The nurse and the nursing assistive personnel (NAP) are caring for a group of postoperative patients who need turning, coughing, deep breathing, incentive spirometer, and leg exercises. Which task will the nurse assign to the NAP?

Correct Answer: D

Rationale: The correct answer is D because it involves a task appropriate for the nursing assistive personnel (NAP) that aligns with their scope of practice. Here's the rationale: 1. NAP can inform the nurse if the patient is unwilling to perform exercises as it requires observation and communication, fitting their role. 2. Teaching postoperative exercises (choice A) involves providing instructions and guidance, which is typically within the nurse's scope of practice. 3. Doing nothing associated with postoperative exercises (choice B) is not appropriate and goes against the principles of patient care. 4. Documenting in the medical record (choice C) requires critical thinking and decision-making skills, typically done by nurses rather than NAP.

Correct Answer: A

Rationale: The correct answer is A: 0.1 mg/mL of a 1:10,000 concentration of epinephrine delivered via the intraosseous route. In neonatal resuscitation, when chest compressions and ventilation do not improve the heart rate, administering epinephrine is crucial. In this scenario, the intraosseous route is preferred due to the difficulty in obtaining IV access in neonates. Intraosseous administration provides rapid access to the circulatory system, ensuring timely delivery of medication. Choice B is incorrect because intramuscular administration may lead to delayed absorption and inconsistent drug levels. Choice C is incorrect as endotracheal administration of epinephrine is less effective and associated with higher doses needed. Choice D is incorrect as intravenous access may be challenging in neonates and intraosseous route is preferred for rapid drug delivery.

Correct Answer: A

Rationale: The correct answer is A: 0.5 to 1 inch. After the endotracheal tube passes through the vocal cords, it should be advanced approximately 0.5 to 1 inch into the trachea before inflating the cuff. This ensures the cuff is positioned below the cords to prevent aspiration and secure ventilation. Choices B and C are too short of a distance, risking dislodgment or improper placement. Choice D is excessively far, potentially leading to endobronchial intubation. The recommended range of 0.5 to 1 inch provides a balance between securing the tube and minimizing complications.

Correct Answer: B

Rationale: The correct answer is B: Spontaneous pneumothorax. In this scenario, the presence of small pockets of air in the subcutaneous tissue of the chest indicates air escaping from the lung into the chest cavity, leading to pneumothorax. Spontaneous pneumothorax commonly presents with sudden chest pain and dyspnea, more prevalent in older individuals, like the patient described. Bacterial pneumonia (A) typically presents with fever, productive cough, and consolidation on lung auscultation. Dry pleurisy (C) refers to inflammation of the pleura without significant fluid accumulation, unlikely to cause subcutaneous emphysema. Chronic obstructive pulmonary disease (D) is characterized by progressive airflow limitation and is not directly associated with subcutaneous emphysema.

Correct Answer: B

Rationale: The correct answer is B: Respiratory acidosis. In this scenario, the patient's shallow and irregular respirations indicate hypoventilation, leading to carbon dioxide retention and decreased pH levels, causing respiratory acidosis. The low SpO2 level further supports inadequate oxygen exchange. Choices A, C, and D are incorrect as they do not align with the hypoventilation and CO2 retention observed in the patient. Option A (Respiratory alkalosis) would be characterized by increased respiratory rate and low CO2 levels. Option C (Metabolic acidosis) involves non-respiratory causes like kidney dysfunction. Option D (Metabolic alkalosis) results from excessive loss of acids like vomiting.