A client presents to the clinic with fatigue, poor appetite, general malaise, and vague joint pain that improves mid-morning. The client has been taking over-the-counter ibuprofen for several months. The healthcare provider makes an initial diagnosis of rheumatoid arthritis (RA).

Which laboratory test(s) should the nurse report to the healthcare provider? Select all that apply.

Choice A reason: Intubation is not the first step in managing COPD exacerbation unless the client is in severe respiratory failure (e.g., unresponsive, unable to protect airway, pH severely low). This client is alert, able to maintain vitals, so less invasive interventions should be tried first.

Choice B reason: High-flow oxygen at 100% can eliminate the hypoxic drive to breathe in COPD patients, leading to CO₂ retention and respiratory acidosis. Controlled oxygen therapy (e.g., nasal cannula or Venturi mask at 1–2 L/min or FiO₂ 24–28%) is preferred.

Choice C reason: This "tripod" position reduces work of breathing by optimizing diaphragmatic expansion and helping accessory muscles function more effectively. It is an evidence-based immediate nursing intervention for acute dyspnea in COPD.

Choice D reason: Obtaining a sputum sample for culture and sensitivity is important for identifying the cause of the infection but is not the immediate priority.

Choice A reason: This client is relatively stable and the care required is within the scope of practice for a practical nurse (PN). Postoperative care for a laparoscopic cholecystectomy typically involves monitoring vital signs, pain management, and encouraging early ambulation, which the PN can perform with supervision.

Choice B reason: The older client with a colostomy for colon cancer may require more complex care and education about stoma management, which might be better suited for the RN.

Choice C reason: An older adult scheduled for foot amputation due to diabetes complications may have complex needs related to diabetes management and preoperative care, which require the RN's expertise.

Choice D reason: An adult with alcoholism, cirrhosis, and hepatic encephalopathy requires close monitoring for changes in mental status and liver function, which is more appropriate for the RN to manage.