The practical nurse (PN) is auscultating a client's lung sounds. Which description should the PN use to document this sound? (Please listen to the audio clip provided).
Audio: [Wheezing sound]
Wheeze.
Rhonchi.
Stridor.
Fine crackles.
The Correct Answer is A
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."
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}
Explanation
Based on the laboratory data, the client has:
Option 1: Pre-diabetes
Option 2: Impaired glucose tolerance
The client's fasting blood glucose level of 122 mg/dL (6.8 mmol/L) falls within the range of 100 to 125 mg/dL (5.56 to 6.9 mmol/L), indicating impaired glucose tolerance. This suggests that the client's blood sugar levels are higher than normal but not high enough to be classified as diabetes mellitus.
Impaired glucose tolerance is considered a precursor to diabetes and indicates an increased risk of developing diabetes in the future. It is important for the practical nurse to educate the client about lifestyle modifications to manage blood sugar levels and prevent the progression to diabetes.
Correct Answer is ["A","D","E"]
Explanation
During a generalized tonic-clonic seizure, it is important for the practical nurse (PN) to prioritize the safety and well-being of the child. The correct actions to implement immediately are:
A. Observe the progression of the seizure: The PN should closely observe the seizure to gather important information that can be helpful for medical professionals in assessing the seizure's characteristics and duration.
D. Pad the side rails with pillows: Padding the side rails of the bed with pillows helps to prevent the child from injuring themselves by hitting the side rails during the seizure.
E. Loosen clothing around the neck: Loosening any tight clothing around the child's neck helps to ensure adequate breathing and prevent any constriction or discomfort during the seizure.
B. Hold the extremities close to the body: This action is not recommended during a seizure as it may increase the risk of injury to the child or the PN.
C. Insert a tongue blade between the teeth: It is not recommended to insert any object, including a tongue blade, between the teeth of a person experiencing a seizure. This can cause injury to the person's mouth or teeth and is no longer considered an appropriate intervention for seizures.
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