When teaching the patient about what was happening when experiencing an intrapulmonary shunt, which explanation is accurate?

Correct Answer: C

Rationale: The correct answer is C. In an intrapulmonary shunt, blood flows through the capillaries in the lungs without participating in gas exchange. This leads to poorly oxygenated blood mixing with well-oxygenated blood, reducing overall oxygenation levels. Choice A is incorrect because it describes a ventilation-perfusion mismatch, not an intrapulmonary shunt. Choice B is incorrect as it describes an intracardiac shunt, not an intrapulmonary shunt. Choice D is incorrect as it refers to conditions like pulmonary fibrosis, not intrapulmonary shunts.

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.

Correct Answer: C

Rationale: The correct answer is C. The nurse should explain the risks the client faces if she leaves the facility with a high INR level of 3.5 while on warfarin. This is important because a high INR puts the client at risk for bleeding, which can be life-threatening. By explaining the risks, the nurse is providing the client with crucial information to help her make an informed decision about leaving against medical advice. Choice A is incorrect because forcing the client to sign an AMA form may not be legally appropriate if the client has decision-making capacity. Choice B is incorrect because threatening the client with insurance consequences is not ethical and does not address the immediate health risk. Choice D is incorrect because involving security is not necessary in this situation and does not address the client's medical needs.