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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["1.3"]
Explanation
- Convert the infant's weight from pounds (lb) to kilograms (kg).
Given weight = 22 lb
Conversion factor = 1 kg = 2.2 lb
Weight (kg) = (Weight in lb / 2.2 lb/kg)
= (22 / 2.2)
= 10 kg.
- Calculate the total daily dose in milligrams (mg/day).
Prescribed dose = 20 mg/kg/day
Total Daily Dose (mg/day) = Weight (kg) x Dose (mg/kg/day)
= 10 kg x 20 mg/kg/day = 200 mg/day.
- Calculate the single dose in milligrams (mg/dose).
Frequency = every 8 hours (3 doses per day)
Single Dose (mg/dose) = (Total Daily Dose / Number of doses per day)
= (200 mg / 3)
= 66.67 mg.
- Calculate the volume in milliliters (mL) to administer per dose.
Available concentration = 250 mg per 5 mL
Volume (mL/dose) = (Single Dose (mg) / Available concentration (mg)) x Available volume (mL)
= (66.67 mg / 250 mg) x 5 mL
= 1.333... mL.
- Round the answer to the nearest tenth.
= 1.3 mL.
Correct Answer is B
Explanation
A. Tolerance: Tolerance refers to the need for increasing amounts of a substance to achieve the same effect. The client is not describing a need for more alcohol, but rather a desire for it, so tolerance is not the main concept.
B. Craving: Craving is an intense desire or urge to use a substance despite awareness of negative consequences. The client’s statement about missing late-night wine reflects a psychological and physiological urge, making craving the most appropriate concept to discuss.
C. Withdrawal: Withdrawal involves physical and psychological symptoms that occur when a person stops using a substance. The client reports feeling fine physically, indicating withdrawal is not occurring.
D. Denial: Denial is a defense mechanism in which the person refuses to acknowledge a problem. The client openly admits missing alcohol, so denial is not applicable in this context.
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