You are treating a COPD patient for mild shortness of breath when you note the presence of pursed lips and sighing-type respirations at 26/minute. Why would the patient present with pursed lips and frequent sighing?

Correct Answer: B

Rationale: The correct answer is B: To prevent atelectasis from occurring at the end of exhalation. Pursed lips and sighing respirations help create positive end-expiratory pressure (PEEP) in the airways, preventing alveolar collapse and promoting gas exchange. Pursed lips maintain airway patency, while sighing helps to recruit collapsed alveoli. A: Incorrect - Pursed lips and sighing are not related to expelling foreign bodies or irritants from the lower airway. C: Incorrect - Pursed lips and sighing are not associated with preventing pleural friction rub or pleurisy. D: Incorrect - Pursed lips and sighing do not directly increase the size of the air sacs in the lungs to improve oxygenation.

Correct Answer: D

Rationale: The correct answer is D: Urinary output. This is because urinary output is a direct indicator of kidney perfusion and function, reflecting the body's response to volume status. Increasing urinary output suggests adequate volume replacement, while decreasing output may indicate hypovolemia. Heart rate, hematocrit, and blood pressure can be influenced by various factors and may not always accurately reflect volume status. Urinary output is considered the most reliable guide to volume replacement during resuscitation as it provides real-time feedback on kidney perfusion and fluid balance.

Correct Answer: B

Rationale: The correct next step is to rewarm the burn victim with a core temperature of 34°C. Hypothermia increases mortality in burn patients. Rewarming is crucial to prevent further complications. Escharotomy is for circulation issues, oxygen mask for respiratory problems, and IV narcotics for pain management, but rewarming takes priority in this scenario to stabilize the patient's core temperature.

Correct Answer: B

Rationale: The correct answer is B: Tilt head and lift chin. This technique, known as the head-tilt chin-lift maneuver, is the simplest and most effective way to open the airway in an unconscious patient. By tilting the head back and lifting the chin, the tongue is moved away from the back of the throat, allowing for better airflow. This maneuver helps prevent airway obstruction and facilitates breathing. Explanation of why other choices are incorrect: A: "Pull out the tongue" - This is incorrect as it can potentially cause harm by pushing the tongue back further and obstructing the airway. C: Lift neck from behind - This is incorrect as it can cause further injury to the neck and spine of an unconscious patient. D: Jaw thrust - While jaw thrust is another technique used to open the airway, it is more complex and requires training to perform correctly, making it less simple than the head-tilt chin-lift maneuver.

Correct Answer: D

Rationale: The correct answer is D: Control of hemorrhage. This is the first priority in managing a long bone fracture to prevent life-threatening blood loss. Hemorrhage can lead to hypovolemic shock and must be addressed immediately. A: Reduction of pain can be addressed after hemorrhage control. B: Prevention of infection is important but secondary to hemorrhage control. C: Prevention of further soft tissue injury is important but not as critical as controlling hemorrhage.