What is your evaluation of Mr. Smith’s skin rash and slight fever after taking INH for 3 months?

Correct Answer: D

Rationale: The correct answer is D because Mr. Smith's skin rash and slight fever after taking INH for 3 months indicate early signs of drug hypersensitivity. This is supported by the timing of symptoms appearing after prolonged use, which is typical for drug hypersensitivity reactions. Other choices are incorrect: A, developing hepatitis would show different symptoms; B, not taking INH would not explain the symptoms; C, a normal response would not involve rash and fever.

Correct Answer: C

Rationale: The correct answer is C, to monitor respiratory status and observe for signs of hypoxia. This is because sudden diarrhea and high fever can indicate a potential infectious illness, which can lead to respiratory complications such as pneumonia. Monitoring respiratory status is crucial to detect any signs of respiratory distress or hypoxia early on. A: Determining his work on an air-conditioning unit is not a priority at this time as it does not directly address his immediate health concerns. B: Placing the patient in isolation may be necessary later depending on the diagnosis, but it is not the priority at this moment. D: Beginning discharge teaching is not appropriate as the patient is currently experiencing acute symptoms that require immediate attention. In summary, monitoring respiratory status is the priority to ensure early detection and intervention for any potential respiratory complications in a patient with sudden diarrhea and high fever.

Correct Answer: C

Rationale: The correct answer is C: Increased anteroposterior chest diameter. In patients with chronic obstructive pulmonary disease (COPD), like Mr. Puff, there is often air trapping leading to hyperinflation of the lungs. This results in an increased anteroposterior chest diameter, known as a "barrel chest" appearance. Option A (‘Blue bloater’ appearance) is associated with chronic bronchitis, not necessarily COPD. Option B (Copious amount of thin sputum) is more indicative of bronchiectasis. Option D (Prolonged inspiratory time) is a nonspecific finding and not typically associated with COPD.

Correct Answer: D

Rationale: In the context of pharmacology and adult medical-surgical care, the correct answer, option D, stating the rationale for avoiding crowds when influenza or colds are prevalent, best reflects the achievement of avoiding infections for Mr. Puff. This is because individuals with compromised respiratory systems, such as Mr. Puff, are more susceptible to respiratory infections like influenza and colds, which can lead to serious complications. Avoiding crowded places reduces the risk of exposure to infectious agents, thereby helping to prevent infections. Option A, explaining the reason for avoiding aerosol sprays and powders, is not the best choice as it pertains more to respiratory irritants and allergens rather than infectious agents. Option B, explaining the reason for avoiding unnecessary physical activity, while important for general health and well-being, is not directly related to avoiding infections in Mr. Puff's case. Option C, listing causative organisms of bronchial infections, though relevant to understanding infections, does not directly address strategies for infection prevention. In an educational context, understanding the rationale behind infection prevention strategies is crucial for providing safe and effective care to patients, especially those with underlying health conditions. By selecting option D, students learn the importance of infection control measures tailored to specific patient needs, which is a fundamental aspect of pharmacological and medical-surgical nursing practice. This reinforces the significance of individualized care and patient education in preventing complications and promoting health outcomes.

Correct Answer: A

Rationale: Administering oxygen in treating COPD is crucial to relieve hypoxemia, which is a common complication of this condition. In COPD, there is impaired gas exchange in the lungs due to damaged airways and alveoli, leading to decreased oxygen levels in the blood. Supplemental oxygen helps to increase the oxygen concentration in the blood, improving oxygen delivery to tissues and organs, thereby alleviating symptoms like shortness of breath and preventing complications of hypoxemia, such as tissue damage and organ dysfunction. Option B is incorrect because administering oxygen does not increase carbon dioxide retention. In fact, it can help reduce carbon dioxide levels by improving oxygenation, which can indirectly decrease the respiratory drive as it is often driven by hypoxemia rather than hypercapnia. Option C is incorrect because administering oxygen does not increase the intensity of respiratory drive. In patients with COPD, the respiratory drive is often blunted due to chronic hypercapnia, so providing oxygen can actually help to normalize respiratory drive by correcting hypoxemia without increasing the drive to dangerous levels. Option D is incorrect because administering oxygen does not directly decrease respiratory secretions. Oxygen therapy is primarily aimed at improving oxygenation in COPD patients and does not have a direct effect on respiratory secretions. Educationally, understanding the rationale for administering oxygen in COPD is essential for nurses and healthcare professionals caring for patients with this condition. It underscores the importance of proper oxygen therapy to manage hypoxemia effectively and improve patient outcomes.