Which clinical finding is most indicative of progression from acute lung injury to 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: 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.

Correct Answer: B

Rationale: Rationale for Correct Answer B: The nurse's signature on the consent form confirms the client appears competent to provide consent. This is important as it ensures the client has the capacity to make informed decisions about their care. The nurse assesses the client's ability to understand the information provided regarding the procedure and its risks and benefits. By signing as a witness, the nurse acknowledges that the client is mentally competent to provide consent. Summary of Incorrect Choices: A: Incorrect. The nurse's signature does not determine if the client has a mental illness. This falls under the purview of the healthcare provider, not the nurse. C: Incorrect. While the nurse may have explained the risks and benefits, this is not the sole purpose of the nurse's signature on the consent form. D: Incorrect. The nurse's signature does not indicate the client's spouse agrees with the procedure; this is not the nurse's role in the consent process.

Correct Answer: D

Rationale: Correct Answer: D (Rescue the clients) Rationale: In a fire emergency, the top priority is to ensure the safety of individuals by rescuing them. Once the clients are safe, the nurse can proceed to other steps like pulling the fire alarm, confining the fire, and extinguishing it. By rescuing the clients first, the nurse minimizes the risk of harm and ensures everyone's safety. Summary of Incorrect Choices: A (Pull the fire alarm): While important, pulling the fire alarm should come after rescuing the clients to alert others and initiate the fire safety protocol. B (Confine the fire): Confining the fire is crucial but should be done after ensuring everyone's safety through rescue. C (Extinguish the fire): Extinguishing the fire is essential, but it should not be the first step as the priority is to rescue individuals from harm.