On assessing Mr. Puff, what would you expect to find?

Correct Answer: C

Rationale: The correct answer is C: Increased anteroposterior chest diameter. In patients with chronic obstructive pulmonary disease (COPD), like Mr. Puff, there is often air trapping leading to hyperinflation of the lungs. This results in an increased anteroposterior chest diameter, known as a "barrel chest" appearance. Option A (‘Blue bloater’ appearance) is associated with chronic bronchitis, not necessarily COPD. Option B (Copious amount of thin sputum) is more indicative of bronchiectasis. Option D (Prolonged inspiratory time) is a nonspecific finding and not typically associated with COPD.

Correct Answer: A

Rationale: Administering oxygen in treating COPD is crucial to relieve hypoxemia, which is a common complication of this condition. In COPD, there is impaired gas exchange in the lungs due to damaged airways and alveoli, leading to decreased oxygen levels in the blood. Supplemental oxygen helps to increase the oxygen concentration in the blood, improving oxygen delivery to tissues and organs, thereby alleviating symptoms like shortness of breath and preventing complications of hypoxemia, such as tissue damage and organ dysfunction. Option B is incorrect because administering oxygen does not increase carbon dioxide retention. In fact, it can help reduce carbon dioxide levels by improving oxygenation, which can indirectly decrease the respiratory drive as it is often driven by hypoxemia rather than hypercapnia. Option C is incorrect because administering oxygen does not increase the intensity of respiratory drive. In patients with COPD, the respiratory drive is often blunted due to chronic hypercapnia, so providing oxygen can actually help to normalize respiratory drive by correcting hypoxemia without increasing the drive to dangerous levels. Option D is incorrect because administering oxygen does not directly decrease respiratory secretions. Oxygen therapy is primarily aimed at improving oxygenation in COPD patients and does not have a direct effect on respiratory secretions. Educationally, understanding the rationale for administering oxygen in COPD is essential for nurses and healthcare professionals caring for patients with this condition. It underscores the importance of proper oxygen therapy to manage hypoxemia effectively and improve patient outcomes.

Correct Answer: D

Rationale: In this scenario, the correct action for the nurse to take if Wendy develops moderate hypotension and an irregular pulse while receiving aminophylline is option D: Slow the rate of aminophylline administration, monitor vital signs, and notify the physician. This option is the most appropriate because aminophylline is a bronchodilator that can cause side effects like hypotension and arrhythmias. By slowing the administration rate, the nurse can help decrease the likelihood of exacerbating these side effects while continuing to provide the therapeutic benefits of the medication. Option A is incorrect because simply monitoring vital signs without taking action to address the hypotension and irregular pulse is not sufficient when a patient is experiencing adverse effects from a medication. Option B is incorrect because abruptly discontinuing aminophylline can lead to rebound bronchoconstriction in patients who are receiving it for respiratory conditions. Option C is inappropriate because administering epinephrine in this situation could worsen the hypotension and irregular pulse, as epinephrine can further increase heart rate and blood pressure. In an educational context, it is crucial for nurses to understand the potential side effects of medications like aminophylline and how to appropriately respond to adverse reactions. By being knowledgeable about pharmacology principles and understanding the rationale behind each action, nurses can provide safe and effective care to their patients. This case highlights the importance of careful monitoring, appropriate interventions, and timely communication with the healthcare team when managing medication-related complications in clinical practice.

Correct Answer: B

Rationale: In the context of pharmacology and adult medical-surgical care, the best method of controlling exposure to illness in any occupational environment is by developing prevention programs (Option B). This answer is correct because prevention is fundamental in reducing the risk of illness transmission. Prevention programs focus on education, vaccination, infection control measures, and promoting a healthy work environment. By implementing preventive strategies, healthcare workers can significantly reduce the likelihood of exposure to infectious agents and occupational hazards. Option A, the use of masks, is a helpful measure in certain situations to prevent the spread of airborne diseases, but it is not as comprehensive as developing prevention programs. Masks alone may not address other routes of transmission or provide a holistic approach to occupational health and safety. Option C, early diagnosis of illness, is crucial in managing diseases but is not primarily focused on controlling exposure in the occupational setting. Early diagnosis helps in timely treatment and preventing disease progression but does not address the prevention of initial exposure. Option D, developing rehabilitation programs, is not directly related to controlling exposure to illness in the occupational environment. Rehabilitation programs are designed to help individuals recover and regain functional abilities after illness or injury, rather than preventing exposure in the first place. Educationally, understanding the importance of prevention programs in occupational health can empower healthcare professionals to proactively mitigate risks and promote a safe working environment. By emphasizing preventive measures, healthcare workers can protect themselves, their colleagues, and patients from potential harm, ultimately enhancing the quality of care provided while minimizing occupational health hazards.

Correct Answer: B

Rationale: In this scenario, option B, ‘I will regain some degree of my sense of smell and taste,’ indicates that Mr. Singer understands his condition after watching the rehabilitation filmstrip. This statement shows insight into the potential outcomes of his condition and the restorative process involved. Option A, ‘I will be able to continue my swimming as usual,’ is incorrect because it does not directly relate to the information provided in a filmstrip about rehabilitation. Option C, ‘I will not be able to bowl anymore,’ is incorrect as it focuses on a specific activity rather than the broader understanding of his condition and recovery. Option D, ‘I will have to give up my tub bath,’ is also incorrect as it does not reflect an understanding of the rehabilitation process and the potential outcomes for Mr. Singer. Educationally, this question assesses the patient's comprehension of their medical condition and the implications of rehabilitation. It highlights the importance of patient education in promoting understanding and active participation in the recovery process. Understanding the potential outcomes and necessary lifestyle adjustments is crucial for patients to make informed decisions and adhere to treatment plans effectively.