The nurse is caring for a patient suspected of having ARDS. What is the most likely diagnostic test ordered in the early stages of this disease to differentiate the patients symptoms from those of a cardiac etiology?

Correct Answer: B

Rationale: In early ARDS, distinguishing respiratory failure from cardiac causes like congestive heart failure (CHF) is crucial, and brain natriuretic peptide (BNP) levels are the most likely test ordered. Elevated BNP, secreted by the heart under strain, indicates cardiac etiology (e.g., pulmonary edema from CHF), whereas normal or low BNP supports ARDS, a non-cardiogenic lung injury with alveolar flooding. Carboxyhemoglobin measures carbon monoxide poisoning, relevant to inhalation injury but not routine for ARDS differentiation. CRP reflects inflammation, common in both ARDS and infection, but lacks specificity for cardiac versus pulmonary origin. A complete blood count provides general health data (e.g., infection) but doesn't pinpoint etiology. BNP, often paired with echocardiography, guides the nurse and team to tailor treatment ventilation for ARDS versus diuretics for CHF ensuring accurate early management of this critical condition.

Correct Answer: A

Rationale: For an emphysema patient with shortness of breath, sitting upright and leaning forward slightly optimizes respiratory mechanics. This position, often instinctive in COPD, elevates the diaphragm, reducing its flattening from hyperinflation, and engages accessory muscles (e.g., pectoralis) to aid expiration, easing dyspnea. Leaning forward may also reduce abdominal pressure on the thorax, enhancing lung expansion. Low Fowler's with neck hyperextension strains breathing by misaligning the airway and limiting diaphragm movement. Prone positioning, face-down, restricts chest expansion, worsening air trapping. Trendelenburg, head-down, elevates abdominal contents against the diaphragm, intensifying dyspnea. The nurse's assistance into this upright, forward-leaning posture often with arms supported maximizes ventilation, aligning with COPD management to relieve acute respiratory distress effectively.

Correct Answer: A

Rationale: Smoking cessation is vital in COPD because smoking increases mucus production, a key pathophysiologic effect. Cigarette smoke irritates goblet cells and mucous glands, overproducing thick mucus that clogs airways, impairs ciliary clearance, and fosters inflammation and infection central to COPD's chronic bronchitis component. Hemoglobin isn't destabilized; smoking forms carboxyhemoglobin, reducing oxygen capacity, but this is secondary. Alveoli don't shrink or collapse acutely emphysema involves their distention and destruction from elastase imbalance. The nurse's emphasis on mucus production educates the group on how smoking drives obstruction and symptoms (e.g., cough, dyspnea), reinforcing cessation's role in halting this cascade, per COPD pathogenesis and public health campaigns.

Correct Answer: B

Rationale: For an acute asthma exacerbation with persistent symptoms, the nurse expects anti-inflammatory drugs, primarily inhaled corticosteroids (e.g., budesonide), to gain underlying control. Asthma's root is airway inflammation corticosteroids reduce mucosal edema, mucus production, and hyperresponsiveness, preventing recurrent attacks and stabilizing lung function long-term. Rescue inhalers (e.g., albuterol) provide quick relief for acute bronchospasm but don't address inflammation, serving as short-term adjuncts. Antibiotics treat bacterial infections, irrelevant unless pneumonia complicates the case, which isn't typical in asthma. Antitussives suppress cough, counterproductive when cough clears mucus in asthma. The nurse anticipates corticosteroids often paired with beta-agonists per asthma guidelines (e.g., NHLBI), monitoring for delivery (e.g., MDI with spacer) and side effects (e.g., thrush), ensuring control of this chronic inflammatory state post-exacerbation.

Correct Answer: A

Rationale: Preoperative assessment aims to establish the patient's baseline of normal function vital signs, labs, and health history to anticipate and prevent postoperative complications like infection or respiratory failure. This baseline guides anesthesia dosing and surgical planning, ensuring deviations (e.g., hypoxia) are quickly recognized. Planning postoperative care, educating the patient and family, and gathering equipment are critical but follow this initial step they're interventions, not the assessment's primary purpose. By documenting norms like respiratory rate or cardiac status, the nurse sets a reference for intraoperative and postoperative monitoring, reducing risks tied to individual variability. This foundational data collection aligns with safety protocols, enabling tailored care throughout the perioperative process.