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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Correct Answer is C

Explanation

Rationale:
A. Hypernatremia: While mild hypernatremia can occur in severe dehydration, it is not a defining or consistent feature of type 1 diabetes. Electrolyte imbalances may vary depending on hydration and glucose levels.

B. Decreased serum osmolality: In type 1 diabetes, serum osmolality is typically increased due to hyperglycemia and the osmotic effect of glucose in the bloodstream, which draws water out of cells and into the vascular space. A decrease would be inconsistent with the expected metabolic state.

C. Ketones in the urine: Ketones in the urine are a hallmark of type 1 diabetes, especially when insulin is deficient. Without insulin, the body breaks down fat for energy, producing ketones as a byproduct, which can be detected in the urine during diabetic ketoacidosis.

D. Hypoglycemia: Hypoglycemia is a complication of diabetes management, often resulting from too much insulin or missed meals. It is not a presenting manifestation of newly diagnosed type 1 diabetes, which typically presents with hyperglycemia and related symptoms.

A. Provide finger food at mealtime. B. Give detailed directions when addressing the client. C. Use written signs to redirect the client. D. Seat the client at a large table for meals.

Correct Answer is A

Explanation

Rationale:
A. Provide finger food at mealtime: Clients with dementia often have difficulty using utensils due to declining motor and cognitive function. Offering finger foods supports independence and helps ensure adequate nutritional intake by simplifying the eating process.

B. Give detailed directions when addressing the client: Detailed instructions can be overwhelming and difficult to process for individuals with dementia. Clear, simple, one-step directions are more effective in promoting understanding and cooperation.

C. Use written signs to redirect the client: As dementia progresses, the ability to read and comprehend written information typically declines. Visual or verbal redirection is more effective for guiding behavior in most clients with moderate to severe dementia.

D. Seat the client at a large table for meals: A large table with many people can create a distracting and overstimulating environment. Smaller, quieter settings help the client focus on eating and reduce agitation during meals.

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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

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