The nurse is caring for a client with acute respiratory distress syndrome (ARDS) on mechanical ventilation. Which intervention is most effective in preventing ventilator-associated pneumonia (VAP)?

Correct Answer: B

Rationale: The correct answer is B: Providing oral care with chlorhexidine. This intervention is effective in preventing VAP because it helps reduce the risk of bacterial colonization in the oral cavity, which can lead to aspiration of pathogens into the lungs. Proper oral care helps maintain oral hygiene and reduces the risk of ventilator-associated pneumonia. A: Performing hand hygiene before client care is important for preventing the spread of infections, but it directly does not prevent VAP. C: Suctioning the endotracheal tube every hour is necessary for maintaining airway patency but does not directly prevent VAP. D: Administering prophylactic antibiotics is not recommended as a routine practice for preventing VAP due to the risk of antibiotic resistance and other complications.

Correct Answer: C

Rationale: The correct answer is C because inhaling deeply and blowing out hard during pulmonary spirometry testing ensures accurate lung function measurements. This technique maximizes the volume of air exhaled, providing reliable test results. Choice A is incorrect because using an inhaler right before the test can affect the test results. Choice B is incorrect as fasting is not necessary for this test. Choice D is incorrect as blood pressure and pulse monitoring are not typically part of pulmonary spirometry testing.

Correct Answer: C

Rationale: The correct answer is C because the discontinuation of epoprostenol infusion in a patient with IPAH can lead to a sudden and severe worsening of symptoms, including potentially life-threatening pulmonary hypertension crisis. This requires immediate action to prevent complications. A: An O2 saturation of 90% is within an acceptable range and does not indicate an immediate crisis. B: A blood pressure of 98/56 mm Hg is slightly low but not critically abnormal to require immediate intervention. D: A prolonged INR may indicate altered coagulation but is not an immediate concern compared to the abrupt discontinuation of a critical medication like epoprostenol.

Correct Answer: A

Rationale: The correct answer is A: Use pursed-lip breathing during activities. Pursed-lip breathing helps COPD patients improve breathing efficiency by reducing air trapping. It slows down breathing rate and helps control shortness of breath during activities. This instruction is crucial for managing COPD symptoms. Choice B is incorrect because increasing oxygen flow rate without medical advice can be harmful and is not recommended as a self-management strategy for COPD. Choice C is incorrect as limiting fluid intake can lead to dehydration and worsen COPD symptoms. Choice D is incorrect as vaccinations are crucial for COPD patients to prevent respiratory infections and complications.

Correct Answer: C

Rationale: The correct answer is C because positioning the patient upright and providing oxygen therapy is crucial in severe respiratory distress to optimize oxygenation. This position helps improve lung expansion and ventilation. Administering a sedative (choice A) may worsen respiratory depression. Performing a complete physical assessment (choice B) is important but not the priority in an emergency situation. Initiating chest physiotherapy (choice D) can be beneficial but is not as immediate as providing oxygen and positioning.