A nurse is assessing a client who has tension pneumothorax. Which of the following findings should the nurse expect following tracheal deviation?
Respiratory alkalosis
Increased venous return
Decreased cardiac output
Dilated ventricles
The Correct Answer is C
Choice A Reason:
Respiratory alkalosis is incorrect. Tension pneumothorax typically leads to respiratory distress and hypoxemia rather than respiratory alkalosis. The respiratory alkalosis may occur initially due to hyperventilation in response to hypoxemia but would not be directly related to tracheal deviation.
Choice B Reason:
Increased venous return is incorrect. Tension pneumothorax actually leads to decreased venous return due to compression of the great vessels in the thorax, particularly the superior vena cava and the inferior vena cava. This compression results from the increased pressure within the thorax, which impedes blood flow back to the heart.
Choice C Reason:
Decreased cardiac output is incorrect. Tension pneumothorax can indeed lead to decreased cardiac output due to compression of the heart and the great vessels by the accumulating air in the pleural space. This compression decreases venous return and impairs cardiac function.
Choice D Reason:
Dilated ventricles is incorrect. As mentioned earlier, tension pneumothorax can lead to compression of the heart, including the ventricles. This compression can cause dilatation of the ventricles, particularly the right ventricle, due to increased afterload and decreased venous return.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason:
Depression is incorrect. While depression can contribute to headaches in some individuals, it is more commonly associated with migraine headaches rather than tension-type headaches or cluster headaches. People with depression may experience changes in neurotransmitter levels and alterations in pain perception, which can exacerbate migraines. However, tension-type headaches and cluster headaches are generally less strongly associated with depression as a precipitating factor compared to migraines.
Choice B Reason:
Smoking is incorrect. Smoking can be a trigger for headaches in some individuals, particularly migraines, due to the vasoconstrictive effects of nicotine and other compounds in tobacco smoke. However, smoking is not universally recognized as a common precipitating factor for tension-type headaches or cluster headaches. While individuals with cluster headaches may have higher rates of smoking compared to the general population, it is not a factor commonly shared with tension-type headaches.
Choice C Reason:
Poor posture is incorrect. Poor posture can contribute to muscle tension and cervical spine strain, which may trigger tension-type headaches. However, poor posture is not typically considered a precipitating factor specific to cluster headaches. While tension-type headaches may be exacerbated by poor posture, cluster headaches are characterized by severe, unilateral pain typically centered around the eye or temple, with associated autonomic symptoms such as tearing, nasal congestion, or ptosis.
Choice D Reason:
Stress is correct. Stress is a well-established precipitating factor for both tension-type headaches and cluster headaches. Stress can lead to muscle tension and contraction, which are common triggers for tension-type headaches. Additionally, stress can also contribute to the onset or worsening of cluster headaches, although the exact mechanisms underlying this association are not fully understood. Therefore, stress is a common precipitating factor for both tension-type headaches and cluster headaches.
Correct Answer is ["A","B","D"]
Explanation
Choice A Reason:
African American clients is appropriate. Research suggests that African Americans have a lower prevalence of MS compared to White Americans, but they tend to have more severe disease progression and higher disability rates when diagnosed with MS.
Choice B Reason:
White American clients: Individuals of European descent, including White Americans, have the highest prevalence of MS, particularly those of northern European ancestry. MS is more common in populations of northern European descent compared to other racial and ethnic groups.
Choice C Reason:
East Asian clients: East Asians, including individuals of Chinese, Japanese, and Korean descent, have historically had lower rates of MS compared to individuals of European descent. However, MS prevalence appears to be increasing in East Asian populations, possibly due to changes in lifestyle and environmental factors.
Choice D Reason:
Hispanic or Latino clients: Studies suggest that the prevalence of MS is lower in Hispanic/Latino populations compared to White Americans but higher than in African Americans. However, there is considerable variation in MS prevalence among different Hispanic/Latino subgroups.
Choice E Reason:
Navajo Indian clients: Native American populations, including Navajo Indians, have been reported to have a lower prevalence of MS compared to individuals of European descent. However, limited data are available on MS prevalence and incidence in specific Native American tribes, and more research is needed to fully understand the disease burden in these populations.
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