A nurse is teaching a class about health disparities that impact access to health care. The nurse should include that which of the following factors can impact access to health care?

Choice A rationale

Joining a professional organization demonstrates professional commitment by showing a dedication to the advancement of the nursing profession and continuous learning. These organizations provide platforms for networking, advocacy, and the development of professional standards. By participating, a nurse shows a willingness to invest time and resources into the broader professional community, which strengthens the profession's collective voice and helps maintain high standards of practice and ethics throughout the healthcare delivery system.

Choice B rationale

Risk management focuses on identifying, assessing, and reducing threats to an organization's capital and earnings, as well as ensuring patient safety by preventing errors. While professional organizations may offer resources related to risk management, the act of joining one is a personal professional choice rather than a direct risk management activity. Risk management is typically a systematic process within a healthcare facility designed to minimize legal liability and clinical mishaps through specific protocols and monitoring.

Choice C rationale

Quality improvement involves systematic and continuous actions that lead to measurable improvements in healthcare services and the health status of targeted patient groups. Professional organizations often advocate for quality improvement and provide evidence based guidelines, but the membership itself is a professional behavior. Quality improvement is a process carried out within clinical settings to enhance patient outcomes, whereas joining an organization reflects a nurse's personal engagement with their professional community and standards.

Choice D rationale

Professional identity refers to how a nurse perceives themselves within the nursing role, encompassing their values, beliefs, and experiences. While joining a professional organization can help shape and strengthen a nurse's professional identity, it is more accurately described as an act of professional commitment. Professional identity is an internal developmental process, whereas membership in an organization is an external action that demonstrates a commitment to the growth and development of the profession as a whole.

Choice A rationale

Oxygen saturation of 88 percent indicates hypoxemia, as the normal range is typically 95 to 100 percent. Deep breathing exercises facilitate alveolar expansion and improve gas exchange by increasing the surface area available for oxygen diffusion into the pulmonary capillaries. This action helps recruitment of collapsed alveoli, thereby increasing the fraction of hemoglobin saturated with oxygen and raising the overall pulse oximetry reading to a safer clinical level.

Choice B rationale

Coughing every 4 hours is an inadequate frequency for a client experiencing acute desaturation. While controlled coughing helps clear secretions that might obstruct the airway, a 4 hour interval does not address the immediate need for improved oxygenation. Effective pulmonary hygiene usually requires more frequent interventions when saturation is low. Relying on such an infrequent schedule fails to provide the rapid physiological support necessary to correct the current hypoxemic state.

Choice C rationale

Decreasing the head of the bed is contraindicated because a flat or supine position can cause the abdominal organs to press against the diaphragm. This pressure restricts lung expansion and reduces tidal volume, further impairing ventilation and gas exchange. Most clients with low oxygen saturation benefit from semi-Fowler's or high-Fowler's positions, which use gravity to lower the diaphragm and maximize the chest cavity space for optimal inhalation.

Choice D rationale

Opioid analgesics are central nervous system depressants that can significantly decrease the respiratory rate and depth of ventilation. Administering these medications to a client who already has a low oxygen saturation of 88 percent could lead to further respiratory depression and potentially respiratory arrest. While pain management is important, using opioids in this context without addressing the underlying respiratory deficit is dangerous and clinically inappropriate for improving oxygenation.