The RN is instructing the unlicensed assistive personnel (UAP) regarding the care of a male client with a diagnosis of COPD. What is the highest priority nursing action to share with the UAP?

Correct Answer: B

Rationale: The correct answer is B: Keep the head of the bed elevated to 45 degrees. This is the highest priority action because it helps improve ventilation and oxygenation in clients with COPD by reducing the work of breathing. Elevating the head of the bed promotes optimal lung expansion and decreases the risk of respiratory distress. Choice A: Encouraging ambulation is important for overall health; however, maintaining proper positioning for respiratory function takes precedence in COPD clients. Choice C: While it is important to monitor and assist clients for safety reasons, maintaining proper positioning for respiratory function is more critical in this scenario. Choice D: While assisting with activities of daily living is essential, maintaining proper positioning for respiratory function is crucial in managing COPD symptoms.

Correct Answer: C

Rationale: The correct answer is C: Tachycardia. Albuterol is a beta-2 agonist bronchodilator that can stimulate beta-2 receptors in the heart, leading to tachycardia as a common side effect. This occurs due to the drug's sympathomimetic effects on the heart, increasing heart rate. Bradycardia (A) is not a typical side effect of albuterol. Hypoglycemia (B) is not a direct side effect of albuterol use. Hypotension (D) is less common with albuterol and is more associated with beta-1 receptor effects.

Correct Answer: B

Rationale: The correct answer is B: Checking for kinks or obstructions in the tubing. This is the priority action because high-pressure alarms indicate a blockage or restriction in the ventilator circuit, which can lead to inadequate ventilation and hypoxia. By checking for kinks or obstructions first, the nurse can address the immediate issue causing the alarm and ensure the client's safety. Silencing the alarm and notifying the healthcare provider (Choice A) can be done after addressing the alarm cause. Increasing oxygen flow rate (Choice C) may not resolve the issue and could potentially worsen the situation. Suctioning the client immediately (Choice D) is not appropriate without first identifying and addressing the cause of the high-pressure alarms.

Correct Answer: B

Rationale: The correct answer is B: Barrel-shaped chest. In emphysema, air becomes trapped in the lungs, causing overinflation and the chest to take on a barrel shape. This is due to the destruction of alveoli and loss of elastic recoil in the lungs. Frequent nighttime cough (A) may occur but is not specific to emphysema. Cyanosis (C) is more indicative of inadequate oxygenation, which may occur in emphysema but is not specific. Peripheral edema (D) is not typically associated with emphysema.

Correct Answer: A

Rationale: The correct answer is A: Decreased peripheral edema. Furosemide is a diuretic that helps reduce fluid volume in the body, which leads to decreased edema. Peripheral edema is a common manifestation of pulmonary edema, so a decrease in peripheral edema indicates that the furosemide is effectively reducing fluid overload. Increased respiratory rate (B) is a sign of respiratory distress, not medication effectiveness. Blood pressure of 150/90 mmHg (C) is within normal range and not a specific indicator of furosemide effectiveness. Weight gain of 2 kg in 24 hours (D) is a sign of fluid retention and not a desirable outcome when treating pulmonary edema.