A pulmonary nurse cares for clients who have chronic obstructive pulmonary disease (COPD). Which client would the nurse assess first?

Correct Answer: B

Rationale: The correct answer is B, a 52-year-old in a tripod position using accessory muscles to breathe. This client is likely experiencing respiratory distress, which is a medical emergency in COPD. The tripod position and use of accessory muscles indicate increased work of breathing and potential respiratory failure, requiring immediate assessment and intervention to prevent further deterioration. Incorrect choices: A: Smoking history is relevant but does not indicate immediate respiratory distress. C: Dependent edema and clubbed fingers suggest advanced disease but not acute respiratory distress. D: Chronic cough and thick secretions are common in COPD but do not indicate acute respiratory compromise.

Correct Answer: C

Rationale: The primary focus of healthcare today is health promotion (Choice C) because it emphasizes preventive measures to maintain overall well-being and reduce the burden of diseases. Health promotion involves educating individuals on healthy lifestyle choices, disease prevention, and early detection. This approach aligns with the shift towards proactive rather than reactive healthcare. Incorrect options: A: Care of acute illnesses - This option focuses on treating immediate health issues rather than preventing them. B: Care of chronic illnesses - While important, this option addresses managing ongoing conditions rather than prioritizing prevention. D: Health restoration - This choice emphasizes restoring health after illness, which is essential but not the primary focus of healthcare today.

Correct Answer: D

Rationale: The correct answer is D because discharge planning aims to ensure that the patient and their family's needs are consistently met post-discharge. This process involves assessing the patient's health status, identifying resources for continued care, and creating a plan to support the patient's transition from the healthcare facility to the home environment. By addressing the physical, emotional, and social needs of the patient and family, healthcare providers can enhance continuity of care, reduce readmission rates, and improve overall patient outcomes. Choice A is incorrect because discharge planning focuses on the post-acute care setting, not the acute care setting. Choice B is incorrect as documenting nursing care is part of the overall patient care process but not the primary rationale for discharge planning. Choice C is incorrect as discharge planning involves assessing available resources and support systems, which may or may not involve family members providing home care.

Correct Answer: C

Rationale: The correct answer is C because it follows the recommended guidelines for documenting data by being factual, objective, and specific. It includes a clear cause and effect relationship between the intervention (oxygen administration) and the outcome (vital signs returning to baseline). This type of documentation is essential for accuracy, continuity of care, and legal purposes. A, B, and D are incorrect because they contain subjective interpretations, lack specificity, and do not provide clear cause-effect relationships. A is subjective, B lacks specificity, and D involves subjective interpretation of patient behavior. Such entries can lead to miscommunication, misunderstanding, and compromised patient care.

Correct Answer: C

Rationale: The correct answer is C: Individualize it to the specific patient. This is important because standardized plans of care are generic and need to be tailored to the patient's unique needs and condition for effective implementation. By personalizing the plan, the nurse ensures that it addresses the specific health concerns, preferences, and goals of the individual. This step is crucial in providing patient-centered care and promoting better outcomes. Choices A and B are incorrect because simply dating or signing the plan without individualizing it does not address the patient's specific needs. Choice D is also incorrect as using the plan as printed, based on common needs, may not adequately address the patient's unique situation.