The nurse observes diminished breath sounds on one side of a patient with a chest tube. What is the nurse's priority action?

Correct Answer: B

Rationale: The correct answer is B: Check the chest tube for kinks or obstructions. The priority action is to ensure the chest tube is functioning properly as diminished breath sounds could indicate a blockage or dislodgement. By checking for kinks or obstructions first, the nurse can address the immediate issue and prevent complications. Reassessing after 30 minutes (A) delays necessary intervention. Clamping the tube (C) can lead to a tension pneumothorax. Notifying the healthcare provider (D) is important but not immediate in this situation.

Correct Answer: C

Rationale: The correct answer is C: Use a tissue to cover your mouth when coughing. This is the priority instruction because TB is spread through respiratory droplets. By covering the mouth when coughing, the patient reduces the risk of spreading the infection to others. Choice A is incorrect because wearing a mask outdoors does not prevent the spread of TB as effectively as covering the mouth when coughing. Choice B is incorrect because stopping medications prematurely can lead to treatment failure and drug resistance. Choice D is incorrect because there is no need to avoid dairy products while on TB treatment unless specifically advised by a healthcare provider.

Correct Answer: C

Rationale: The most appropriate action is to instruct the patient to remain still during the thoracentesis procedure to minimize the risk of complications such as injury to surrounding tissues. Moving during the procedure can lead to inaccurate placement of the needle and potential damage. Positioning the patient in a semi-Fowler's position (A) is often used for comfort but not crucial for the procedure. Ensuring NPO status (B) is not necessary for thoracentesis. Administering analgesics (D) is not typically done before the procedure unless there is a specific reason.

Correct Answer: B

Rationale: The correct answer is B: Sitting upright and leaning over a bedside table. This position allows gravity to assist in moving the fluid away from the needle insertion site, reducing the risk of puncturing underlying structures. Sitting position also facilitates easier breathing during the procedure. A: Supine with the head of the bed flat is incorrect because it may not allow adequate drainage of the pleural effusion and increases the risk of complications. C: Prone with arms extended forward is incorrect as it does not promote effective drainage of the fluid and may cause discomfort to the patient. D: Lying on the unaffected side is incorrect as it does not utilize gravity to assist in fluid drainage and may not provide optimal access for the procedure.

Correct Answer: A

Rationale: Step 1: Identifying the correct answer - Choice A states the patient's history of no acute asthma attacks, which is relevant for a patient with COPD as it indicates good disease management. Step 2: Rationale - Patients with COPD may also have comorbid asthma, so a lack of asthma attacks suggests good control of both conditions, making the patient more likely to adhere to discharge teachings. Step 3: Summary - Choices B, C, and D are incorrect. B is irrelevant to improving compliance, C refers to spirometry testing technique, not compliance, and D suggests non-adherence to medication, which is detrimental in COPD management. Choice A emphasizes disease control and adherence, making it the most effective in improving compliance.