While reading a physician’s note, a student learns the patient is having hypoxia. Which abnormal patient assessments would a student expect to find with hypoxia?

Choice A reason: Setting mutual goals is important but premature without assessing the patient’s knowledge. Goals depend on understanding gaps, which are identified through assessment. Without this, goals may be irrelevant, reducing teaching effectiveness, per patient education and learning theory principles.

Choice B reason: Teaching what the patient wants to know assumes prior assessment of their needs and knowledge of their baseline. Without assessing existing knowledge, the nurse risks delivering redundant or irrelevant information, decreasing engagement and retention, per adult learning and education strategies.

Choice C reason: Assessing the patient’s current knowledge of hypertension is the first, as it establishes a baseline understanding, identifying gaps and misconceptions. This guides tailored education, ensuring relevance and effectiveness, enhancing patient engagement, and adherence to management, per patient-centered education and health literacy principles.

Choice D reason: Evaluating outcomes follows education, not precedes it. Assessment of knowledge is needed first to inform teaching. Evaluation without teaching is illogical, as there are no interventions to assess, making this step irrelevant at the start, per educational process and nursing teaching frameworks.

Choice A reason: Crackles indicate fluid or mucus in alveoli, often from pneumonia or pulmonary edema. Deep breathing and coughing mobilize secretions, potentially clearing airways. Repeating auscultation assesses if crackles persist, guiding diagnosis. This intervention enhances gas exchange by clearing alveoli, reducing hypoxia risk, and is the first step before escalating care.

Choice B reason: Limiting fluid intake to less than 2,000 mL/day is inappropriate without a diagnosis like heart failure. Crackles suggest alveolar fluid, but restricting fluids could worsen dehydration in infections like pneumonia. Deep breathing and coughing are prioritized to clear airways, improving oxygenation, while fluid restriction requires medical evaluation of underlying causes.

Choice C reason: Preparing antibiotics assumes a bacterial infection, but crackles may stem from non-infectious causes like pulmonary edema. Antibiotics target bacterial cell walls but are premature without confirmed infection. Repeating auscultation after coughing assesses airway clearance, guiding whether further diagnostic tests or treatments, like antibiotics, are needed based on findings.

Choice D reason: Semi-Fowler’s position aids breathing but does not address crackles directly. Crackles indicate fluid or mucus obstructing alveoli, impairing gas exchange. Deep breathing and coughing mobilize secretions, potentially resolving crackles, while positioning is a supportive measure. Repeating auscultation after coughing is the priority to assess airway clearance and guide interventions.