A client with a history of COPD is being assessed. When the nurse percusses the client's chest, which characteristic sound is expected?
Tympany
Hyperresonance
Resonance
Dullness
The Correct Answer is B
Choice a reason:
Tympany is a drum-like, resonant sound that is typically heard over air-filled structures, such as the gastric bubble, not the chest. It is not a sound associated with the lungs, especially in the context of COPD.
Choice b reason:
Hyperresonance is an abnormally loud, lower-pitched sound than normal resonance heard over hyperinflated areas of the lung, such as in cases of COPD. This is due to the increased air content within the lungs, often because of overdistension or destruction of alveolar tissue, as seen in emphysema, a common type of COPD.
Choice c reason:
Resonance is the normal sound heard over healthy lung tissue when percussed. However, in the case of COPD, particularly emphysema, the destruction of lung tissue leads to hyperinflation and thus a hyperresonant sound rather than the normal resonance.
Choice d reason:
Dullness is heard when fluid or solid tissue replaces air in the lung or occupies the pleural space, as in the case of pneumonia or pleural effusion. This is not characteristic of COPD, where there is an increase in air due to the breakdown of alveolar walls.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason:
Discussing reactions to allergens typically focuses on environmental or food triggers that may cause allergic reactions. While it's important to understand a client's allergies, this topic is not closely related to alcohol use, which has different implications for health and lifestyle choices.
Choice B reason:
Asking about alcohol use naturally follows the discussion about cigarette smoking because both involve substance use and have potential health risks. It allows the nurse to transition smoothly from one lifestyle factor to another, which can impact the client's overall health. This approach also helps in creating a comprehensive picture of the client's habits that may contribute to or affect their current health status.
Choice C reason:
Reviewing current medications is an essential part of the health history, as it can reveal potential interactions with alcohol. However, it might be more appropriate to ask about alcohol use after discussing other lifestyle habits such as smoking, as they are more directly related. Once the client's substance use habits are established, the nurse can then discuss how these might interact with prescribed medications.
Choice D reason:
Asking about previous surgeries is important for understanding a client's medical history, but it is not directly related to the client's current lifestyle habits like alcohol use. Therefore, it would be more natural to ask about alcohol use in the context of other substance use discussions rather than after surgical history.
Correct Answer is C
Explanation
Choice a reason:
A firm toothbrush is not recommended for plaque removal as it can damage the gums and tooth enamel. Soft-bristled toothbrushes are preferred because they are effective at removing plaque while being gentle on the gums and enamel.
Choice b reason:
Brushing more than twice per day does not necessarily irritate the gums unless done with improper technique or with a hard-bristled toothbrush. It is important to brush gently with a soft-bristled toothbrush and to use fluoride toothpaste to maintain oral hygiene and prevent gingivitis.
Choice c reason:
Ensuring that dental restorations such as fillings and crowns fit well is crucial in preventing gingivitis. Poorly fitted restorations can trap food particles and bacteria, leading to plaque buildup and gum inflammation. Regular dental check-ups can help ensure that restorations remain intact and do not contribute to gingivitis.
Choice d reason:
Flossing should not be avoided even if there is bleeding at the gumline. Bleeding can be a sign of gingivitis, and flossing can help remove the plaque and bacteria causing the inflammation. If bleeding persists, it is important to consult a dentist.
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