A nurse in a clinic is caring for a female client who has gonorrhea.
Which of the following actions should the nurse take?

Choice A rationale

Administering an IV infusion like Lactated Ringer's addresses potential hypovolemia or shock but is not the immediate priority for a client with pulmonary embolism (PE). PE primarily causes an obstruction of pulmonary blood flow, leading to ventilation-perfusion (V/Q) mismatch and resulting in hypoxemia, which must be addressed first.

Choice B rationale

IV morphine can alleviate the pleuritic chest pain and anxiety associated with a pulmonary embolism by depressing the central nervous system and reducing myocardial oxygen demand. However, managing pain is a secondary intervention to the life-threatening impairment of oxygenation.

Choice C rationale

Initiating cardiac monitoring is vital for detecting potential complications such as dysrhythmias or right heart strain secondary to increased pulmonary vascular resistance. Nevertheless, the immediate threat to life is profound hypoxemia due to the massive V/Q mismatch, making oxygen delivery paramount.

Choice D rationale

Beginning oxygen therapy is the priority intervention because a pulmonary embolism obstructs blood flow to the alveoli, causing a severe ventilation-perfusion (V/Q) mismatch and hypoxemia. Supplemental oxygen directly increases the PaO_2 and SaO_2, which are essential for maintaining adequate tissue oxygenation and preventing organ damage.

Choice A rationale

Vitamin D is crucial for calcium absorption in the gut, which is essential for bone mineralization and strength. Osteoporosis is characterized by decreased bone mass, so a decrease in Vitamin D intake would exacerbate the condition by impairing calcium homeostasis and potentially leading to hypocalcemia and increased bone resorption.

Choice B rationale

Weight-bearing exercises, such as walking, stimulate osteoblast activity, promoting bone formation and increasing bone mineral density. A consistent regimen, such as walking five times a week, applies mechanical stress to the bone, which is a known physiological stimulus for bone remodeling and is effective in slowing bone loss associated with osteoporosis.

Choice C rationale

Corticosteroids (e.g., prednisone) are well-known to be a risk factor for osteoporosis. They increase bone resorption, decrease bone formation, and impair calcium absorption, leading to accelerated bone loss. Their use would be contraindicated for managing osteoporosis symptoms, as it worsens the underlying pathology.

Choice D rationale

Applying cool clothes or ice is primarily effective for acute inflammation or muscle strains. While potentially helpful for temporary joint pain, it does not address the underlying systemic pathology of osteoporosis, which is a reduction in bone density and structural integrity, not a primary inflammatory joint process. Management focuses on slowing bone loss and preventing fractures.