Based on the patient’s respiratory assessment and history, which assessment finding would indicate a worsening of Maria’s respiratory status?

Respiratory rate decreases to 18 breaths per minute.

Oxygen saturation increases to 90% on 2 L oxygen via nasal cannula.

Increased use of accessory muscles for breathing.

Productive cough with yellowish sputum.

Answer and Explanation

The Correct Answer is C

Choice A reason: Respiratory rate dropping to 18 breaths/min may suggest improvement or fatigue, not worsening, in respiratory status. Normal range (12-20) makes this less alarming than signs of increased breathing effort.

Choice B reason: Oxygen saturation rising to 90% on 2 L indicates better oxygenation, not worsening. It reflects treatment response, improving gas exchange, so this finding contradicts a decline in respiratory status.

Choice C reason: Increased accessory muscle use signals worsening respiratory distress, as it compensates for airway resistance or fatigue. It reflects higher work of breathing, a critical sign of decompensation needing intervention.

Choice D reason: Productive cough with yellowish sputum suggests infection, not immediate worsening of respiratory mechanics. It’s a chronic sign, less urgent than accessory muscle use indicating acute respiratory effort escalation.

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Correct Answer is C

Explanation

Choice A reason: Wheezing indicates airway narrowing, typical in asthma or COPD, not pneumonia. Pneumonia causes alveolar fluid, producing crackles, so diffuse wheezing doesn’t align with its pathophysiology of consolidation.

Choice B reason: Finger clubbing and pallor suggest chronic hypoxia or anemia, not acute pneumonia. These develop over time, whereas pneumonia presents with acute respiratory signs like crackles, not chronic markers.

Choice C reason: Crackles or rales occur in pneumonia from fluid or pus in alveoli, disrupting airflow. Heard on auscultation, they’re a classic sign, reflecting consolidation or inflammation in affected lung regions.

Choice D reason: Edema is fluid in tissues, linked to heart failure, not pneumonia directly. Pneumonia affects lungs, causing crackles, not peripheral swelling, making this unrelated to typical respiratory findings.

A. Daily alcohol use B. Asthma C. Peptic ulcer disease D. Myocardial infarction (MI)

Correct Answer is B

Explanation

Choice A reason: Daily alcohol use may amplify propranolol’s CNS depression, but it’s not a contraindication. It warrants monitoring for sedation, yet hypertension treatment proceeds, as no direct physiologic conflict exists with beta-blockade.

Choice B reason: Asthma contraindicates propranolol, a non-selective beta-blocker, as it blocks β2 receptors, causing bronchoconstriction. This risks severe airway obstruction in asthmatics, prompting consultation for a cardioselective alternative like atenolol.

Choice C reason: Peptic ulcer disease isn’t affected by propranolol directly; beta-blockers don’t alter gastric acid. It’s not a contraindication, though stress-related hypertension management might consider other factors, not this drug.

Choice D reason: Post-MI, propranolol reduces myocardial demand, aiding recovery. It’s beneficial, not contraindicated, lowering reinfarction risk via β1 blockade, so no consultation is needed unless acute decompensation occurs.

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Based on the patient’s respiratory assessment and history, which assessment finding would indicate a worsening of Maria’s respiratory status?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is B

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