The unlicensed assistive personnel (UAP) is bathing the client diagnosed with acute respiratory distress syndrome (ARDS). The bed is in a high position with the opposite side rail in the low position. Which action should the nurse implement?

Correct Answer: A

Rationale: The correct answer is A because demonstrating the correct technique for giving a bed bath ensures proper care for the client with ARDS. This includes maintaining proper positioning to prevent respiratory distress. Encouraging the UAP to put the bed in the lowest position (B) is incorrect as it may not be necessary and could potentially worsen the client's condition. Instructing the UAP to get another person to help (C) is unnecessary and may delay care. Providing praise for performing the bath safely (D) is inappropriate as it does not address the importance of proper technique in caring for a client with ARDS.

Correct Answer: B

Rationale: The correct answer is B: To minimize the risk of barotrauma and volutrauma. Low tidal volume ventilation in ARDS reduces the risk of lung injury by decreasing the pressure and volume delivered to the lungs, thus lowering the chances of barotrauma (lung injury from high pressure) and volutrauma (lung injury from excessive volume). This strategy helps protect the fragile alveoli, prevents further damage, and improves outcomes. Choice A is incorrect because low tidal volume ventilation does not directly prevent fluid accumulation in the alveoli. Choice C is incorrect because it focuses on carbon dioxide elimination, which is not the primary goal of low tidal volume ventilation in ARDS. Choice D is incorrect because although improving perfusion in dependent lung areas is important, it is not the primary benefit of low tidal volume ventilation in ARDS.

Correct Answer: A

Rationale: The correct answer is A: PaO2/FiO2 ratio less than 200. This ratio is a key indicator in diagnosing ARDS, with a value below 200 being a hallmark of the condition. ARDS is characterized by severe hypoxemia, which is reflected in a low PaO2/FiO2 ratio. The other choices are incorrect because bilateral wheezing (B) is more suggestive of asthma or COPD exacerbation, hyperinflation on chest x-ray (C) is not specific to ARDS, and fever and purulent sputum (D) may indicate an infection but are not specific to ARDS progression.

Correct Answer: C

Rationale: Rationale for Choice C: Providing frequent mouth care and oral hygiene is key to preventing ventilator-associated pneumonia in ARDS patients. This intervention helps reduce the risk of oral bacteria entering the lungs, which can lead to pneumonia. Maintaining oral hygiene also decreases the colonization of pathogens in the oropharynx, reducing the risk of aspiration. This intervention is supported by evidence-based practice guidelines for preventing ventilator-associated pneumonia. Summary of other choices: A: Scheduled prophylactic nasopharyngeal suctioning is not recommended as a routine preventive measure for ventilator-associated pneumonia in ARDS patients. B: Instilling normal saline down the endotracheal tube can increase the risk of infection and does not address the root cause of ventilator-associated pneumonia. D: Using high tidal volumes on the ventilator can exacerbate lung injury in ARDS patients and is not a preventive measure for ventilator-associated pneumonia.

Correct Answer: D

Rationale: Correct Answer: D Rationale: 1. Positive End-Expiratory Pressure (PEEP) helps open collapsed alveoli by maintaining pressure in the lungs during exhalation. 2. In ARDS, alveoli collapse, leading to ventilation-perfusion mismatch and hypoxemia. 3. By applying PEEP, alveoli are kept open, improving oxygenation and lung compliance. 4. Option A is incorrect as PEEP doesn't directly assist with breathing in and out or improve airflow. 5. Option B is incorrect as PEEP can affect cardiac output but the primary goal is to recruit collapsed alveoli. 6. Option C is incorrect as PEEP doesn't specifically prevent fluid from filling alveoli but rather helps with lung recruitment.