The emergency room nurse is assessing a client with jugular venous distention, ascites, shortness of breath, and a 3-pound weight gain in the past 24 hours. Which of the following would the nurse anticipate being ordered?

Pulmonary Function Test

Alpha-1 Antitrypsin

Brain Natriuretic Peptide

Doppler Ultrasound

Answer and Explanation

The Correct Answer is C

A. A pulmonary function test is used to assess lung diseases like COPD or asthma. It is not the primary diagnostic test for fluid overload and heart failure.
B. Alpha-1 antitrypsin deficiency is associated with early-onset COPD, but it does not relate to symptoms of fluid retention and heart failure as described in the question.
C. Brain Natriuretic Peptide (BNP) is correct. BNP is released when the ventricles stretch due to fluid overload, making it a key diagnostic marker for heart failure. Elevated BNP levels indicate increased cardiac filling pressures and volume overload, which match the client’s symptoms.
D. A Doppler ultrasound is useful for detecting deep vein thrombosis (DVT) or vascular issues, but it does not assess systemic fluid retention and heart failure.

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Correct Answer is C

Explanation

A. Immediately notify the provider . A rise in the water seal chamber with inspiration (tidaling) is a normal finding, indicating proper function of the chest drainage system. There is no need for immediate provider notification.
B. Clamp the chest tube near the water seal . Clamping the chest tube can lead to a tension pneumothorax by trapping air inside the pleural space. This action is only done temporarily for specific indications, such as assessing for an air leak or changing the drainage system.
C. Continue to monitor the client . Tidaling (fluctuation of water with inspiration and expiration) is expected in the water seal chamber. The nurse should continue to monitor for any sudden cessation of tidaling (which may indicate obstruction) or continuous bubbling (which may indicate an air leak).
D. Reposition the client toward the left side . Position changes do not affect normal tidaling in a functioning chest tube system. However, frequent repositioning is encouraged to promote lung expansion.

A. Hypertension B. Male C. Alpha-1 Antitrypsin Deficiency D. History of Pulmonary Embolism

Correct Answer is C

Explanation

A. Hypertension is not a direct risk factor for COPD. However, COPD and hypertension can coexist, especially in smokers.
B. Being male was once associated with a higher COPD prevalence, but COPD affects both sexes, especially as smoking habits have become more equal.
C. Alpha-1 Antitrypsin (AAT) deficiency is correct. AAT deficiency is a genetic disorder that leads to early-onset emphysema, even in non-smokers. It impairs the lungs' ability to protect themselves from enzymatic damage.
D. History of pulmonary embolism is not a primary risk factor for COPD, though lung damage from recurrent emboli can contribute to respiratory issues.

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The emergency room nurse is assessing a client with jugular venous distention, ascites, shortness of breath, and a 3-pound weight gain in the past 24 hours. Which of the following would the nurse anticipate being ordered?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a closed chest tube system. Which of the following actions should the nurse take after noticing a rise in the water seal chamber with client inspiration? Utilize image to see area that is being described.

Correct Answer is C

Explanation

Which of the following is considered a risk factor for COPD?

Correct Answer is C

Explanation

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