After spinal anesthesia, how should the nurse position the client?

Correct Answer: B

Rationale: The correct answer is B - Flat on back. After spinal anesthesia, the nurse should position the client flat on their back to prevent complications such as hypotension and improve blood flow to the brain. This position also helps distribute the anesthetic evenly and reduces the risk of nerve damage. Choice A is incorrect because positioning the client on the side does not necessarily prevent airway obstruction by the tongue, and it can increase the risk of hypotension. Choice C is incorrect as flexing the knees can impede blood flow and does not provide optimal distribution of the anesthetic. Choice D is incorrect as lying flat on the stomach can increase the risk of respiratory issues and hinder monitoring of the client.

Correct Answer: C

Rationale: The correct answer is C: Pneumonia. In a 77-year-old male with fever, cough, and pleuritic chest pain, pneumonia is the most likely diagnosis. Fever, cough, and chest pain are common symptoms of pneumonia, especially when the pain worsens with breathing (pleuritic chest pain). Pneumonia is an infection of the lungs commonly caused by bacteria or viruses, leading to inflammation and fluid accumulation in the air sacs. ARDS (choice A) typically presents with severe respiratory distress after an acute injury to the lungs. MI (choice B) presents with chest pain, but usually not pleuritic, and other symptoms like sweating, nausea, and arm pain. Tuberculosis (choice D) can present with cough and chest pain, but it is less likely in this scenario without other specific risk factors.

Correct Answer: A

Rationale: The correct answer is A: Providing rest periods throughout the day. This is the most important nursing intervention for a client with anemia and cerebral tissue hypoxia because rest helps reduce oxygen demand and allows for tissue oxygenation. Rest periods aid in preventing further tissue hypoxia, promoting healing, and improving overall well-being. Summary of other choices: B: Instituting energy conservation techniques - While conserving energy is important, rest is crucial for oxygenation in this scenario. C: Assisting in ambulation to the bathroom - Ambulation may be necessary, but rest takes precedence for oxygenation. D: Checking the temperature of water prior to bathing - Ensuring water temperature safety is important, but rest is essential for addressing cerebral tissue hypoxia.

Correct Answer: D

Rationale: The correct answer is D: Stridor. Stridor is a high-pitched, noisy breathing sound that indicates airway obstruction, a potential complication of bronchoscopy. Immediate reporting is crucial for prompt intervention. A: Blood-streaked sputum may occur post-bronchoscopy but does not require immediate reporting unless excessive or persistent. B: Dry cough is a common post-procedure symptom and does not necessitate immediate reporting. C: Hematuria (blood in urine) is not a typical complication of bronchoscopy and would not be directly related to the procedure.

Correct Answer: D

Rationale: The correct answer is D: Give 3 hyperinflations. Hyperventilating a patient before suctioning helps increase oxygen levels and reduce the risk of hypoxemia during the procedure. Hyperinflations involve delivering 3 deep breaths to the patient, which helps improve oxygenation and prepare the patient for suctioning. Choices A, B, and C are incorrect because simply giving inflations, adjusting oxygen flow rate, or providing 100% oxygen without hyperinflations may not adequately prepare the patient for suctioning and prevent hypoxemia.