An admitting nurse is assessing a patient with COPD. The nurse auscultates diminished breath sounds, which signify changes in the airway. These changes indicate to the nurse to monitor the patient for what?

Correct Answer: B

Rationale: Diminished breath sounds in COPD, from airway narrowing or hyperinflation (e.g., emphysema), signal reduced ventilation, prompting the nurse to monitor for dyspnea and hypoxemia. Air trapping and obstruction lower air entry, audible as faint sounds, risking oxygen desaturation (hypoxemia) and shortness of breath (dyspnea) core COPD features. Kyphosis (spinal curvature) and clubbing (finger deformity) occur in advanced stages but aren't immediate concerns from diminished sounds. Sepsis and pneumothorax are complications, not direct sequelae of this finding sepsis needs systemic signs, pneumothorax absent sounds on one side. Bradypnea (slow breathing) contradicts COPD's tachypnea; pursed-lip breathing is a coping strategy, not a risk. Monitoring dyspnea and hypoxemia via symptoms and oximetry guides timely intervention (e.g., oxygen), per COPD care standards.

Correct Answer: A

Rationale: Correct diaphragmatic breathing is confirmed when hands on the rib cage borders touch as the chest wall contracts during exhalation. This reflects the diaphragm's upward movement, pushing air out, while inhalation separates fingers as the diaphragm descends, expanding the abdomen. Chest wall hand placement showing separation on contraction suggests shallow breathing, not diaphragmatic. Feeling upward diaphragm movement during inspiration or downward during expiration reverses normal mechanics diaphragm moves down to inhale, up to exhale. This tactile feedback, taught by the nurse, ensures deep, effective breaths, preventing atelectasis by maximizing lung expansion, a key postoperative recovery skill.

Correct Answer: A

Rationale: Notifying the operating suite of a latex allergy is most important, as latex is pervasive in surgical settings (gloves, tubes), and exposure risks anaphylaxis, requiring immediate room preparation with latex-free supplies. This preempts delays or emergencies, prioritizing safety. Documenting a bath, obtaining vital signs, or giving antibiotics are routine but secondary latex reaction prevention is urgent due to its acute, life-threatening potential. The nurse's action ensures a safe environment, aligning with allergy management protocols to protect the patient throughout surgery.

Correct Answer: B

Rationale: A coronary artery bypass graft, a major procedure, requires intensive care unit (ICU) monitoring immediately post-op due to prolonged anesthesia and risks like arrhythmias or bleeding. ICU provides advanced oversight (e.g., cardiac monitoring) beyond a medical-surgical unit's capacity. Ambulatory settings suit minor surgeries, not this complexity. The nurse's expectation ensures critical care, aligning with standards for high-risk postoperative recovery.

Correct Answer: B

Rationale: Obligate anaerobes are microorganisms that cannot utilize oxygen for growth and find it toxic, thriving instead in oxygen-free environments. 'Obligate anaerobes,' is correct because these organisms, like Clostridium botulinum, lack the enzymes (e.g., catalase) to neutralize oxygen's reactive byproducts, making oxygen lethal to them. 'Obligate aerobes,' require oxygen for survival, the opposite of the question's description. 'Aerotolerant anaerobes,' can tolerate oxygen but don't use it, differing from being harmed by it. 'Facultative aerobes,' can switch between oxygen and anaerobic metabolism, adapting to its presence. The defining trait here is oxygen's toxicity, not mere avoidance, aligning with obligate anaerobes' biological characteristics, as seen in microbiology studies of anaerobic bacteria, making B the precise answer over the others.