The experienced LPN/LVN is providing nursing care for a client with a respiratory problem. Which of the following actions are appropriate to the scope of practice for an experienced LPN/LVN? (Choose all that apply.)

Correct Answer: D

Rationale: In this scenario, option D is the most appropriate action for an experienced LPN/LVN. Evaluating the client's technique for using MDIs is within the scope of practice for an LPN/LVN as it involves assessing and ensuring proper medication administration, which is a crucial aspect of nursing care. Option A, auscultating breath sounds, is more aligned with the role of a registered nurse or respiratory therapist who have advanced assessment skills. Option B, administering MDI medications, typically falls under the responsibilities of a registered nurse or a healthcare provider with prescriptive authority. Option C, checking oxygen saturation using pulse oximetry, is also usually performed by a registered nurse or respiratory therapist who can interpret the results and make appropriate clinical decisions based on the findings. This question provides valuable educational context by highlighting the importance of understanding the scope of practice for different levels of nursing personnel and emphasizes the significance of appropriate delegation and collaboration within a healthcare team to ensure safe and effective patient care.

Correct Answer: D

Rationale: In this scenario, the nurse should suspect a spontaneous pneumothorax is occurring. A spontaneous pneumothorax typically happens in individuals with underlying lung conditions, such as COPD, and can be triggered by smoking. In this case, the patient's history of COPD and smoking increases the likelihood of a spontaneous pneumothorax. A tension pneumothorax (Option A) is characterized by a buildup of air under pressure in the pleural space, leading to mediastinal shift and compromised cardiac output. This condition is typically associated with trauma or invasive medical procedures (Iatrogenic pneumothorax - Option B), rather than COPD and smoking. Traumatic pneumothorax (Option C) results from physical injury to the chest, which is not indicated in this patient's history. Understanding the different types of pneumothorax and their associated risk factors is crucial for nurses caring for patients with respiratory conditions. Recognizing the signs and symptoms of each type helps in prompt identification and appropriate intervention, thus improving patient outcomes. In this case, linking the patient's history with the most likely type of pneumothorax enhances critical thinking and clinical decision-making skills in nursing practice.

Correct Answer: B

Rationale: The correct answer is B: Absent breath sounds. This finding could indicate a pneumothorax, a serious complication post lung biopsy requiring immediate intervention. Absent breath sounds suggest air accumulation in the pleural space, causing lung collapse. Prompt action is crucial to prevent respiratory distress. Increased temperature (A) may indicate infection but not as urgent as addressing a pneumothorax. Productive cough (C) is common post-procedure. Incisional discomfort (D) is expected and can be managed with appropriate pain relief measures.

Correct Answer: D

Rationale: The correct answer is D: All these. The phrenic nerve innervates the diaphragm, which is responsible for inspiration (A). During parturition (B), the diaphragm plays a role in the pushing phase of labor. While the diaphragm is not directly involved in micturition and defecation (C), it indirectly affects these processes by helping to create intra-abdominal pressure. Therefore, the correct answer is D as the diaphragm is involved in inspiration, parturition, and indirectly affects micturition and defecation.

Correct Answer: D

Rationale: The correct answer is D, "All these." PAS, Ethambutol, and Streptomycin are all common drugs used against TB. PAS inhibits bacterial folic acid synthesis, Ethambutol inhibits cell wall synthesis, and Streptomycin inhibits protein synthesis. Using a combination of these drugs helps to target different aspects of TB bacteria, reducing the likelihood of resistance development. Therefore, all of these drugs are essential in the treatment of TB, making choice D the correct answer.