.

Correct Answer: B

Rationale: The correct answer is B: Identify and avoid environmental triggers. This is the most important point because it addresses the root cause of allergic rhinitis, which is exposure to allergens. By identifying and avoiding triggers such as pollen, dust mites, and pet dander, the patient can effectively manage their symptoms. Using oral antihistamines preemptively (choice A) may provide some relief, but does not address the underlying cause. Washing hands frequently (choice C) is important for preventing infections but not directly related to managing allergic rhinitis. Limiting corticosteroid nasal sprays (choice D) is incorrect as they are commonly used and effective in managing allergic rhinitis symptoms without significant systemic effects when used as directed.

Correct Answer: B

Rationale: The correct position for thoracentesis is sitting upright and leaning forward (Choice B). This position allows better access to the thoracic cavity, facilitating the procedure and reducing the risk of complications. Sitting upright helps expand the intercostal space, making it easier to insert the needle accurately. Leaning forward also helps the patient breathe more comfortably during the procedure. Supine position (Choice A) with the head of the bed flat may not provide optimal access to the thoracic cavity. Lying on the affected side (Choice C) may not allow proper visualization and access to the site. Prone position with arms raised above the head (Choice D) is not suitable for thoracentesis as it does not facilitate proper access to the thoracic cavity.

Correct Answer: B

Rationale: The correct answer is B: Assess lung sounds for crackles. This is the priority nursing action because the patient's worsening fatigue and shortness of breath may indicate developing pneumonia, a common complication of influenza. Assessing lung sounds for crackles helps in identifying any signs of respiratory distress or infection, which require immediate intervention. Encouraging rest and fluid intake (choice A) is important but not the priority in this case. Providing supportive oxygen therapy (choice C) may be necessary based on assessment findings but should come after assessing lung sounds. Notifying the healthcare provider immediately (choice D) is important but assessing the patient's condition first is crucial for prompt intervention.