The nurse is admitting a patient diagnosed with an acute exacerbation of chronic obstructive pulmonary disease (COPD). How should the nurse determine the appropriate O₂ flow rate?

Correct Answer: B

Rationale: In the context of a patient with an acute exacerbation of COPD, maintaining the pulse oximetry level at 90% or greater (Option B) is the correct approach for determining the appropriate O₂ flow rate. This practice ensures an adequate oxygenation level for the patient while also preventing the risk of suppressing the patient's respiratory drive. Option A is incorrect because minimizing O₂ use to avoid dependency can compromise the patient's oxygenation needs during an acute exacerbation. Option C, administering O₂ based on the patient's level of dyspnea alone, may not guarantee optimal oxygenation. Option D is incorrect as limiting O₂ to 2 L/min may not be sufficient to maintain adequate oxygenation in a patient with a COPD exacerbation. Educationally, understanding the rationale behind the appropriate O₂ flow rate in COPD exacerbation is crucial for nurses to provide safe and effective care. By prioritizing oxygen saturation levels while considering the risk of respiratory drive suppression, nurses can optimize patient outcomes in managing COPD exacerbations. This knowledge helps nurses make informed clinical decisions that align with evidence-based practice guidelines, ensuring patient safety and well-being.

Correct Answer: A

Rationale: Because iodine-based contrast media is used during a spiral CT, the patient may need to have the CT scan without contrast or be premedicated before injection of the contrast media. The increased pulse, low oxygen saturation, and tachypnea all indicate a need for further assessment or intervention but do not indicate a need to modify the CT procedure.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) Patient with a muffled voice. This patient requires rapid assessment because a muffled voice can be indicative of a peritonsillar abscess. Peritonsillar abscesses can lead to airway compromise and require immediate evaluation and intervention to prevent respiratory distress and potential life-threatening situations. Option B) Patient with a nasal fracture may have pain, swelling, and bleeding but these symptoms do not typically lead to a muffled voice or immediate airway concerns. Option C) Patient with epistaxis (nosebleed) usually presents with bleeding from the nose and does not directly relate to a muffled voice. Option D) Patient with allergic rhinitis may have nasal congestion and sneezing due to allergies but this does not typically cause a muffled voice or require urgent assessment for airway compromise. Educationally, it is important for healthcare providers to recognize the significance of certain symptoms like a muffled voice which can be a red flag for potentially serious conditions. Understanding the urgency of assessing and managing patients based on specific clinical presentations is crucial in providing safe and effective care. This question highlights the importance of prioritizing assessments based on critical symptoms to ensure timely interventions and positive patient outcomes.

Correct Answer: A

Rationale: The correct answer is A) Use of protective equipment. This is the most effective action for preventing lung disease as it directly addresses the root cause of exposure to harmful substances. Protective equipment, such as masks, can prevent inhalation of harmful particles and chemicals that can lead to lung damage over time. Option B) Early treatment is important for managing lung diseases once they have developed, but it does not prevent the initial onset of the disease. Option C) Monitoring symptoms can help in early detection of lung disease, but without the use of protective equipment, the damage may already be done. Option D) Frequent check-ups are important for overall health maintenance and early detection of diseases, but they do not directly prevent lung disease. In an educational context, it is crucial to emphasize the importance of prevention when it comes to lung health. Teaching individuals about the significance of using protective equipment in environments where they may be exposed to harmful substances can help them take proactive steps to safeguard their lung health. By understanding the root causes of lung disease and the actions that can be taken to prevent it, individuals can make informed decisions to protect their respiratory system.

Correct Answer: C

Rationale: The correct answer to how a chest wound should be dressed to prevent tension pneumothorax is option C, which is to tape the dressing on three sides. This method is effective because it allows for the release of air during expiration when intrapleural pressure increases, preventing the buildup of tension pneumothorax. By taping the dressing on three sides, it creates a flutter valve effect, enabling air to escape while maintaining a barrier to prevent air from entering the pleural space during inspiration. Option A, using an occlusive dressing, is not the best choice because it can lead to the development of tension pneumothorax by completely sealing the wound and trapping air inside the pleural space. Option B, positioning the individual on the left side, is not a recommended method for dressing a chest wound to prevent tension pneumothorax as it does not address the issue of air escaping or entering the pleural space. Option D, fully taping the dressing, does not allow for the necessary release of air and can potentially exacerbate the condition. Educationally, understanding the rationale behind dressing a chest wound in a particular way is crucial for healthcare providers, especially those involved in emergency care or trauma situations. This knowledge can significantly impact patient outcomes by preventing complications such as tension pneumothorax, which can be life-threatening if not managed appropriately. Proper dressing techniques based on physiological principles are essential skills for healthcare professionals to master in order to provide effective and safe patient care.