The emergency department (ED) manager is reviewing client charts to determine how well the staff perform when treating clients with community-acquired pneumonia. What outcome demonstrates that goals for this client type have been met?

Correct Answer: A

Rationale: The correct answer is A: Antibiotics started before admission. This outcome demonstrates that the staff are meeting the goal for treating clients with community-acquired pneumonia because timely administration of antibiotics is crucial in managing this condition effectively. Starting antibiotics promptly helps to reduce the spread of infection and improve patient outcomes. Blood cultures obtained within 20 minutes (B) is important for diagnosing the specific pathogen causing pneumonia but does not directly reflect the treatment goal achievement. Chest x-ray within 30 minutes (C) is essential for diagnosis but does not indicate treatment success. Pulse oximetry on all clients (D) is important for monitoring oxygen levels but does not directly show if the treatment goal for pneumonia has been met.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A: Assist client to sit up on the side of the bed. This intervention is appropriate to be delegated to a nursing assistant because it is a basic task that falls within their scope of practice and does not require specialized training or clinical judgment. Option B, instructing the client to cough effectively, involves providing specific guidance on a therapeutic technique that requires more knowledge and skill, making it more appropriate for a nurse to perform. Option C, teaching the client to use incentive spirometry, involves education on a medical device and its proper use, which is beyond the scope of a nursing assistant's role. Option D, auscultating breath sounds every 4 hours, is a skilled nursing assessment task that requires clinical judgment to interpret findings. This task should be performed by a nurse who can analyze the data collected and make appropriate decisions based on the assessment findings. In an educational context, understanding the delegation of tasks is crucial for healthcare professionals to work effectively as a team. By clearly delineating roles and responsibilities based on skill levels and scopes of practice, patient care can be delivered safely and efficiently. Nursing assistants play a vital role in supporting patient care by carrying out delegated tasks under the supervision of licensed nurses, ensuring that each team member contributes to the overall well-being of the patient.

Correct Answer: D

Rationale: The correct answer is D) Small airway closure earlier in expiration. As individuals age, changes occur in the respiratory system that can impact secretion clearance. Small airway closure earlier in expiration is a common age-related change that can hinder the effective clearance of secretions from the lungs. This closure can lead to air trapping and impaired gas exchange, making it harder to clear mucus and other secretions, thus increasing the risk of respiratory infections. Option A) Decreased functional cilia is not the correct answer because while cilia function may decline with age, it is not a primary factor contributing to decreased secretion clearance. Cilia play a role in moving mucus out of the airways, but their decline alone does not have as significant an impact as small airway closure. Option B) Decreased force of cough is not the correct answer because while cough strength may diminish with age, it is not the primary reason for decreased secretion clearance. Coughing is a mechanism to clear secretions, but small airway closure has a more direct impact on secretion clearance. Option C) Decreased chest wall compliance is not the correct answer because this factor primarily affects lung expansion and respiratory function but is not directly related to secretion clearance. While decreased chest wall compliance can impact overall lung function, it is not the primary reason for decreased secretion clearance in the respiratory system. Educationally, understanding age-related changes in the respiratory system is crucial for healthcare providers, especially those working with older adults. By recognizing these changes and their implications on respiratory function, providers can implement appropriate interventions to support effective secretion clearance and respiratory health in aging individuals.

Correct Answer: C

Rationale: The correct answer is C) Follow the written asthma action plan (e.g., take quick-relief medication) if the expiratory flow rate is in the yellow zone. This is the correct instruction because peak flow meters are used to monitor lung function in asthma patients. The yellow zone on the peak flow meter indicates caution, signaling that the patient's lung function is decreasing. By following the asthma action plan if the expiratory flow rate falls into the yellow zone, the patient can take appropriate steps to manage their asthma and prevent exacerbations. Option A is incorrect because carrying the flow meter at all times is not necessary and may lead to unnecessary anxiety for the patient. Option B is incorrect as checking the status of asthma every time quick-relief medication is taken may not be necessary and could lead to overuse of medication. Option D is incorrect as it describes the technique of using the flow meter, which is not the main focus of the question. Educationally, understanding how to use a peak flow meter and interpret the results is crucial for asthma management. Teaching patients how to monitor their lung function empowers them to take control of their condition and make informed decisions about their care. It also helps healthcare providers assess the effectiveness of treatment plans and adjust them accordingly.