The nurse is preparing to assess Maria’s respiratory system. Which assessment findings are likely to be associated with pneumonia?

Wheezing heard throughout both lung fields

Finger clubbing and pallor

Crackles or rales heard upon auscultation

Edema

Answer and Explanation

The Correct Answer is C

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.

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Correct Answer is B

Explanation

Choice A reason: Metabolic alkalosis shows pH >7.45 with HCO3- >26 mEq/L from base excess. Here, pH is 7.48, but HCO3- is normal at 24 mEq/L, ruling out metabolic cause. PaO2 of 55 mmHg indicates hypoxemia, but the primary issue isn’t metabolic.

Choice B reason: Respiratory alkalosis occurs with pH >7.45 and PaCO2 <35 mmHg from hyperventilation. Here, pH is 7.48, PaCO2 is 28 mmHg, and HCO3- is normal, confirming respiratory etiology. PaO2 of 55 mmHg shows hypoxemia, matching this acute ventilatory pattern.

Choice C reason: Metabolic acidosis has pH <7.35 and HCO3- <22 mEq/L from acid gain. Here, pH is 7.48 and HCO3- is 24 mEq/L, contradicting acidosis. PaO2 of 55 mmHg indicates hypoxemia, but the acid-base status is alkalotic, not acidic.

Choice D reason: Respiratory acidosis features pH <7.35 and PaCO2 >45 mmHg from CO2 retention. Here, pH is 7.48 and PaCO2 is 28 mmHg, showing CO2 loss, not retention. Hypoxemia (PaO2 55 mmHg) is present, but the pattern is alkalotic.

A. Encouraging the patient to ambulate as much as tolerated B. Evaluating the effectiveness of opioid analgesics C. Teaching the patient about high-protein, high-calorie foods D. Limiting the patient’s intake of oral and IV fluids

Correct Answer is B

Explanation

Choice A reason: Ambulation in sickle cell crisis risks worsening pain and ischemia from exertion. Rest preserves oxygen, as sickle hemoglobin clogs vessels; encouraging movement contradicts physiology, delaying recovery in acute vaso-occlusion.

Choice B reason: Opioids relieve severe pain in sickle cell crisis from vaso-occlusion. Evaluating their effect ensures adequate control, as pain signals ongoing tissue hypoxia, guiding dose adjustments for comfort and healing.

Choice C reason: High-protein, high-calorie diets support chronic sickle cell needs, not acute crisis. Teaching this now is secondary, as pain and hydration take priority over nutrition education during active vaso-occlusive events.

Choice D reason: Limiting fluids worsens sickle cell crisis by increasing blood viscosity, promoting sickling. Hydration (IV/oral) dilutes hemoglobin S, improving flow, so restriction contradicts evidence-based crisis management principles.

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The nurse is preparing to assess Maria’s respiratory system. Which assessment findings are likely to be associated with pneumonia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Interpret the ABG results: pH: 7.48, PaCO2: 28 mmHg, PaO2: 55 mmHg, HCO3-: 24 mEq/L, SaO2: 87%

Correct Answer is B

Explanation

Which nursing intervention is important when providing care for a patient in sickle cell crisis?

Correct Answer is B

Explanation

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