The nurse is caring for an 82-year-old patient with a diagnosis of tracheobronchitis. The patient begins complaining of right-sided chest pain that gets worse when he coughs or breathes deeply. Vital signs are within normal limits. What would you suspect this patient is experiencing?

Correct Answer: C

Rationale: Right-sided chest pain worsening with coughing or deep breathing in an 82-year-old with tracheobronchitis suggests pleuritic pain, likely from pleural inflammation secondary to the airway infection. Pleurisy's hallmark is sharp, movement-exacerbated pain due to irritated pleural surfaces rubbing together, often unilateral, and may decrease as fluid accumulates later. Stable vital signs rule out severe systemic issues. Traumatic pneumothorax requires injury, absent here, and would show respiratory distress or absent breath sounds. Empyema, a pleural infection, typically involves fever and systemic signs, not just pain, and isn't indicated without infection escalation. Myocardial infarction causes central, pressure-like pain, often with vital sign changes (e.g., tachycardia, hypotension), not pleuritic features. The nurse's suspicion of pleuritic pain prompts pain management and monitoring for progression, aligning with tracheobronchitis complications.

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.

Correct Answer: A

Rationale: For a minor procedure like arm cyst removal, starting with clear liquids, soup, and crackers, then advancing as tolerated, best supports diet progression. Anesthesia can slow gastrointestinal motility, risking nausea; a gradual approach tests tolerance, avoiding vomiting that could strain the surgical site. No limitations risk digestive upset from heavy foods too soon. A 24-hour clear liquid restriction is excessive for ambulatory surgery recovery is faster. Timed progression (2 hours each) is too rigid; tolerance varies. This flexible, patient-led explanation ensures comfort and hydration, aligning with ambulatory care standards for quick, safe recovery.