A patient with pneumonia has a fever of 101.4° F (38.6° C), a nonproductive cough, and an O2 saturation of 88%. The patient is weak and needs assistance to get out of bed. Which patient problem should the nurse assign as the priority?

Correct Answer: D

Rationale: The correct answer is D: Impaired gas exchange. This is the priority patient problem because the patient's low O2 saturation of 88% indicates inadequate exchange of oxygen and carbon dioxide in the lungs, which can lead to hypoxia and further complications. The patient's symptoms of pneumonia, fever, and weakness also support this priority as they contribute to impaired gas exchange. A: Fatigue is a common symptom in pneumonia but is secondary to impaired gas exchange in this case. B: Hyperthermia is important to address but is not the priority over impaired gas exchange affecting oxygenation. C: Impaired mobility is a concern, but it is not as critical as addressing impaired gas exchange to ensure adequate oxygenation for the patient's recovery.

Correct Answer: C

Rationale: The correct answer is C: Decreases coronary artery spasms. Diltiazem is a calcium channel blocker that works by relaxing and dilating coronary arteries, thereby reducing spasms in Prinzmetal's angina. This action helps to improve blood flow to the heart muscle and alleviate chest pain. Choice A is incorrect because diltiazem does not directly reduce heart palpitations. Choice B is incorrect because diltiazem does not prevent coronary artery plaque buildup. Choice D is incorrect because diltiazem does not increase the contractile force of the heart; in fact, it may actually decrease contractility due to its negative inotropic effects. In summary, the accurate action of diltiazem in the context of Prinzmetal's angina is to decrease coronary artery spasms, which improves blood flow to the heart and relieves chest pain.

Correct Answer: C

Rationale: The correct answer is C because taking the long-acting beta2 agonist every morning helps prevent acute asthma attacks by providing sustained bronchodilation. Choice A is incorrect as long-acting medications are not for immediate relief. Choice B is incorrect because it indicates using the medication only during an attack. Choice D is incorrect as abruptly stopping long-acting beta2 agonists can lead to worsening asthma symptoms.

Correct Answer: C

Rationale: The correct action is to assess the client's medications first. Step 1: Determine potential causes of bradycardia. Step 2: Medications are common culprits in slowing heart rate. Step 3: Assessing medications can reveal drugs like beta blockers or calcium channel blockers. Step 4: Adjusting medication regimen can potentially resolve bradycardia. This approach addresses the root cause before considering immediate interventions like external pacing or atropine administration. Option A is not proactive in addressing the client's health concern. Option B is premature without identifying the cause. Option D is not indicated without understanding the underlying reason for the bradycardia.

Correct Answer: D

Rationale: The correct answer is D. Exercise to the point of discomfort should be questioned because in patients with peripheral artery disease, it is important to avoid excessive exertion that could worsen symptoms or lead to complications. Cilostazol and omeprazole are commonly used in the management of peripheral artery disease and do not have contraindications with clopidogrel. The use of treadmill for exercise is beneficial for patients with peripheral artery disease as it helps improve circulation and overall cardiovascular health.