A nurse assessing a client’s lung sounds hears continuous low-pitched harsh rattling sounds over the client’s trachea that are most evident on expiration and are decreased after coughing.
Which term is the appropriate choice to accurately document this lung sound?
Rhonchi.
Wheezing.
Crackles.
Pleural friction rub.
The Correct Answer is A
Rhonchi. Rhonchi are low-pitched, rattling sounds that indicate mucus in the larger airways. They are most evident on expiration and may decrease after coughing.
Choice B is wrong because wheezes are high-pitched, squeaking sounds that indicate narrowed small air passages. They are usually heard on both inspiration and expiration.
Choice C is wrong because crackles are short, high-pitched popping sounds that indicate fluid or inflammation in the alveoli. They are usually heard on inspiration.
Choice D is wrong because pleural friction rubs are creaking or grating sounds that indicate inflammation of the pleura. They are usually heard on both inspiration and expiration and do not change with coughing.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
This is because non-steroidal anti-inflammatory drugs (NSAIDs) are medicines that are used to treat rheumatoid arthritis by reducing pain, inflammation, and swelling.
However, NSAIDs do not slow down the disease progression or prevent joint
damage. Therefore, they are often used along with other types of medications, such as methotrexate or biologics, that can modify the disease course. NSAIDs may take up to two weeks to reach their full anti-inflammatory effect.
Choice A is wrong because using aspirin to relieve other types of pain can increase the risk of bleeding and stomach ulcers when taken with NSAIDs.
Choice C is wrong because taking the medication on an empty stomach can increase the risk of stomach irritation and ulcers.
Choice D is wrong because taking the medication after exercising does not prevent the progression of disease or joint damage.
Correct Answer is B
Explanation
The nurse should hold and notify the prescriber because hydrochlorothiazide is a diuretic that can lower the serum potassium level. The client already has a high serum potassium level of 5.2 mmol/L, which is above the normal range of 3.5 to 5.0 mmol/L.
Giving hydrochlorothiazide could worsen the client’s condition and cause hypokalemia.
Choice A is wrong because metoprolol is a beta-blocker that can lower the blood pressure and heart rate.
The client’s blood pressure and heart rate are not given, so there is no reason to hold metoprolol based on the information provided.
Choice C is wrong because enoxaparin is an anticoagulant that can prevent blood clots. The client has a low platelet count of 98,000/mm, which is below the normal range of 150,000 to 450,000/mm.
However, this does not contraindicate the use of enoxaparin, unless the client has signs of bleeding or bruising.
Choice D is wrong because atorvastatin is a statin that can lower the serum cholesterol
level. The client has a high serum cholesterol level of 250 mg/dL, which is above the desirable level of less than 200 mg/dL.
Giving atorvastatin could help reduce the client’s risk of cardiovascular complications.
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