1. A nurse is caring for a patient with chronic obstructive pulmonary

disease (COPD) who has been admitted with an acute exacerbation. The

nurse notices that the patient's oxygen saturation is 88% on room air.

What is the most appropriate action for the nurse to take?

a) Administer oxygen via nasal cannula at 2 L/min

b) Administer oxygen via non-rebreather mask at 15 L/min

c) Administer oxygen via venturi mask at 24% FiO2

d) *Administer oxygen via nasal cannula at 1 L/min*

Rationale: The correct answer is d. Patients with COPD have a chronic

hypoxic drive to breathe and may experience respiratory depression if

given too much oxygen. The goal is to maintain their oxygen saturation

between 88% and 92%. A nasal cannula at 1 L/min can provide about

24% FiO2, which is appropriate for this patient. Options a and b would

deliver too much oxygen and could cause carbon dioxide retention and

respiratory acidosis. Option c would deliver a fixed concentration of

oxygen, but a venturi mask is more suitable for patients who require

precise oxygen delivery, such as those with acute respiratory distress

syndrome (ARDS).

2. A nurse is conducting a health history interview with a patient who has

a history of hypertension, diabetes mellitus, and coronary artery disease.

The nurse asks the patient about their medication adherence and learns

that the patient often forgets to take their medications or skips doses when

they feel well. What is the best way for the nurse to address this issue with

the patient?

a) *Use motivational interviewing techniques to explore the patient's

reasons for non-adherence and help them identify strategies to improve

their medication-taking behavior*

b) Educate the patient about the importance of taking their medications as

prescribed and the potential complications of uncontrolled hypertension,

diabetes, and coronary artery disease

c) Refer the patient to a social worker or a case manager who can assist

them with obtaining their medications and remind them of their

appointments

d) Prescribe a pill organizer or a medication reminder app for the patient

to use to keep track of their medications and doses

Rationale: The correct answer is a. Motivational interviewing is a client-