A client's respiratory assessment reveals crackles, decreased tactile fremitus, and a dull sound in left lower chest during percussion. Which condition should the nurse document in the electronic medical record?

Pleural effusion.

Emphysema.

Bronchitis.

Pneumothorax.

Answer and Explanation

The Correct Answer is A

A. Pleural effusion: The combination of crackles, decreased tactile fremitus, and dullness to percussion is most consistent with pleural effusion. Fluid in the pleural space dampens vibration transmission, decreases fremitus, and creates a dull percussion sound while causing adventitious breath sounds.

B. Emphysema: Emphysema typically presents with hyperresonance on percussion due to air trapping, along with diminished breath sounds. Fremitus is decreased as well, but crackles and dullness are not characteristic findings.

C. Bronchitis: Bronchitis may cause crackles or wheezes due to airway inflammation, but tactile fremitus is usually normal or increased, and percussion tones remain resonant. The dullness noted here makes bronchitis unlikely.

D. Pneumothorax: Pneumothorax produces hyperresonant percussion sounds with absent or markedly decreased breath sounds. Fremitus is also decreased, but dullness and crackles are not expected, distinguishing it from pleural effusion.

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Correct Answer is A

Explanation

A. Wear closed-toe shoes that are comfortable and fit well: Proper footwear is essential to prevent foot injuries, ulcers, and infections in clients with diabetes, especially because neuropathy can reduce sensation. This response indicates understanding of a key self-care measure.

B. Check blood sugar levels every four to six hours every day: Blood glucose monitoring frequency should be individualized based on treatment regimen, activity, and glycemic control. A blanket schedule every four to six hours may not be appropriate for all clients.

C. Restrict alcoholic beverages to no more than 1 to 2 per week: Alcohol guidelines should be individualized, and alcohol can affect blood glucose unpredictably. Limiting intake is important, but this statement alone does not fully reflect diabetes management understanding.

D. Obtain an A1C blood test every year to monitor glucose control: The recommended frequency for A1C testing is usually every 3 months when starting treatment or if therapy changes, and every 6 months for stable control.

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}

Explanation

Rationale for correct choices:

• Respirations: Morphine is an opioid analgesic that can depress the respiratory center in the brainstem, leading to slowed breathing and hypoventilation. Monitoring respirations after administration is critical to detect early signs of opioid-induced respiratory depression.

• Ice application to the shoulder: Applying ice reduces swelling, pain, and inflammation by causing vasoconstriction and limiting fluid accumulation at the injury site. For an acute humeral fracture with significant swelling and bruising, cold therapy is the appropriate intervention.

Rationale for incorrect choices:

• Nausea: While morphine can cause nausea and vomiting as side effects, they are not the most life-threatening concerns compared to respiratory depression. Monitoring nausea is appropriate but not the priority when evaluating opioid safety.

• Blood pressure: Morphine can cause hypotension, but this effect is less common and typically secondary to respiratory depression and vasodilation. Continuous monitoring of blood pressure is helpful, but respiratory monitoring takes priority in detecting opioid complications.

• Early active range of motion: Active movement of the injured arm is not recommended immediately after a displaced humeral fracture, as it can worsen displacement and interfere with healing. Immobilization and stabilization are required before introducing range-of-motion exercises.

• Heat application to the shoulder: Heat increases blood flow to tissues, which can worsen swelling and bleeding in the acute phase of injury. Applying heat too soon after a fracture increases the risk of complications rather than reducing them.

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A client's respiratory assessment reveals crackles, decreased tactile fremitus, and a dull sound in left lower chest during percussion. Which condition should the nurse document in the electronic medical record?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing teaching to a client newly diagnosed with type 2 diabetes mellitus about disease management. Which response by the client indicates understanding?

Correct Answer is A

Explanation

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}

Explanation

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