While obtaining a client’s health history related to smoking cigarettes, the nurse plans to determine the client’s smoking pack years. What information should the nurse obtain for this calculation? Select all that apply.
Packs of cigarettes smoked per day.
Number of attempts to quit smoking.
Client’s current age.
Age when the client started smoking.
Number of years the client smoked.
Correct Answer : A,D,E
Choice A rationale
Packs of cigarettes smoked per day is essential information for calculating smoking pack years.
Choice B rationale
The number of attempts to quit smoking is not required for calculating smoking pack years.
Choice C rationale
The client’s current age is not required for calculating smoking pack years.
Choice D rationale
The age when the client started smoking is necessary to determine the total number of years smoked.
Choice E rationale
The number of years the client smoked is essential for calculating smoking pack years.
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Correct Answer is A
Explanation
Choice A rationale: Administering oxygen via nasal cannula is the first priority in this scenario. The client’s oxygen saturation is 88% on room air, which indicates hypoxemia. Providing supplemental oxygen will help improve the client’s oxygenation and alleviate symptoms of shortness of breath. Ensuring adequate oxygenation is crucial to prevent further respiratory distress and potential complications.
Choice B rationale: Obtaining a sputum culture is important to identify the causative organism of the client’s respiratory infection and guide appropriate antibiotic therapy. However, this action is not the immediate priority. Addressing the client’s hypoxemia by administering oxygen takes precedence to stabilize the client’s condition.
Choice C rationale: Administering an antipyretic medication can help reduce the client’s fever and improve comfort. However, this is not the immediate priority. The client’s hypoxemia and respiratory distress need to be addressed first by administering oxygen.
Choice D rationale: Encouraging the client to increase fluid intake is important for maintaining hydration and helping to thin respiratory secretions. However, this action is not the immediate priority. The client’s hypoxemia and respiratory distress need to be addressed first by administering oxygen
Correct Answer is C
Explanation
Choice A rationale
Documenting the presence of borborygmi is appropriate, but it does not address the need for a thorough assessment of all quadrants. Borborygmi are loud, high-pitched, almost continuous gurgling sounds that indicate hyperactive bowel sounds.
Choice B rationale
Auscultating the remaining quadrants is necessary to complete the assessment and ensure that the findings are consistent throughout the abdomen. This step helps to identify any variations in bowel sounds that may indicate different underlying conditions.
Choice C rationale
Elevating the head of the client’s bed immediately is not indicated in this situation. The primary focus should be on completing the assessment of bowel sounds in all quadrants.
Choice D rationale
Using the bell of the stethoscope to auscultate again is not necessary, as the diaphragm is the appropriate part of the stethoscope to use for assessing bowel sounds. The diaphragm is better suited for picking up high-pitched sounds like borborygmi.