A patient with severe chronic obstructive pulmonary disease (COPD) tells the nurse, 'I wish I were dead! I'm just a burden on everybody.' Based on this information, which nursing diagnosis is most appropriate?

Correct Answer: B

Rationale: The statement reflects feelings of worthlessness tied to dependence, fitting chronic low self-esteem.

Correct Answer: D

Rationale: These ABGs indicate uncompensated respiratory acidosis and should be reported to the health care provider. The other values are normal, close to normal, or compensated.

Correct Answer: D

Rationale: Because the highest priority action is to remove the foreign object from the nare, the nurse's first action should be to assist the patient to remove the object. The other actions are also appropriate but should be done after attempting to clear the nose.

Correct Answer: B

Rationale: The large amount of blood may indicate that the patient is in danger of developing hypovolemic shock. An air leak would be expected immediately after chest tube placement for a pneumothorax.

Correct Answer: A

Rationale: The increased rate of pertussis in adults is thought to be caused by decreasing immunity after childhood immunization. Immunization is the most effective method of protecting communities from infectious diseases. Hand washing should be taught, but pertussis is spread by droplets and contact with secretions. Supportive care does not shorten the course of the disease or the risk for transmission. Taking antibiotics as prescribed does assist with decreased transmission, but patients are likely to have already transmitted the disease by the time the diagnosis is made.