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A nurse is caring for a group of patients. Which patient should the nurse see first?

A.

A patient with hypercapnia wearing an oxygen mask

B.

A patient with a chest tube ambulating with the chest tube unclamped

C.

A patient with thick secretions being tracheal suctioned first and then orally

D.

A patient with a new tracheostomy and tracheostomy obturator at bedside

Answer and Explanation

The Correct Answer is B

A. A patient with hypercapnia requires monitoring, but wearing an oxygen mask indicates some level of intervention is in place.  

 

B. A patient with a chest tube should never ambulate with the chest tube unclamped, as this can lead to a collapsed lung and respiratory distress; thus, this patient should be prioritized.  

 

C. While a patient with thick secretions may need suctioning, this is not as critical as ensuring the safety of a patient with an unclamped chest tube. 

 

D. A patient with a new tracheostomy requires monitoring, but the presence of the obturator indicates readiness for emergencies; this does not take priority over the safety of the patient with the chest tube.


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Correct Answer is D

Explanation

A. An increase in heart rate does not directly affect hemoglobin levels; this option is incorrect.

B. A higher heart rate decreases diastolic filling time, as there is less time for the heart to fill between beats, which can lead to reduced stroke volume.

C. An increased heart rate does not inherently increase stroke volume; in fact, at very high rates, stroke volume can decrease due to reduced filling time.

D. The significant increase in heart rate to 164 beats/min can lead to decreased cardiac output due to compromised diastolic filling and reduced stroke volume.

Correct Answer is B

Explanation

A. While anxiety relief is important, holistic care encompasses the patient's overall well-being and not just the alleviation of symptoms.

B. Understanding how anxiety impacts the patient's daily functioning allows for a more comprehensive approach to care, addressing both psychological and practical concerns.

C. It is inappropriate to suggest to the patient that there is little hope for relief, as this can negatively affect their mental health.

D. Focusing solely on quick fixes does not address the underlying issues of chronic anxiety and may not lead to long-term improvements.

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