A nurse is assessing a client who has COPD and experienced recent weight loss. Which of the following findings should the nurse report provider immediately?
A barrel chest
Coughing and wheezing after eating
Abdominal bloating
A drop in oxygen saturation to 91% while eating
The Correct Answer is D
A. A barrel chest: A barrel-shaped chest is a common structural change in clients with long-standing COPD. While it reflects chronic disease, it is not an acute change requiring immediate provider notification.
B. Coughing and wheezing after eating: This may indicate mild aspiration or gastroesophageal reflux, which should be monitored and addressed, but it is not immediately life-threatening if the client remains stable.
C. Abdominal bloating: Abdominal bloating can occur due to air swallowing or gastrointestinal changes in COPD, but it is not an urgent concern unless accompanied by severe pain, distention, or other acute symptoms.
D. A drop in oxygen saturation to 91% while eating: A sudden decrease in oxygen saturation indicates hypoxemia and potential respiratory compromise, especially in a client with COPD. This acute change requires immediate provider notification and possible intervention, making it the highest priority finding.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Neutropenia: Neutropenia is a decreased white blood cell count, often seen in clients with bone marrow suppression or certain infections, but it is not a typical finding in bacterial pneumonia. Pneumococcal pneumonia usually causes leukocytosis rather than neutropenia.
B. Nuchal rigidity: Stiff neck is characteristic of meningitis, not pneumonia. While systemic infections can have various symptoms, nuchal rigidity is not expected in pneumococcal pneumonia.
C. Tachypnea: Rapid breathing is a common manifestation of pneumonia due to impaired gas exchange, hypoxemia, and increased work of breathing. Tachypnea helps compensate for reduced oxygenation and is an expected clinical finding in pneumococcal pneumonia.
D. Flail chest: Flail chest results from multiple rib fractures causing a segment of the chest wall to move paradoxically during respiration. This is a traumatic injury, not a complication of pneumococcal pneumonia.
Correct Answer is "{\"xRanges\":[30.940896739130434,33.33220108695652],\"yRanges\":[36.748633879781416,39.75409836065574]}"
Explanation
A. Location A (Aortic Area): This area is located at the second intercostal space (ICS), just to the right of the sternal border. Aortic Valve Closing: The Aortic Valve closes at the beginning of diastole, contributing to the second heart sound, the "dub". The sound is best conducted and heard in this area because the blood flow from the left ventricle into the aorta travels toward the client's right shoulder.
B. Location B (Tricuspid Area): Located at the 4th or 5th ICS along the left sternal border. Best for hearing the Tricuspid Valve.
C. Location C (Mitral/Apical Area): Located at the 5th ICS at the midclavicular line (where the apex of the heart rests). Best for hearing the Mitral Valve and the point of maximal impulse.
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