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

Answer and Explanation

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

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is ["A","B","D"]

Explanation

Choice A Reason:

"Have you had any nausea and vomiting with your headache?": This question is appropriate. Nausea and vomiting are common symptoms associated with migraines. Asking about these symptoms can help confirm the diagnosis of a migraine headache.

Choice B Reason:

"Are you bothered by the lights in here?" This question is appropriate. Sensitivity to light, known as photophobia, is a classic symptom of migraines. Inquiring about light sensitivity can provide additional evidence for the diagnosis.

Choice C Reason:

"Have you noticed any confused or cloudy thinking?". This question is inappropriate. Confusion or cognitive symptoms are not typical of migraines. However, some individuals may experience difficulty concentrating or cognitive symptoms during a migraine aura. This question may help assess for aura symptoms.

Choice D Reason
Have you experienced or are you experiencing any strange smells?" This question is appropriate. Some individuals may experience olfactory hallucinations or sensitivity to odors during a migraine aura. Asking about strange smells can help identify possible aura symptoms.

Choice E Reason:

"Did you feel weak before the headache started or do you feel weak now?" This question is inappropriate. While weakness is not a typical symptom of migraines, some individuals may experience fatigue or muscle weakness during a migraine attack. This question may help assess the overall impact of the headache on the client.

A. Photosensitivity B. Memory issues C. Lhermitte's sign D. Seizures E. Central vision loss

Correct Answer is ["B","C","E"]

Explanation

Choice A Reason:

Photosensitivity is incorrect. Photosensitivity, or sensitivity to light, is not a common symptom of multiple sclerosis. While individuals with MS may experience visual disturbances, such as blurred vision or optic neuritis, sensitivity to light is not typically reported as a primary symptom.

Choice B Reason:

Memory issues is correct. Memory issues, including problems with short-term memory, concentration, and cognitive processing speed, are common neurological symptoms in individuals with multiple sclerosis. Cognitive impairment can affect various aspects of memory and cognitive function.

Choice C Reason:

Lhermitte's sign is correct. Lhermitte's sign is a classic neurological sign characterized by an electric shock-like sensation that radiates down the spine or into the limbs upon flexing the neck. It is a common symptom in multiple sclerosis, often associated with cervical spinal cord lesions.

Choice D Reason:

Seizures is incorrect. Seizures are not a typical symptom of multiple sclerosis. While individuals with MS may experience various neurological symptoms, seizures are not a common manifestation of the disease.

Choice E Reason:

Central vision loss is correct. Visual disturbances, including central vision loss, blurred vision, double vision, or optic neuritis, are common symptoms of multiple sclerosis. Optic neuritis, inflammation of the optic nerve, is a frequent manifestation of MS that can lead to temporary or permanent central vision loss.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse is assessing a client who has tension pneumothorax. Which of the following findings should the nurse expect following tracheal deviation?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who has a history of migraines reports to a clinic with a throbbing headache. Which of the following questions should the nurse include in the assessment? (Select All that Apply.)

Correct Answer is ["A","B","D"]

Explanation

A nurse is caring for a client who has multiple sclerosis. Which of the following assessment findings should the nurse anticipate with this client? (Select All that Apply.)

Correct Answer is ["B","C","E"]

Explanation

A nurse is teaching a group of nursing students about spinal cord injuries in clients who are aged 65 years and older. Which of the following should the nurse identify as the most common cause of spinal cord injuries for this age group?

A nurse is caring for a client who has chronic respiratory acidosis due to chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse expect with this client?

Which of the following are the most common manifestations of COPD? (Select all that apply.) (Select All that Apply.)

A nurse is caring for a client with asthma. Which of the following happens physiologically when bronchospasm occurs?

A nurse is caring for six clients. Which of the following clients are at risk for developing peripheral neuropathy (PN)? (Select All that Apply.)

A nurse is providing care to a client who is experiencing wheezing after receiving an antibiotic 20 min ago. Which of the following findings is the priority of the nurse to monitor for?

A nurse is providing a client who has COPD with education regarding adapting their behavior. Which of the following describes an anticipated outcome following education of the client?

A nurse is caring for a client who has a cerebral aneurysm. In the event of a ruptured cerebral aneurysm, which of the following manifestations would be present in the client? (Select All that Apply.)