The nurse is caring for a client with a lower left lobe pulmonary abscess. Which position should the nurse instruct the client to maintain?

Correct Answer: A

Rationale: In the context of a client with a lower left lobe pulmonary abscess, the correct position for the nurse to instruct the client to maintain is the left lateral position (Option A). The rationale behind this instruction is to facilitate drainage and prevent pooling of secretions in the affected area. By positioning the client on the left side, gravity can assist in draining the abscess and reducing the risk of further complications such as pneumonia or respiratory distress. Option B (Supine, knees flexed) is not the optimal position for a client with a lower left lobe pulmonary abscess as lying flat on the back may lead to pooling of secretions in the affected lobe, potentially worsening the condition. Option C (Dorsal recumbent) is also not ideal in this case as it involves lying on the back, which as mentioned earlier, can lead to pooling of secretions and compromise respiratory function in a client with a pulmonary abscess. Option D (Knee-chest) is not the correct position for this client either. While the knee-chest position can be used to assist with drainage in some respiratory conditions, it may not be the most comfortable or practical position for a client with a lower left lobe pulmonary abscess. In an educational context, understanding the rationale behind positioning in specific respiratory conditions is crucial for nurses caring for pediatric clients with cardiovascular disorders. Proper positioning can significantly impact ventilation, oxygenation, and overall respiratory function, ultimately influencing patient outcomes. By mastering these principles, nurses can provide optimal care and support for clients with complex respiratory conditions like pulmonary abscesses.

Correct Answer: D

Rationale: In this scenario, the correct action for the nurse to take is to continue to monitor the fingers until the color returns to normal (Option D). This is because the client is exhibiting symptoms of Raynaud phenomenon, a condition characterized by vasospasm of the blood vessels in response to cold or stress. In Raynaud phenomenon, fingers first turn pale due to reduced blood flow, then cyanotic due to lack of oxygen, and finally red with a burning sensation as blood flow returns. Applying a cool compress (Option A) would exacerbate the vasoconstriction and worsen the symptoms. While monitoring oxygen saturation with a pulse oximeter (Option B) is important in some cases, it is not the priority here as the issue is related to vasospasm rather than decreased oxygenation. Reporting the finding to the healthcare provider (Option C) may be necessary eventually, but immediate intervention to address the vasospasm is more crucial in this acute situation. Educationally, this question highlights the importance of understanding the pathophysiology of Raynaud phenomenon and the appropriate nursing interventions. It underscores the need for nurses to recognize and respond to vascular disorders promptly to prevent further complications and provide optimal care for clients with such conditions.

Correct Answer: B

Rationale: The correct answer is option B) A 65-year-old fair-skinned male who is a construction worker. Fair-skinned individuals have less melanin in their skin, making them more susceptible to skin damage from UV radiation, which increases the risk of developing skin cancer. Additionally, working outdoors as a construction worker exposes him to prolonged sun exposure, further increasing his risk. Option A) A 16-year-old dark-skinned female who tans in tanning beds once a week is at risk for skin damage and premature aging but has a lower risk of developing skin cancer compared to fair-skinned individuals due to higher melanin levels. Option C) A 25-year-old dark-skinned male whose mother had skin cancer may have a genetic predisposition to skin cancer, but his dark skin provides natural protection against UV radiation, lowering his risk compared to fair-skinned individuals. Option D) A 70-year-old fair-skinned female who works as a secretary is at risk due to her fair skin, but her indoor job likely exposes her to less sun compared to an outdoor worker like the construction worker, reducing her risk compared to option B. In an educational context, understanding individual risk factors for skin cancer based on skin type, sun exposure, and genetic predisposition is crucial for healthcare providers to educate patients on preventive measures such as sun protection and regular skin screenings. This knowledge helps in personalized patient care and early detection of skin cancer.

Correct Answer: B

Rationale: The correct answer is B) Practice inhaling through the nose and exhaling slowly through pursed lips. This technique, known as pursed lip breathing, helps to slow down breathing, improve oxygen exchange, and reduce shortness of breath in patients with emphysema. It prevents small airways from collapsing, making breathing more efficient. Option A is incorrect because allowing additional time for physical activities does not directly address dyspnea management in emphysema. It may help reduce oxygen demand but does not teach the client a specific technique to manage dyspnea. Option C is incorrect as using a humidifier may be beneficial for some respiratory conditions, but it is not the most effective strategy for managing dyspnea in emphysema. Emphysema is characterized by air trapping in the lungs, not necessarily related to air humidity. Option D is also incorrect because strengthening abdominal muscles through leg raises does not directly target dyspnea management in emphysema. While overall physical fitness is important, specific breathing techniques like pursed lip breathing are more effective for dyspnea control in emphysema. In an educational context, it's important for nurses to understand and teach evidence-based strategies for managing respiratory conditions like emphysema. Teaching patients effective breathing techniques empowers them to take control of their symptoms and improve their quality of life. Nurses play a crucial role in educating patients on self-management strategies to promote better health outcomes.

Correct Answer: C

Rationale: In this scenario, option C is the most useful information in determining the possible cause of the exacerbation of eczema symptoms. The presence of a new dog can trigger allergic reactions in individuals with eczema due to pet dander and potential allergens present in the dog's fur or saliva. This information is crucial as it points towards a potential trigger for the worsening of symptoms. Option A is incorrect as the presence of a friend with eczema does not directly correlate with the exacerbation of the client's symptoms unless there was direct contact leading to an allergic reaction. Option B is less likely to be the cause as receiving an influenza immunization typically does not exacerbate eczema symptoms unless the client has a specific allergic reaction to the vaccine components. Option D is also less likely to be the cause as corticosteroid cream is a common treatment for eczema and should not worsen symptoms unless the cream itself is expired or contaminated. From an educational perspective, this question highlights the importance of understanding potential triggers for eczema exacerbations, such as exposure to new allergens like pet dander. It emphasizes the need for nurses to conduct thorough assessments and gather relevant information to identify and address the root cause of a client's worsening symptoms effectively.