A 28 y.o. female presents to the ED with sudden onset of chest pain and difficulty breathing after a fall from her bicycle. She reports a history of smoking. On examination, decreased breath sounds and unequal chest excursion.
What condition is this client experiencing?
Pleural effusion
Asthma exacerbation
Pneumothorax
Pulmonary embolism
The Correct Answer is C
A. Pleural effusion: This involves fluid accumulation in the pleural space, leading to diminished breath sounds and dyspnea. However, it typically develops gradually, not with sudden onset following trauma.
B. Asthma exacerbation: Asthma usually presents with wheezing, prolonged expiration, and airway inflammation. The absence of wheezing and the presence of unequal chest excursion make this less likely.
C. Pneumothorax: Sudden chest pain, dyspnea, decreased breath sounds, and unequal chest excursion strongly suggest pneumothorax. The history of trauma increases the likelihood, as air enters the pleural space causing lung collapse.
D. Pulmonary embolism: This causes sudden dyspnea and chest pain, but breath sounds are usually normal or clear. The presence of trauma, decreased breath sounds, and unequal chest expansion makes pulmonary embolism less consistent with this case.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Kaposi Sarcoma: This is an AIDS-defining illness caused by human herpesvirus-8 and is characterized by painless, purplish-brown lesions on the skin and mucous membranes. It is commonly seen in clients with advanced untreated HIV infection due to severe immunosuppression.
B. Atopic Dermatitis: Atopic dermatitis presents as itchy, inflamed, and eczematous skin lesions, often with a history of allergies or asthma. It does not cause purple lesions on the skin or oral mucosa and is unrelated to untreated HIV progression.
C. Herpes simplex virus type 2: HSV-2 usually causes painful vesicular lesions in the genital or perianal region. While HIV clients are at higher risk of herpes outbreaks, the presentation is painful blisters or ulcers, not painless purplish patches.
D. Oral candidiasis: Oral candidiasis presents with white, creamy plaques on the tongue and oral mucosa that can be scraped off. It is common in HIV but looks different from purplish lesions, making it distinct from Kaposi sarcoma.
Correct Answer is C
Explanation
A. Depressive characteristics of schizophrenia: While some atypical antipsychotics may have mood-stabilizing effects, paliperidone is not primarily indicated for treating depressive symptoms. Antidepressants are more effective for depressive features rather than antipsychotic agents.
B. Negative symptoms of schizophrenia only: Paliperidone helps address negative symptoms such as social withdrawal and blunted affect, but it is not limited to these alone. Its mechanism of action also targets positive symptoms, making this option incomplete.
C. Both positive and negative symptoms of schizophrenia: Paliperidone, an atypical antipsychotic, blocks dopamine D2 receptors and serotonin 5-HT2A receptors. This dual action makes it effective for reducing hallucinations and delusions (positive symptoms) as well as improving motivation and affect (negative symptoms).
D. Low serotonin levels: Paliperidone does act on serotonin receptors, but it does not treat “low serotonin levels” as a standalone condition. Instead, the benefit is its balanced effect on both dopamine and serotonin pathways, reducing positive and negative symptoms in schizophrenia.
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