Which action by the nurse is most important when administering a bronchodilator via nebulizer?

Correct Answer: D

Rationale: The correct answer is D: Ensuring the patient is sitting upright during the treatment. This is important because being in an upright position optimizes lung expansion and airflow, promoting better drug delivery to the lungs. Sitting upright also helps prevent potential aspiration of the medication. Choice A is incorrect because the breathing technique (in through nose, out through mouth) is not the most critical aspect of nebulizer administration. Choice B is incorrect because while monitoring for tachycardia is important, it is not the most crucial action during bronchodilator administration. Choice C is incorrect because diluting the medication with normal saline may be necessary for certain medications, but it is not the most important action when administering a bronchodilator via nebulizer.

Correct Answer: B

Rationale: The correct answer is B: Assess for tracheal deviation. This is the priority because it can indicate a pneumothorax, a potentially life-threatening complication of thoracotomy. Tracheal deviation could suggest a tension pneumothorax, which requires immediate intervention to prevent respiratory distress and cardiac compromise. Administering analgesics (A) may be necessary but not the first priority. Encouraging the use of an incentive spirometer (C) and positioning the patient in semi-Fowler's position (D) can help improve lung function but are not as urgent as assessing for tracheal deviation.

Correct Answer: B

Rationale: The correct initial action for a patient with suspected pulmonary embolism is to elevate the head of the bed and apply oxygen (Choice B). Elevating the head of the bed helps improve oxygenation and reduces the workload on the heart. Providing oxygen is crucial to ensure adequate oxygen supply to the tissues. Administering anticoagulants (Choice A) should come after stabilizing the patient. Preparing for a chest x-ray (Choice C) is important but not the immediate action. Placing the patient in a supine position (Choice D) can worsen the condition by reducing blood flow to the heart.

Correct Answer: B

Rationale: The correct answer is B: Rinse your mouth after using the inhaler. This is important because corticosteroid inhalers can cause oral thrush, a fungal infection in the mouth. Rinsing the mouth after use helps prevent this side effect. Choice A is incorrect because corticosteroid inhalers are used for long-term control, not during acute attacks. Choice C is incorrect as corticosteroid inhalers are usually taken on an empty stomach. Choice D is incorrect as using a spacer with the inhaler can actually improve drug delivery and effectiveness.

Correct Answer: B

Rationale: The correct interpretation is B: Metabolic acidosis. The low pH indicates acidosis. The low HCO3- level (<22 mEq/L) indicates a primary metabolic acidosis. The PaCO2 level is not elevated, ruling out respiratory compensation. Choice A is incorrect because the primary disturbance is metabolic, not respiratory alkalosis. Choice C is incorrect as it suggests both acidosis and alkalosis, which is not the case. Choice D is incorrect because the PaCO2 is not elevated, ruling out respiratory acidosis.