A nurse is assessing a client who has chronic bronchitis. Which of the following percussion sounds should the nurse expect?
Dullness
Tympany
Resonance
Flatness
The Correct Answer is C
Choice A reason: Dullness on percussion typically indicates increased lung density, such as in conditions where lung tissue is consolidated or fluid-filled. This sound is heard in cases of: Pneumonia (due to alveolar consolidation) Pleural effusion (fluid in the pleural space) Lung tumors (solid masses in lung tissue) Since chronic bronchitis is primarily an airway disease characterized by inflammation and mucus production rather than lung consolidation or fluid accumulation, dullness is not an expected finding..
Choice B reason: Tympany is usually heard over air-filled structures and is not a percussion sound typically associated with chronic bronchitis.
Choice C reason:
Resonance is the normal percussion sound heard over healthy lung fields, indicating air-filled alveoli. Since chronic bronchitis does not cause significant air trapping or lung consolidation, percussion remains resonant rather than hyperresonant (as in emphysema) or dull (as in pneumonia). Thus, resonance is the expected finding in chronic bronchitis because the lung parenchyma remains relatively unaffected despite the chronic airway inflammation.
Choice D reason: Flatness is heard over very dense tissue, such as muscle or bone, and is not characteristic of chronic bronchitis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: The medication administration record is an important document, but it is not the primary source for verification before administering blood products. It is used to record the administration after the fact.
Choice B reason: The identification wristband is the priority source for verification. It contains the client's essential information, such as name and hospital ID, which must match the blood product label to ensure patient safety⁸.
Choice C reason: The order sheet contains the physician's orders, which is crucial for verifying what has been prescribed but is secondary to the identification wristband for the actual administration process.
Choice D reason: The chart contains a comprehensive record of the client's medical history and care but is not the primary source for verification when administering blood products.
Correct Answer is A
Explanation
Choice A reason: Neurological checks are essential after spinal surgery to monitor for any changes or deterioration in the patient's neurological status. The frequency of these checks can vary based on the patient's condition, but a common standard is to perform them every 4 hours or sooner. However, in some cases, especially immediately post operation, checks may be required more frequently, such as every 2 hours, to ensure any complications are identified and managed promptly.
Choice B reason: While mobilization is an important aspect of postsurgical care to prevent complications such as deep vein thrombosis, positioning a patient in a chair every 2 hours may not be appropriate immediately following spinal surgery. The patient's mobility and pain level must be assessed, and activities should be gradually increased as tolerated.
Choice C reason: Inspecting the spinal dressing is important to identify signs of infection or complications. However, clear drainage is not typically expected and could indicate cerebrospinal fluid leakage, which requires immediate medical attention.
Choice D reason: The term "criminal checks" is not relevant to nursing care and seems to be a typographical error. The nurse's focus should be on clinical assessments and interventions related to the patient's health status.
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