A nurse is auscultating the breath sounds of a client who has chronic obstructive pulmonary disease.
When the client exhales, the nurse hears continuous high-pitched whistling sound.
The nurse should document this as?
Rhonchi.
Stridor.
Wheezes.
Crackles.
The Correct Answer is C
Choice A rationale
Rhonchi are low-pitched, coarse sounds typically heard during expiration, associated with secretions in large airways, not high-pitched continuous sounds.
Choice B rationale
Stridor is a high-pitched sound heard during inspiration, typically indicating upper airway obstruction.
Choice C rationale
Wheezes are continuous high-pitched whistling sounds heard during expiration, common in conditions like chronic obstructive pulmonary disease, where airway narrowing is present.
Choice D rationale
Crackles are discontinuous sounds heard during inspiration, usually associated with fluid in the lungs or alveolar opening, not continuous high-pitched sounds. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Alcohol consumption, obesity, diabetes, stress, and high cholesterol are all significant risk factors for heart disease. However, smoking is not listed in this choice. Smoking is a major risk factor for heart disease as it damages the lining of the arteries, leads to the build-up of fatty deposits (atherosclerosis), and increases the risk of heart attacks and strokes.
Choice B rationale
Smoking, hypertension, obesity, diabetes, and high cholesterol are all major risk factors for heart disease. Smoking contributes to the development of atherosclerosis and increases the risk of heart attacks. Hypertension, or high blood pressure, strains the heart and blood vessels, increasing the risk of heart disease. Obesity is linked to multiple risk factors, including high cholesterol, diabetes, and hypertension. Diabetes can cause damage to blood vessels and increase the risk of cardiovascular complications. High cholesterol contributes to the formation of plaques in the arteries, leading to atherosclerosis.
Choice C rationale
Personality type is not a major risk factor for heart disease. Although certain personality traits, such as Type A behavior (characterized by competitiveness, urgency, and hostility), have been associated with increased stress and a higher risk of cardiovascular events, they are not considered primary risk factors. High cholesterol, diabetes, and smoking are significant risk factors, but this choice does not include hypertension or obesity, which are also crucial risk factors for heart disease.
Choice D rationale
Family history, hypertension, stress, and age are important risk factors for heart disease, but this choice does not include some key factors such as smoking, obesity, or diabetes. Family history of heart disease can indicate a genetic predisposition to cardiovascular conditions. Hypertension and stress contribute to cardiovascular risk, and age is a non-modifiable risk factor as the risk of heart disease increases with age. However, the absence of smoking, obesity, and diabetes makes this choice less comprehensive in assessing heart disease risk factors. .
Correct Answer is B
Explanation
Choice A rationale
Loss of peripheral vision is more commonly associated with glaucoma, where increased intraocular pressure damages the optic nerve. This condition leads to gradual loss of peripheral vision, often described as "tunnel vision.”. Cataracts typically do not cause this symptom.
Choice B rationale
Cataracts involve the clouding of the eye's natural lens, leading to blurred vision and decreased ability to perceive colors. The clouding scatters light, reducing the clarity of color perception and overall vision. This symptom is consistent with cataract formation.
Choice C rationale
Seeing bright flashes of light and floaters is more commonly associated with retinal detachment or posterior vitreous detachment. These conditions involve changes in the retina or vitreous humor, leading to such visual disturbances. Cataracts do not typically cause these symptoms.
Choice D rationale
Loss of central vision is more commonly associated with age-related macular degeneration (AMD), where the central part of the retina (macula) deteriorates. This condition affects central vision, making activities like reading and recognizing faces difficult. Cataracts primarily cause generalized blurred vision, not central vision loss.
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