The nurse monitors a patient in the emergency department after chest tube placement for a hemopneumothorax. The nurse is most concerned if which assessment finding is observed?

Correct Answer: A

Rationale: The correct answer is A) A large air leak in the water-seal chamber. This finding is of most concern because it suggests a persistent pneumothorax or malfunction of the chest tube, which can lead to inadequate lung re-expansion and potential respiratory compromise. Addressing this issue promptly is critical to prevent complications such as tension pneumothorax. Option B) 400 mL of blood in the collection chamber is not as concerning as an air leak because it indicates ongoing drainage of blood from the pleural space, which is expected after chest tube placement for a hemopneumothorax. Option C) Complaint of pain with each deep inspiration is a common finding post chest tube insertion and may indicate irritation of the pleura or chest wall. While this symptom should be managed, it is not as urgent as addressing an air leak. Option D) Subcutaneous emphysema at the insertion site can occur due to air tracking along tissue planes and is a common benign finding after chest tube placement. It is not as concerning as a large air leak that could compromise respiratory function. In an educational context, understanding the significance of monitoring chest tube drainage systems and recognizing concerning assessment findings is crucial for nurses caring for patients with chest tubes. Prompt identification and management of complications can prevent serious respiratory compromise and improve patient outcomes.

Correct Answer: C

Rationale: In this scenario, option C is the correct answer because it provides accurate information regarding the benefits of oxygen therapy for patients with COPD. Educating the patient that O₂ use can improve prognosis and enhance quality of life is crucial for promoting adherence to the prescribed therapy. This information empowers the patient to understand the importance of compliance and fosters positive health outcomes. Option A is incorrect because it is overly restrictive and may lead to misconceptions about O₂ therapy. Travel is possible with O₂ devices, and patients should be encouraged to continue their activities while using oxygen, with appropriate precautions in place. Option B is incorrect as it suggests increasing O₂ flow without any specific guidance or monitoring, which can be dangerous and potentially lead to oxygen toxicity. Adjusting oxygen flow should only be done under healthcare provider guidance. Option D is incorrect as it provides outdated and inaccurate information about the storage of oxygen. Oxygen tanks come in various sizes and durations, and they do not necessarily require large metal tanks that last for a specific duration. Educationally, understanding the rationale behind each answer option helps reinforce the importance of accurate and up-to-date information in patient education. It emphasizes the need for nurses to provide clear and evidence-based instructions to patients to ensure safe and effective self-management of their condition.

Correct Answer: B

Rationale: The correct answer is B) Instruct the patient to use the prescribed albuterol (Ventolin HFA) first. In this scenario, the patient's peak flow has decreased to 70% of their baseline, indicating a moderate exacerbation of asthma. Albuterol is a short-acting bronchodilator that helps to open up the airways quickly, making it the appropriate first step to manage acute symptoms and improve airflow. Option A is incorrect because sending the patient to the hospital emergency department would be an overreaction at this stage. Option C is not the first priority, although it is important to assess triggers, it is not the immediate action needed in this acute situation. Option D is also not the first step, as inhaled corticosteroids are used for long-term asthma control and not for immediate symptom relief. This question provides a valuable educational context by testing the nurse's ability to prioritize interventions based on the patient's peak flow readings. Understanding the use of bronchodilators like albuterol in managing asthma exacerbations is crucial for nurses to provide timely and effective care to patients with asthma. This scenario highlights the importance of quick decision-making and appropriate medication administration in acute asthma exacerbations.

Correct Answer: D

Rationale: All the values are abnormal, but the low PaO2 indicates that the patient is at the point on the oxyhemoglobin dissociation curve where a small change in the PaO2 will cause a large drop in the O2 saturation and a decrease in tissue oxygenation. The nurse should intervene immediately to improve the patient's oxygenation.

Correct Answer: B

Rationale: The crackles indicate that the patient may be developing pneumonia, a common complication of influenza, which would require aggressive treatment. Myalgia, headache, mild temperature elevation, and sore throat with cough are typical manifestations of influenza and are treated with supportive care measures.