The practical nurse (PN) is assigning tasks to an unlicensed assistive personnel (UAP) who is giving basic care to a group of residents in a long-term care facility. Which client's task should be completed by a PN, rather than the UAP?

This is the correct answer because it allows the practical nurse (PN) to assess the parents' knowledge and understanding of hypospadias, and to provide accurate and relevant information based on their needs.
Hypospadias is a birth defect in boys in which the opening of the urethra is not located at the tip of the penis, but on the underside of the penis or in the scrotum²³. It is a common condition that affects about one in every 250 males at birth. Hypospadias does not resolve on its own and usually require surgical correction to prevent complications such as urinary tract infections, difficulty with urination and sexual function, and psychological distress¹². The PN should explain these facts to the parents and encourage them to discuss their concerns and questions with the health care provider. The PN should also provide emotional support and empathy to the parents, as they may feel anxious or guilty about their child's condition.

Based on the provided audio clip, the sound heard is a high-pitched, continuous, musical sound. This sound is characteristic of wheezing, which is caused by the narrowing of the airways due to inflammation, bronchoconstriction, or the presence of mucus. Wheezing is commonly associated with conditions such as asthma, chronic obstructive pulmonary disease (COPD), or bronchitis.

Let's evaluate the other options:

b) Rhonchi: Rhonchi are low-pitched, coarse, ratling sounds that typically indicate the presence of mucus or fluid in the larger airways. Rhonchi are often heard in conditions such as pneumonia or bronchitis, but they are different from the high-pitched wheezing sound heard in the audio clip.

c) Stridor: Stridor is a high-pitched, harsh, and crowing sound that is heard during inspiration. It is often associated with upper airway obstruction, such as in cases of croup, epiglottitis, or a foreign body obstruction. The sound in the audio clip does not match the characteristics of stridor.

d) Fine crackles: Fine crackles are discontinuous, high-pitched, and brief sounds that are typically heard during inspiration. They are often described as "velcro-like" or "rice crispies" and are associated with conditions such as pulmonary fibrosis or congestive heart failure. The sound in the audio clip does not resemble fine crackles.

In summary, the sound in the provided audio clip is best described as wheezing, characterized by a high- pitched, continuous, musical sound. Therefore, the practical nurse (PN) should document this sound as "wheeze."