The nurse observes a student who is listening to a patient's lungs. Which action by the student indicates a need to review respiratory assessment skills?

Correct Answer: B

Rationale: The correct answer is B because the student should listen during both inspiratory and expiratory phases without moving the stethoscope in between. This ensures a comprehensive assessment of lung sounds. Choice A is correct as comparing breath sounds from side to side is a good practice. Choice C is also correct as starting at the apices and moving down towards the bases is a proper technique. Choice D is incorrect because instructing the patient to breathe slowly and deeply is a standard instruction for a respiratory assessment.

Correct Answer: B

Rationale: The correct answer is B: Instruct the patient to refrain from smoking for 6 hours before testing. Rationale: 1. Smoking can affect lung function, so refraining from smoking before pulmonary function tests helps obtain accurate results. 2. Smoking can lead to airway constriction, affecting test outcomes. 3. The 6-hour timeframe allows for a sufficient period for the effects of smoking to diminish. 4. Not smoking before testing ensures that the test results reflect the patient's true lung function. Summary: - Choice A is incorrect because using bronchodilators before the test may alter the test results. - Choice C is incorrect as fasting is not necessary for pulmonary function tests. - Choice D is incorrect as incentive spirometry is not typically performed before pulmonary function tests.

Correct Answer: B

Rationale: The correct next step is to schedule a chest x-ray to evaluate for active tuberculosis. A positive Mantoux test indicates exposure to the tuberculosis bacteria but doesn't confirm active disease. A chest x-ray helps determine if there is active infection in the lungs. Starting four-drug therapy for tuberculosis (A) is premature without confirming active disease. Repeating the Mantoux test (C) is unnecessary as it won't differentiate between latent and active infection. Administering the BCG vaccine (D) is not indicated in this case as the patient already has a positive Mantoux test.

Correct Answer: A

Rationale: The correct answer is A because maintaining oxygen saturation above 90% is essential for patients with COPD to prevent further respiratory complications. Oxygen therapy helps improve oxygen levels in the blood, reducing the workload on the heart and improving overall oxygen delivery to tissues. Administering oxygen is the immediate intervention needed to improve the patient's oxygen saturation. Option B is incorrect as deep breathing exercises alone may not be sufficient to increase oxygen levels in the blood significantly. Option C is incorrect because notifying the healthcare provider is not the immediate action needed to address the low oxygen saturation. Option D is incorrect as monitoring respiratory rate alone does not address the immediate need to improve oxygen saturation levels.

Correct Answer: A

Rationale: The correct answer is A: Performing oral care with chlorhexidine. This action is effective in preventing VAP by reducing the bacterial load in the oral cavity, which can decrease the risk of aspiration of pathogens into the lungs. Chlorhexidine has antimicrobial properties that help to kill or inhibit the growth of bacteria. Regular oral care can help maintain oral hygiene and prevent colonization of pathogens. Choice B, administering antibiotics prophylactically, is not recommended as routine prophylactic use of antibiotics can lead to antibiotic resistance and disrupt the normal flora, potentially causing more harm than good. Choice C, suctioning the airway every hour, is important for maintaining airway patency but is not the most effective action for preventing VAP. Over-suctioning can irritate the airway and increase the risk of infection. Choice D, keeping the patient sedated at all times, is not a recommended practice as it can lead to complications such as ventilator-associated pneumonia. Sedation can impair the