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Only the flail segment pulling inward during expiration: During expiration, the flail segment moves outward while the rest of the chest wall moves inward, showing paradoxical movement, not inward movement alone.

The entire chest pulling inward during expiration: Normal chest movement involves inward motion of the entire chest during expiration, but flail chest specifically shows paradoxical motion of the detached segment relative to the rest of the chest.

The entire chest pushing outward during inspiration: During inspiration, the majority of the chest expands outward, but the flail segment moves inward due to its detachment. The entire chest pushing outward does not describe the paradoxical motion characteristic of flail chest.

High fever in the early morning: Fever associated with tuberculosis typically occurs in the afternoon or evening and is usually low-grade. Early morning high fever is not a common presentation.

Increased appetite: Clients with tuberculosis often experience weight loss and decreased appetite due to chronic infection and systemic inflammation. Increased appetite is not characteristic of the disease.

Edema: Edema is not a typical finding in pulmonary tuberculosis. Fluid retention is not commonly associated with this condition unless there are complications such as hypoalbuminemia or cardiac involvement.

Nasal congestion: Nasal congestion is treated with decongestants or antihistamines. Albuterol does not relieve congestion in the upper respiratory tract.

Dyspnea on exertion: While albuterol may improve exercise tolerance in some clients with asthma, its primary indication is the rapid relief of acute bronchospasm rather than chronic dyspnea on exertion.

Acute allergies: Acute allergic reactions are usually treated with antihistamines, corticosteroids, or epinephrine. Albuterol does not directly address allergic responses.

Pleural friction rub: A pleural friction rub is a coarse, grating sound produced by inflamed pleural surfaces rubbing together. It is associated with pleuritis or pleurisy, not asthma, and is typically heard during both inspiration and expiration.

Fine rales: Fine rales, also called crackles, are brief, high-pitched popping sounds heard during inspiration. They are often associated with fluid in the alveoli, as seen in conditions like pneumonia or heart failure, rather than bronchospasm in asthma.

Rhonchi: Rhonchi are low-pitched, snoring-like sounds caused by secretions in larger airways. While they may be present in some airway disorders, they are less characteristic of acute asthma than expiratory wheezing.

Requesting the pharmacy to dispense 10 mL of dextromethorphan PO: Dextromethorphan is an antitussive used to suppress cough. It does not relieve bronchospasm or improve oxygenation in an asthma exacerbation and is not appropriate for acute wheezing or hypoxemia.

Increasing oxygen to maintain an oxygen saturation of 95% or greater in the client: While supplemental oxygen may be necessary to maintain adequate oxygenation, the priority in acute asthma with wheezing and low oxygen saturation is to relieve bronchospasm with a bronchodilator. Oxygen alone does not address the underlying airway obstruction.

Asking the provider to repeat another radiograph of the chest: A chest radiograph may be indicated if complications or differential diagnoses are suspected, but it does not provide immediate relief of bronchospasm or improve oxygenation during an acute asthma attack.

Any size of a pulmonary embolism is fatal: Not all pulmonary emboli are fatal. Small emboli may cause minimal symptoms and can be treated effectively with anticoagulation therapy. The severity depends on the size and location of the clot, as well as the patient’s overall health.

Rest when experiencing symptoms of a pulmonary embolism: While rest may help reduce strain, immediate medical attention is critical if a pulmonary embolism is suspected. Symptoms such as sudden shortness of breath or chest pain require prompt evaluation rather than simple rest.

Follow-up is not needed: Follow-up care is essential to monitor anticoagulation therapy, assess for recurrence, and evaluate for complications. Skipping follow-up can lead to inadequate treatment and increase the risk of future thromboembolic events.

Turn off the ventilator alarms before suctioning the client's airway: Ventilator alarms should never be turned off because they alert staff to changes in airway pressure, disconnection, or other critical issues.

Reposition the client every 4 hr: Clients on mechanical ventilation should be repositioned more frequently, typically every 2 hours, to prevent pressure injuries and improve lung expansion. Waiting 4 hours may increase the risk of complications such as skin breakdown and atelectasis.

Provide mouth care every 10 to 12 hr with hydrogen peroxide: Oral care should be provided at least every 2–4 hours with appropriate antiseptic solutions (e.g., chlorhexidine) rather than hydrogen peroxide every 10–12 hours.

Pleural friction rub: A pleural friction rub is a grating sound caused by inflamed pleural surfaces rubbing together, usually associated with pleuritis or pneumonia. It is not a common finding in chronic obstructive pulmonary disease.

Spoon nails: Spoon-shaped nails (koilonychia) are typically associated with iron-deficiency anemia, not COPD. They are unrelated to the chronic pulmonary changes seen in this condition.

Peripheral edema: Peripheral edema may occur in late-stage COPD with cor pulmonale due to right-sided heart failure. However, it is not an expected finding in all clients with COPD and usually develops secondary to disease progression.

Inspiratory stridor: Inspiratory stridor is a high-pitched sound caused by upper airway obstruction, such as in croup or airway swelling. It is not associated with a pneumothorax, which affects the pleural space rather than the upper airway.

Expiratory wheeze: Expiratory wheezing is caused by narrowing of the lower airways, such as in asthma or bronchospasm. A pneumothorax does not typically produce wheezing but instead results in impaired lung expansion.

Coarse crackles: Coarse crackles are discontinuous, bubbling sounds caused by fluid in the alveoli, commonly seen in pneumonia or pulmonary edema. They are not characteristic of a pneumothorax, which involves air in the pleural space.