The nurse is preparing to administer ibuprofen to a client for pain relief. The client is diagnosed with a bleeding disorder. What should the nurse do?

Correct Answer: C

Rationale: The correct answer is C: Contact the healthcare provider (HCP). Ibuprofen can worsen bleeding in clients with a bleeding disorder. The nurse should consult the HCP to determine a safer alternative for pain relief. Administering the medication (A) could lead to complications. Administering with food (B) does not address the risk of worsening bleeding. Asking the client if the medication is desired (D) is not appropriate as the nurse's priority is the client's safety. Consulting the HCP ensures a proper and safe plan of care.

Correct Answer: C

Rationale: The correct answer is C: Reality orientation. This intervention involves helping the older adult understand and be more aware of their time, place, and person. It helps them stay oriented to their surroundings and maintain a sense of reality. This can be achieved through methods like displaying clocks, calendars, and familiar objects, providing consistent communication about time and place, and encouraging engagement in daily routines. Reminiscence (A) focuses on recalling past memories, Validation therapy (B) validates the emotions and feelings of the individual rather than emphasizing reality, and Body image interventions (D) are unrelated to the goal of helping the person be more in touch with time, place, and person.

Correct Answer: D

Rationale: The correct answer is D: Ensure that the ET tube is secure. This is important to prevent accidental extubation and maintain proper airway support. Securing the ET tube also prevents movement that can lead to tissue damage. Option A is incorrect as the ET tube may need adjustment. Option B is unnecessary unless there are specific concerns. Option C is important but ensuring the tube is secure takes precedence.

Correct Answer: A

Rationale: The correct answer is A: Positive pressure ventilation. Positive pressure ventilation helps improve oxygenation by increasing the mean airway pressure, which helps recruit collapsed alveoli and improve ventilation-perfusion matching in the presence of an intrapulmonary shunt. This therapy can effectively increase the PaO2 levels in this patient. Choice B: Oxygen administration at a FIO2 of 100% may not be sufficient to overcome the intrapulmonary shunt and improve oxygenation significantly. Choice C: Administration of O2 per nasal cannula at 1 to 3 L/min may not provide enough oxygen to overcome the shunting effect and improve oxygenation adequately. Choice D: Clearance of airway secretions with coughing and suctioning may be beneficial for airway clearance but is not directly related to correcting the underlying oxygenation issue caused by the intrapulmonary shunt.

Correct Answer: C

Rationale: The correct answer is C because in pulmonary fibrosis, there is thickening of the alveoli which leads to decreased transfer of oxygen into the blood. This happens because the thickened alveolar walls make it harder for oxygen to pass from the air sacs into the bloodstream. This results in poor oxygenation of the blood. Option A is incorrect because too-rapid movement of blood flow through the pulmonary blood vessels does not directly affect oxygenation in pulmonary fibrosis. Option B is incorrect because incomplete filling of the alveoli with air due to reduced respiratory ability may impact oxygenation, but this is not the primary mechanism in pulmonary fibrosis. Option D is incorrect because a mismatch between lung ventilation and blood flow through the blood vessels is not the main issue in pulmonary fibrosis; it is more relevant in conditions like pulmonary embolism.