The nurse assesses a patient with chronic obstructive pulmonary disease (COPD) who has been admitted with increasing dyspnea over the past 3 days. Which finding is important for the nurse to report to the health care provider?

Correct Answer: A

Rationale: The correct answer is A because an increased respiratory rate of 36 breaths/min in a patient with COPD and worsening dyspnea can indicate respiratory distress or impending respiratory failure. This finding is crucial to report promptly to the healthcare provider for further evaluation and intervention. Choice B is incorrect because an anterior-posterior chest ratio of 1:1 is within normal limits and not directly related to the patient's current respiratory distress. Choice C is incorrect as decreased lung expansion bilaterally can be expected in a patient with COPD and may not necessarily warrant immediate concern unless it is significantly asymmetric or accompanied by other concerning signs. Choice D is incorrect as hyperresonance to percussion may be a typical finding in COPD due to increased lung volumes and is not an immediate priority compared to the elevated respiratory rate.

Correct Answer: B

Rationale: The correct answer is B: Prothrombin time/international normalized ratio (PT/INR). PT/INR measures the clotting ability of the blood and is used to monitor the effectiveness of anticoagulant therapy. In patients with pulmonary embolism, the goal is to prevent further clot formation. Monitoring PT/INR helps adjust anticoagulant dosage to maintain therapeutic levels and prevent bleeding or clotting complications. Incorrect Choices: A: CBC provides information about red and white blood cells, not directly related to anticoagulant therapy monitoring. C: Serum creatinine is used to assess kidney function, not specifically related to anticoagulant therapy monitoring. D: Electrolyte levels are important for overall health, but not directly related to monitoring anticoagulant therapy effectiveness.

Correct Answer: C

Rationale: The correct answer is C because the patient should continue wearing a mask even after symptoms improve to prevent the spread of TB. Step 1: Wearing a mask helps minimize airborne transmission. Step 2: Discontinuing mask prematurely increases infection risk. Step 3: Options A, B, and D are correct as they promote isolation, ventilation, and precautions during the contagious period.

Correct Answer: C

Rationale: The correct action is to check the system for air leaks (Option C) because bubbling in the water-seal chamber indicates air is leaking into the system, which can compromise the chest tube's function. By identifying and addressing the air leak, the nurse can ensure proper drainage and prevent complications. Clamping the chest tube (Option A) can lead to tension pneumothorax. Increasing suction (Option B) can worsen the problem. Notifying the healthcare provider (Option D) should be done after checking for air leaks.

Correct Answer: A

Rationale: The correct answer is A: Use of accessory muscles during respiration. This finding in a patient with asthma indicates a need for immediate intervention because it signifies severe respiratory distress and impending respiratory failure. Accessory muscle use suggests that the patient is struggling to breathe and is unable to maintain adequate oxygenation. This requires prompt medical attention to prevent further deterioration. Summary: B: Oxygen saturation of 92% on room air may indicate mild hypoxemia but is not as urgent as the use of accessory muscles. C: Mild expiratory wheezing is a common finding in asthma exacerbations and may not necessarily require immediate intervention. D: Peak expiratory flow rate of 85% of personal best indicates moderate airflow limitation but does not necessarily require immediate intervention unless accompanied by other severe symptoms.