A client in the emergency department is experiencing an acute asthma exacerbation, which has not improved with albuterol nebulizer treatments. The client is obviously struggling to breathe. The nurse anticipates that intubation and mechanical ventilation will be needed based on which of the following assessment findings?

Tachycardia

Anxiety

Hypotension

Loud expiratory wheezing

Answer and Explanation

The Correct Answer is C

A.   Tachycardia (rapid heart rate) can occur in response to hypoxia (low oxygen levels), stress, or as a side effect of medications like albuterol. While tachycardia is a concerning sign in the context of an asthma exacerbation, it alone does not directly indicate the need for intubation and mechanical ventilation. It is often managed by addressing the underlying respiratory distress and improving oxygenation.
B.   Anxiety is common in patients struggling to breathe, as they may feel frightened or panicked due to their difficulty breathing. However, anxiety itself is not an indicator for intubation and mechanical ventilation. It is a symptom of respiratory distress but does not directly assess the severity of the physiological need for mechanical support.
C.   Hypotension (low blood pressure) in the context of an asthma exacerbation can be a sign of severe illness, possibly indicating shock or severe respiratory distress leading to reduced cardiac output. While hypotension is a serious concern, it is less directly related to the immediate need for intubation and mechanical ventilation compared to other indicators of respiratory failure.
D.   Loud expiratory wheezing indicates significant airway obstruction but does not necessarily reflect the need for intubation and mechanical ventilation. Wheezing can be a sign of severe asthma but may not be sufficient on its own to necessitate intubation if the patient can still maintain adequate oxygenation and ventilation.

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Correct Answer is B

Explanation

A. A pneumothorax, or collapsed lung, occurs when air enters the pleural space, leading to lung collapse. While a pneumothorax can be a serious issue, it is not a typical finding associated with advanced COPD.
B. Hyperinflation is a hallmark finding of advanced COPD. It occurs when air becomes trapped in the lungs due to obstructed airways and damaged alveoli, leading to increased lung volumes and overexpansion of the lungs. On a chest X-ray, hyperinflation appears as an increased retrosternal air space, flattened diaphragm, and possibly increased lung volumes.
C. The presence of masses on a chest X-ray might suggest malignancies or other lung pathologies, but it is not a typical finding in COPD. While lung cancer can co-occur with COPD, masses themselves are not a direct indicator of COPD but rather a potential separate issue that would need further evaluation.
D. Atelectasis refers to the collapse of lung tissue due to loss of air in the alveoli, which can occur from various causes including obstruction or compression of the lung. While atelectasis can be seen in various pulmonary conditions, it is not specific to advanced COPD.

A. Elevated serum cholesterol B. Low thyroid stimulating hormone (TSH) C. Elevated free T4 D. Elevated adrenocorticotropic hormone (ACTH)

Correct Answer is A

Explanation

A. Elevated serum cholesterol is a common finding in hypothyroidism. The thyroid hormones play a role in regulating lipid metabolism, so low levels of thyroid hormones can lead to increased cholesterol levels. This is a typical finding in Hashimoto's disease, as it often results in hypothyroidism.
B. In Hashimoto's disease, which leads to hypothyroidism, TSH levels are usually elevated rather than low. TSH is produced by the pituitary gland and stimulates the thyroid gland to produce thyroid hormones (T3 and T4). When the thyroid gland is underactive and not producing enough hormones, the pituitary gland compensates by increasing TSH production. Therefore, a low TSH level would not be expected in Hashimoto's disease.
C. Free T4 (thyroxine) is typically low in hypothyroidism. Hashimoto's disease causes an underactive thyroid gland, which leads to decreased production of thyroid hormones, including free T4. Elevated free T4 would not be consistent with the diagnosis of Hashimoto's disease.
D. Elevated ACTH is more relevant to conditions involving the adrenal glands, such as Addison's disease or Cushing's syndrome. It is not a typical finding in Hashimoto's disease. Hashimoto's primarily affects thyroid function and does not directly impact ACTH levels.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has shortness of breath and a chronic cough. The client has smoked one pack of cigarettes per day for the last 20 years. Which finding on the client's chest x-ray would be consistent with a diagnosis of advanced COPD?

Correct Answer is B

Explanation

A nurse is reviewing the laboratory results of a client who has a new diagnosis of Hashimoto's disease. Which of the following lab results would the nurse expect to find?

Correct Answer is A

Explanation

A nurse is reviewing the medical record of a client who has been on levothyroxine for several months. Which of the following findings indicates a therapeutic response to the medication?

A nurse is assessing a client who is 12 hours postoperative following a thyroidectomy. Which of the following findings is indicative of thyrotoxic crisis?

A client is scheduled for an adrenocorticotropic hormone (ACTH) stimulation test to help diagnose suspected Addison's disease. What should the nurse include when teaching the client about this test?

A client with age-related macular degeneration (AMD) is undergoing photodynamic therapy with the medication Verteporfin. What should the nurse include in the discharge teaching for this client?

A female client with systemic lupus erythematosus (SLE) asks the nurse about pregnancy and lupus. Which information should the nurse include when educating the client?

The nurse is performing an admission assessment on a client who is being admitted for right- sided heart failure. Which statement made by the patient would be consistent with right-sided heart failure?

Which information will the nurse include when teaching a patient who is scheduled for a radiofrequency catheter ablation for treatment of atrial flutter?