The client is admitted to the emergency department complaining of shortness of breath, and is febrile. Vital signs are T 101.2; P 94; RR 24; BP 96/54.  Which concept does the nurse identify as an immediate concern? Select all that apply 

The client was sent to the ED by their provider The client was in the office for an appointment and the provider believes that the client has pneumonia. Client has elevated temperature, fatigue, muscle aches, chills, dyspnea, and a productive cough with yellow-greenish sputum. Client also reports nausea and diarrhea for the last 24 hours.   Past medical history: Asthma and diabetes mellitus type 2.   Current medications: Albuterol 2 inhalations per metered dose inhaler every 6 hr.  Metformin 500 mg PO BID. Vital Signs Temperature: 39.7º C (103.4º F)Apical Pulse: 110/minRespiratory Rate: 26/minBlood Pressure: 100/54 mm HgPulse Oximetry: 87% on room air Nurses’ Notes (1200) Skin warm and dry, face flushed. Skin turgor poor. Mucous membranes pink and dry. Heart sounds regular and moderate. Lung sounds crackles. (1300) Sitting at bedside, reports of increased shortness of breath. Respiratory rate irregular at 28/min. Oxygen saturation 90%. Apical Pulse 108/min. Reports loss of taste. Provider notified. Which of the following actions should the nurse take? Select all that apply

Which referral is most appropriate for a client diagnosed wih end- stage COPD?

Which concept should have the highest priority dor discharge during teaching for a client who has chronic bronchitis and is a smoker?

A nurse has received change of shift report on the following clients. Which patient should the nurse prioritize to see first?

The nurse is caring for a client with end- stage COPD. What data warrants immediate action by the nurse? 

A nurse in the emergency department is assessing an elderly client who has community- acquired pneumonia. Which of the following findings should the nurse expect?

The nurse is assessing a client with COPD. What preventative health promotion information is most important for the nurse to obtain?

The client diagnosed with influenza is being discharged from the emergency department with a prescription for antibiotics. Which statement by the client indicates an uderstanding of this prescription?

The nurse has been assigned to a pulmonary unit, and is assigned multiple patients. Which task can the Registered Nurse delegate to an unlicensed assistive personnel?