The nurse auscultates a client's breath sounds as seen in the picture. Which type of normal sounds should the nurse hear over these lung fields?
Crackles.
Vesicular.
Bronchial.
Wheezes.
The Correct Answer is B
A.Crackles: Crackles, also known as rales, are abnormal lung sounds that can indicate conditions such as pneumonia, pulmonary edema, or interstitial lung disease. They are often described as fine or coarse, and they may be heard during inspiration, expiration, or both. Crackles are typically heard over areas of fluid-filled alveoli or small airways.
B. Vesicular. These sounds are typically heard over most of the lung fields and are associated with normal airflow through smaller airways.
C. Bronchial: Bronchial breath sounds are typically heard over the trachea and mainstem bronchi. These sounds are louder and higher in pitch compared to vesicular sounds, with a shorter inspiratory phase and a longer expiratory phase. Hearing bronchial sounds over peripheral lung fields would suggest consolidation or compression of lung tissue, such as in pneumonia or atelectasis.
D. Wheezes: Wheezes are high-pitched, musical sounds heard primarily during expiration. They are typically associated with narrowed airways, such as in asthma, chronic obstructive pulmonary disease (COPD), or bronchitis. Wheezes may be heard over the lung fields if there is widespread airway obstruction or bronchoconstriction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Listen for abnormal sounds. Before identifying abnormal sounds, it's essential to first establish a baseline by identifying the normal heart sounds (S1 and S2).
B. Identify S1 and S2 heart sounds. This is the correct first step in a systematic assessment of heart sounds. S1 ("lub") corresponds to the closure of the atrioventricular valves (mitral and tricuspid), while S2 ("dub") corresponds to the closure of the semilunar valves (aortic and pulmonic).
C. Move the stethoscope to the apical site. While the apical site is important for auscultating specific heart sounds, it's best to first identify S1 and S2 at the traditional auscultatory areas (aortic, pulmonic, tricuspid, and mitral).
D. Change to the bell of the stethoscope. The bell of the stethoscope is used to listen for lower-pitched sounds, but it's not typically used for identifying S1 and S2 heart sounds, which are higher-pitched.
Correct Answer is B
Explanation
A. Stand behind the client to avoid intimidation. This is not an appropriate teaching strategy. Standing behind a client can actually increase intimidation and anxiety, as it does not allow for direct eye contact and clear communication.
B. Turn on overhead lights while giving instructions. Proper lighting is essential for older adults, who may have visual impairments. Turning on overhead lights ensures that the client can clearly see the materials and the nurse, enhancing understanding and engagement during the teaching session.
C. Provide handouts written at a 12th grade reading level. Handouts for patient education should be written at a lower reading level, generally around the 5th to 6th grade level, to ensure comprehension by a broad audience, including those with limited literacy skills. A 12th grade reading level is too high for effective patient education for most adults.
D. Use background music to promote relaxation. Background music can be distracting rather than relaxing during educational sessions, especially for older adults who may have hearing impairments or cognitive issues. Clear and focused communication is more effective without additional auditory distractions.
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