The nurse is planning care for the client diagnosed with chronic obstructive pulmonary disease (COPD) who has a breathing rate of 32 per minute, elevated blood pressure, and fatigue. Which nursing diagnosis is the priority for this client?

Correct Answer: D

Rationale: The correct answer for the nursing diagnosis priority for a client with COPD exhibiting a breathing rate of 32 per minute, elevated blood pressure, and fatigue is D) Ineffective Breathing Pattern. In COPD, ineffective breathing patterns are a common issue due to airway obstruction and impaired gas exchange. The elevated breathing rate signifies the body's attempt to compensate for the decreased oxygen levels and increased carbon dioxide levels in the blood. Fatigue can result from the increased work of breathing associated with COPD. Option A) Ineffective Coping may be a secondary concern but addressing the client's physiological needs, such as breathing, takes precedence. Option B) Ineffective Airway Clearance is not the priority in this scenario as the client's airway obstruction is not the immediate issue. Option C) Anxiety may be present but is a psychological response secondary to the client's physiological distress. Educationally, understanding the priority of nursing diagnoses in respiratory conditions like COPD is crucial for providing effective care. By recognizing the signs and symptoms of ineffective breathing patterns, nurses can intervene promptly to optimize oxygenation and prevent respiratory distress in clients with COPD. This rationale highlights the importance of prioritizing physiological needs in nursing care planning.

Correct Answer: B

Rationale: In this scenario, option B is the correct answer because promptly reporting abnormal oxygen saturation to the patient's nurse is crucial for timely intervention and clinical decision-making. This immediate communication allows the nurse to assess the patient, determine the underlying cause of the low oxygen saturation, and implement appropriate interventions promptly. Option A is incorrect because simply reassessing oxygen saturation in a different location does not address the urgency of the situation or facilitate immediate intervention. Option C, encouraging the patient to rest quietly, does not address the critical need for prompt action when oxygen saturation is abnormal. Option D, asking the patient about respiratory difficulties, is not the best initial action as it delays informing the primary nurse and potentially delays necessary interventions. In an educational context, it is essential to emphasize the importance of prompt reporting of abnormal vital signs, such as oxygen saturation, to the appropriate healthcare provider. This practice ensures patient safety and timely management of potentially life-threatening situations. Teaching ancillary staff to prioritize communication of critical findings can significantly impact patient outcomes and improve the quality of care provided.

Correct Answer: A

Rationale: The correct answer to the question is A) The region of Earth's atmosphere absorbing UV rays; CFCs, HCFCs, etc. This is because the ozone layer is a protective layer in Earth's atmosphere that absorbs the majority of the Sun's harmful ultraviolet (UV) radiation. The ozone layer plays a crucial role in shielding life on Earth from the harmful effects of excessive UV radiation. However, the depletion of the ozone layer is primarily caused by human activities such as the release of chemicals like chlorofluorocarbons (CFCs) and hydrochlorofluorocarbons (HCFCs) into the atmosphere. These chemicals break down ozone molecules, leading to a reduction in the ozone layer's thickness and effectiveness in absorbing UV radiation. Option B) A layer below the Earth's crust is incorrect as it does not accurately describe the ozone layer in the Earth's atmosphere. Option C) A cycle producing oxygen is also incorrect as it does not relate to the function or composition of the ozone layer. Option D) None of the above is incorrect as option A clearly aligns with the definition and role of the ozone layer in the atmosphere. Educationally, understanding the importance of the ozone layer and the factors contributing to its depletion is crucial for students studying environmental science, atmospheric chemistry, or related fields. This knowledge is also relevant for healthcare professionals, as the depletion of the ozone layer can have significant health implications due to increased UV exposure. By comprehending the connection between human activities and environmental consequences like ozone layer depletion, individuals can make informed decisions to mitigate harmful impacts on the planet and promote sustainability.

Correct Answer: B

Rationale: In the context of oxygenation and respiratory function, understanding the role of surfactant in the alveoli is crucial. Type II pneumocytes are responsible for producing surfactant, which is a phospholipoprotein that reduces surface tension in the alveoli. This reduction in surface tension prevents alveolar collapse during expiration, ultimately promoting effective gas exchange. Choosing option B as the correct answer is essential because Type II pneumocytes are specialized cells designed for surfactant production. These cells play a critical role in maintaining lung compliance and preventing atelectasis, which can compromise oxygenation. Option A, Type I pneumocytes, are primarily involved in gas exchange due to their thin structure and large surface area. Goblet cells, option C, are found in the respiratory epithelium and are responsible for secreting mucus to trap pathogens and particulate matter, not surfactant production. Adipose cells, option D, are not directly involved in the production of surfactant or respiratory function. Educationally, understanding the specific functions of different alveolar cells enhances students' comprehension of respiratory physiology and the mechanisms underlying oxygenation. By clarifying the roles of Type II pneumocytes in surfactant production, learners can appreciate the intricate processes that ensure optimal gas exchange and lung function. This knowledge is fundamental for healthcare professionals in providing quality care to patients with respiratory conditions.

Correct Answer: B

Rationale: The correct answer is B) Chest tube thoracostomy. In the context of pleural effusion, a chest tube thoracostomy is the appropriate intervention to drain fluid or air from the pleural space, relieving pressure on the lungs and restoring proper oxygenation. Option A) Chest tube thoracotomy is incorrect because a thoracotomy involves a surgical incision into the chest wall, which is a more invasive procedure than a thoracostomy. Option C) Closed tube thoracotomy is incorrect because "closed tube" is not a commonly used term in the context of pleural effusion management. Option D) Closed tube thoracostomy is incorrect because a chest tube thoracostomy is an open procedure involving the insertion of a tube into the pleural space to drain fluid or air, not a closed system. Educationally, understanding the correct terminology and procedures related to oxygenation and respiratory health is crucial for healthcare professionals. Recognizing the difference between thoracostomy and thoracotomy is essential in providing appropriate care for patients with conditions affecting oxygenation, such as pleural effusion. This knowledge ensures timely and effective interventions to optimize respiratory function and patient outcomes.