A nurse is assessing a client following the insertion of a central venous catheter.
Which of the following findings indicates a pneumothorax?
Distended neck veins.
Itching over the incision.
Irregular heart rate.
Diminished breath sounds.
The Correct Answer is D
A pneumothorax is a collapsed lung that occurs when air leaks into the space between the lung and the chest wall.
This can cause diminished breath sounds on the affected side. Distended neck veins are not a symptom of pneumothorax.
B) Itching over the incision is not a symptom of pneumothorax.
C) Irregular heart rate is not a symptom of pneumothorax.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
White rice is a low-potassium food that can be recommended for a client who has chronic kidney disease and must limit potassium intake.
Nonfat yogurt (choice A) contains moderate amounts of potassium and may not be the best choice for someone who needs to limit their potassium intake.
A medium baked potato with skin (choice B) is high in potassium and should be limited to a low-potassium diet.
Peanut butter (choice C) also contains moderate amounts of potassium and may not be the best choice for someone who needs to limit their potassium intake.
Correct Answer is A
Explanation
The nurse’s priority assessment in the PACU (Post-Anesthesia Care Unit) should be the client’s respiratory status.
This is because the client is recovering from anesthesia and may have an altered respiratory function.
Choice B, assessing the surgical site, is not an answer because it is not the priority assessment for a client in the PACU.
Choice C, assessing the level of consciousness, is not an answer because it is not the priority assessment for a client in the PACU.
Choice D, assessing the pain level, is not an answer because it is not the priority assessment for a client in the PACU.
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