The healthcare provider is caring for a client who has heart failure and a history of asthma. The provider reviews the orders and recognizes that clarification is needed for which of the following medications?

Correct Answer: B

Rationale: The correct answer is B: Fluticasone. Fluticasone is an inhaled corticosteroid used to treat asthma, which can worsen heart failure symptoms. The healthcare provider needs to clarify this medication due to the client's history of asthma and heart failure. Carvedilol (A) is a beta-blocker used to treat heart failure. Captopril (C) is an ACE inhibitor also used in heart failure. Isosorbide dinitrate (D) is a vasodilator used for heart failure and angina, not contraindicated in asthma.

Correct Answer: D

Rationale: The correct answer is D: A hyperextended position. During bronchoscopy with a rigid scope, the client's neck needs to be hyperextended to facilitate optimal insertion of the scope into the trachea. Hyperextension straightens and opens up the airway, providing better visualization and access to the bronchial tree. Choice A (flexed position) would obstruct the airway and make insertion difficult. Choice B (extended position) would not provide the necessary alignment for scope insertion. Choice C (neutral position) may not offer sufficient airway visibility and access. In summary, a hyperextended position is crucial for successful bronchoscopy with a rigid scope, as it ensures proper alignment, airway visibility, and scope insertion.

Correct Answer: A

Rationale: The correct answer is A: Withhold food and liquids until the client's gag reflex returns. After a flexible bronchoscopy, the client may have a decreased gag reflex due to topical anesthesia used during the procedure, which increases the risk of aspiration. Withholding food and liquids helps prevent aspiration until the gag reflex returns, usually within 1-2 hours. B: Irrigating the client's throat every 4 hours is unnecessary and may not be indicated post-bronchoscopy. C: Having the client refrain from talking for 24 hours is not necessary after a flexible bronchoscopy unless specifically instructed by the healthcare provider. D: Suctioning the client's oropharynx frequently is not indicated unless there is a clinical indication for it, such as excessive secretions or respiratory distress. Frequent suctioning can increase the risk of trauma to the airway.

Correct Answer: C

Rationale: The correct answer is C, increased heart rate, as it indicates a potential complication such as hemorrhage or pneumothorax post-thoracentesis. An increased heart rate can signify hypovolemia or respiratory distress, requiring immediate provider notification. Serosanguineous drainage (A) is expected initially, discomfort (B) is common, and decreased temperature (D) is not typically a complication post-thoracentesis.

Correct Answer: C

Rationale: The correct answer is C: Respiratory acidosis. In this case, the low pH indicates acidosis, and the elevated PaCO2 indicates respiratory involvement. In respiratory acidosis, the lungs cannot eliminate enough CO2, leading to an increase in carbonic acid and a decrease in pH. Metabolic acidosis (choice A) would involve a primary decrease in bicarbonate levels, not seen in this scenario. Metabolic alkalosis (choice B) would involve an increase in bicarbonate levels, which is not indicated by the given information. Respiratory alkalosis (choice D) would have a low PaCO2 and an elevated pH, opposite of what is seen here.