A nurse is conducting a lung assessment on a client suspected of having pneumonia. Which finding should the nurse report to the physician immediately?
Asymmetrical chest expansion
Breath sounds equal bilaterally
Bilateral symmetric vocal fremitus
Chest symmetrical
The Correct Answer is A
During a lung assessment on a client suspected of having pneumonia, the nurse should report asymmetrical chest expansion to the physician immediately. Asymmetrical chest expansion can be a sign of a serious lung condition such as pneumonia. The other options (Breath sounds equal bilaterally, Bilateral symmetric vocal fremitus, and Chest symmetrical) are normal findings and do not need to be reported immediately.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The number "+3" in this documentation represents the pulse amplitude. Pulse amplitude refers to the strength or force of the pulse and is typically measured on a scale of 0 to 4+. A "+3" pulse is considered to be full or strong, indicating good blood flow to the area being palpated.
Correct Answer is ["C","D"]
Explanation
If a visitor in the dining room at the hospital has a forceful cough, the nurse should first allow the visitor to continue coughing. Coughing is a natural reflex that helps clear the airway of foreign objects or mucus. The nurse should also assess the effectiveness of the cough. If the cough is weak or ineffective, further intervention may be necessary.
Starting cardiopulmonary resuscitation (CPR) or performing the Heimlich maneuver would only be appropriate if the visitor is choking and unable to breathe. Assisting the client to a sitting position on the floor may not be necessary and could potentially cause harm.
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