A nurse is assessing a client who has hypoxemic respiratory failure. Which of the following findings should the nurse expect?

Pulmonary edema

Opioid toxicity

Myasthenia gravis

Flail chest

Answer and Explanation

The Correct Answer is A

A. Pulmonary edema: Pulmonary edema occurs when fluid accumulates in the lungs, impairing gas exchange and leading to hypoxemia. This condition is a common cause of hypoxemic respiratory failure, and patients often present with symptoms such as dyspnea, crackles on auscultation, and hypoxemia. The nurse would expect this finding in a client experiencing hypoxemic respiratory failure.
B. Opioid toxicity: Opioid toxicity can cause respiratory depression, but it typically leads to hypoventilation, which results in hypercapnic respiratory failure (elevated carbon dioxide levels) rather than hypoxemic respiratory failure. Therefore, while opioid toxicity affects breathing, it is not directly associated with hypoxemic respiratory failure.
C. Myasthenia gravis: Myasthenia gravis is a neuromuscular disorder that leads to muscle weakness, including respiratory muscles. While it can cause respiratory failure in severe cases, it does not directly cause hypoxemic respiratory failure. Respiratory failure in myasthenia gravis is often due to insufficient ventilation rather than impaired oxygenation, so this is not the expected finding in hypoxemic respiratory failure.
D. Flail chest: Flail chest occurs due to multiple rib fractures that result in a segment of the chest wall moving paradoxically, impairing ventilation. While this condition can lead to respiratory failure, it typically causes hypercapnic rather than hypoxemic respiratory failure. Therefore, it is less likely to be the cause of hypoxemic respiratory failure in this scenario.

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Correct Answer is D

Explanation

A. Tachycardia: Tachycardia is a common early sign of pulmonary embolism caused by hypoxia and sympathetic stimulation. However, it is nonspecific and not a direct indicator of embolism size or mortality risk.
B. Pleural effusion: A small pleural effusion can occur with a pulmonary embolism due to inflammation or infarction, but its presence does not correlate with embolism severity or predict outcomes such as death.
C. Respiratory alkalosis: Respiratory alkalosis is a typical response to hyperventilation in early PE. While common, it does not indicate the extent of the embolism or the risk of mortality and can be seen in mild cases.
D. Increased troponin levels: Elevated troponin indicates right ventricular strain or injury due to a moderate to large pulmonary embolism. This cardiac biomarker is associated with a higher risk of complications and death, signaling hemodynamic stress from the embolic event..

A. The SA node sends an electrical signal greater than 100/min. B. The heart's electrical signals are rapid, chaotic, and irregular. C. An early electrical signal occurs before the expected sinoatrial (SA) node signal. D. The heart's electrical transmission through the atrioventricular (AV) node is unusually slow.

Correct Answer is B

Explanation

A. The SA node sends an electrical signal greater than 100/min: A fast SA node firing rate may indicate sinus tachycardia, not atrial fibrillation. In atrial fibrillation, the SA node is not the primary pacemaker because disorganized signals originate from multiple ectopic foci in the atria, leading to ineffective atrial contractions.
B. The heart's electrical signals are rapid, chaotic, and irregular: In atrial fibrillation, the atria experience disorganized and chaotic electrical impulses, causing an irregular and often rapid heart rhythm. This results in decreased cardiac output, leading to symptoms like dizziness and palpitations due to poor perfusion.
C. An early electrical signal occurs before the expected sinoatrial (SA) node signal: This describes a premature atrial contraction (PAC), not atrial fibrillation. PACs are isolated early beats and do not typically result in sustained irregular rhythms or significant hemodynamic symptoms like those seen in atrial fibrillation.
D. The heart's electrical transmission through the atrioventricular (AV) node is unusually slow:
Delayed conduction through the AV node is associated with AV blocks, not atrial fibrillation. While AV conduction may be variable in atrial fibrillation, the root problem lies in the atria, not in slowed AV nodal transmission.

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A nurse is assessing a client who has hypoxemic respiratory failure. Which of the following findings should the nurse expect?

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