A nurse is caring for a client who has developed acute respiratory distress syndrome (ARDS). Which of the following findings should the nurse identify as a manifestation of this syndrome?

An audible pleural friction rub

Tracheal deviation from the midline

Refractory hypoxemia

Bloody expectorant when coughing

Answer and Explanation

The Correct Answer is C

Rationale:
A. An audible pleural friction rub: A pleural friction rub is typically heard in conditions involving pleural inflammation, such as pleurisy or pericarditis. It is not a defining feature of acute respiratory distress syndrome, which primarily involves alveolar damage and pulmonary edema.

B. Tracheal deviation from the midline: Tracheal deviation is usually associated with a tension pneumothorax or large pleural effusion. ARDS does not typically cause tracheal shift, as it affects the lungs diffusely rather than exerting pressure on one side.

C. Refractory hypoxemia: This is a hallmark of ARDS. It refers to hypoxemia that does not improve significantly with supplemental oxygen due to impaired gas exchange from widespread alveolar-capillary membrane damage, leading to severe ventilation-perfusion mismatch.

D. Bloody expectorant when coughing: Hemoptysis (bloody sputum) can occur in various respiratory conditions but is not a characteristic manifestation of ARDS. In ARDS, secretions are more likely to be frothy and pink-tinged if pulmonary edema is present.

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Free Nursing Study Resources

Correct Answer is A

Explanation

Rationale:
A. "If my heart starts racing, my provider might need to adjust my dosage.": This statement shows understanding. Tachycardia is a common sign of overtreatment with levothyroxine, which may lead to hyperthyroidism. The provider should be notified to adjust the dosage if such symptoms occur.

B. "I will keep a journal of my daily food intake to show the provider.": While nutrition is important, this is not a routine requirement for levothyroxine management. The effectiveness of therapy is primarily monitored through thyroid function tests, not dietary logs.

C. "Once my weight is back to normal, I can gradually reduce and then stop the medication.": This indicates a misunderstanding. Levothyroxine is a lifelong therapy for most clients with hypothyroidism, and stopping it can lead to a return of symptoms and complications.

D. "I'm not forgetful, so I do not need a pill reminder system.": While this may be true for some, consistent daily dosing is critical with levothyroxine. Even clients with good memory may benefit from reminder systems to ensure adherence and maintain stable hormone levels.

A. Maintain the head of the bed greater than 45°. B. Place a donut-shaped cushion under the client’s sacrum. C. Massage bony prominences three times daily. D. Apply moisturizer to damp skin after bathing.

Correct Answer is D

Explanation

Rationale:
A. Maintain the head of the bed greater than 45°: Elevating the head of the bed beyond 30° increases pressure and shear forces on the sacrum, contributing to skin breakdown. The bed should be maintained at the lowest elevation necessary to reduce pressure injury risk.

B. Place a donut-shaped cushion under the client’s sacrum: Donut-shaped cushions can impede blood flow and concentrate pressure on surrounding tissues, increasing the risk of pressure injuries rather than preventing them. Specialty foam or gel cushions are preferred for pressure redistribution.

C. Massage bony prominences three times daily: Massaging over bony areas is contraindicated as it may cause further tissue damage in areas already at risk for pressure injury. Prevention strategies focus on pressure relief, skin protection, and improved circulation without direct trauma.

D. Apply moisturizer to damp skin after bathing: Applying moisturizer to slightly damp skin helps retain moisture, prevents dryness and cracking, and maintains skin integrity. This is an evidence-based practice in pressure injury prevention, especially for clients with fragile or at-risk skin.

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A nurse is caring for a client who has developed acute respiratory distress syndrome (ARDS). Which of the following findings should the nurse identify as a manifestation of this syndrome?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client who has a new prescription for levothyroxine to treat hypothyroidism. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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