During a routine physical examination of a middle-aged female client, chest palpation is determined to be normal except for a 2 inch diameter area of crepitus over the upper right anterior chest. Which is the most accurate interpretation of this finding?

Since this client has only a small area of crepitus, it probably is not a significant finding.

Crepitus is always abnormal and should be followed-up with a more detailed assessment.

Trapped subcutaneous air causing crepitus will be absorbed, so the finding is not significant.

Since a fractured rib often creates crepitus, a chest x-ray should be scheduled immediately.

Answer and Explanation

The Correct Answer is B

A.   The presence of crepitus, regardless of size, indicates air trapped in the subcutaneous tissue, which can be associated with various conditions including trauma, infection, or underlying lung issues. Therefore, it is important to evaluate the finding further rather than assuming it is insignificant.
B.   This is the most accurate interpretation. Crepitus is indeed an abnormal finding and warrants further investigation. Its presence can indicate underlying issues such as subcutaneous emphysema, which may be related to trauma, infections, or other conditions that need to be addressed. A more detailed assessment, including possible imaging or additional diagnostic tests, should be pursued to determine the cause and appropriate management.
C.   While it is true that subcutaneous air can be absorbed over time, the presence of crepitus is still an abnormal finding that needs to be evaluated. The underlying cause of the trapped air must be identified, as it may indicate an injury or other health issues that require intervention. Simply assuming that it will resolve on its own without further investigation could overlook a potentially serious condition.
D.   While a fractured rib can cause crepitus, this finding alone does not necessarily mean an immediate chest x-ray is required. The decision to order an x-ray should be based on a comprehensive assessment of the client’s symptoms, history, and physical examination findings. Although a rib fracture is a possible cause, other conditions such as subcutaneous emphysema or infections should also be considered.

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 B

Explanation

A. This maneuver assesses shoulder strength and endurance but is not a direct measure of the normal range of motion. The test involves resistance but does not provide information on the full range of shoulder movement. It might reveal issues with muscle strength or endurance but does not effectively assess ROM.
B. This assessment technique evaluates shoulder flexion, where the client raises their arms straight up beside the ears, which is a key movement to measure in shoulder ROM. It assesses the ability to lift the arms fully overhead, which is an essential component of shoulder range of motion. This technique directly tests the normal ROM for shoulder flexion and abduction.
C. This maneuver tests coordination and proprioception rather than the range of motion. It is a test for the accuracy of movements and neurological function, particularly useful in assessing cerebellar function, but does not directly measure shoulder ROM.
D. This test assesses shoulder strength and stability rather than range of motion. It is useful for evaluating how well the shoulder can maintain a position but does not provide specific information about the range of motion in different directions.

A. Trains for competition and runs 12 miles every day. B. Received an implanted intrauterine device (IUD) last month. C. Reports a history of chronic urinary track infections. D. Increased calcium intake with 3 glasses of non-fat milk daily.

Correct Answer is A

Explanation

A. Intense physical exercise, particularly when combined with a low body mass index, can lead to
amenorrhea. This condition, often referred to as "athletic amenorrhea," occurs due to the body’s response to excessive physical stress and insufficient fat stores. A low BMI combined with high levels of physical activity can disrupt the hormonal balance necessary for regular menstrual cycles.
B. While certain types of IUDs (especially hormonal ones) can cause changes in menstrual patterns, they are not typically associated with the same degree of amenorrhea as seen with significant weight loss or low BMI. The timeline of one month after IUD insertion is relatively short for such significant changes to occur solely due to the device, making it a less likely cause of the client’s amenorrhea in this context.
C. Chronic UTIs generally do not affect menstrual cycles or cause amenorrhea. They are more likely to result in symptoms related to the urinary system rather than hormonal imbalances that influence menstrual cycles.
D. Increased calcium intake is generally associated with positive health benefits, including bone health, but it is not typically linked to amenorrhea. Calcium intake alone, especially if it is not accompanied by other significant dietary or lifestyle changes, is unlikely to be a contributing factor to amenorrhea.

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

During a routine physical examination of a middle-aged female client, chest palpation is determined to be normal except for a 2 inch diameter area of crepitus over the upper right anterior chest. Which is the most accurate interpretation of this finding?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client comes to the clinic due to shoulder discomfort and intermittent pain while swimming laps. To identify normal range of motion (ROM) of the client's shoulder, which assessment technique should the nurse ask the client to perform?

Correct Answer is B

Explanation

Correct Answer is A

Explanation

The nurse auscultates the precordium of a client who is diagnosed with mitral valve regurgitation and hears a grade IV systolic murmur. When documenting the comparison of systolic murmurs, which characteristics should the nurse use to support this systolic finding?

When assessing an adult client, the nurse notes that the client has unequal lung expansion. Which conclusion regarding this finding is most likely to be accurate?

While obtaining a health history, a client tells the nurse that he sometimes experiences shortness of breath. The nurse determines that the client's respirations are regular and deep, and his respiratory rate is 14 breaths/minute. What is the best nursing action?

When assessing a client's lower extremities, which finding requires immediate intervention by the nurse?

Which assessment technique should the nurse use to confirm the presence of papilledema in a client with a rapidly decreasing level of consciousness?

The nurse is completing an assessment for a client with uncontrolled diabetes mellitus (DM) who came to the clinic reporting frequent, painful urination. Which screening test should the nurse perform first?

The nurse is assessing a female client who states that her hemorrhoids are inflamed and hurt constantly. Which intervention is best for the nurse implement to complete a focused assessment?

The nurse is assessing a client with type 2 diabetes mellitus and observes an abnormal response when using a monofilament. Which finding should the nurse document that is consistent with an abnormal finding?