A nurse is collecting data from a school-age child who has asthma. The nurse should identify which of the following findings?
Periodic episodes of wheezing
Low-grade fever in the afternoon
Abrupt onset of
set of sharp pleuritic pain
The Correct Answer is A
A. Wheezing, which is a high-pitched whistling sound heard during expiration, is a common symptom of asthma. It occurs due to narrowed airways and airflow obstruction, often in response to triggers such as allergens, respiratory infections, or exercise.
B. Low-grade fever in the afternoon is not typically associated with asthma. Fever is more commonly seen in response to infections, such as respiratory infections, which can exacerbate asthma symptoms but is not a direct manifestation of asthma itself.
C. Without the complete statement, it is difficult to assess its relevance to asthma symptoms. However, an abrupt onset of symptoms, such as sudden shortness of breath or chest tightness, may occur during an asthma attack or exacerbation.
D. Sharp pleuritic pain is not a typical finding in asthma. Pleuritic pain, which is sharp and worsened by breathing, is more commonly associated with conditions affecting the pleura, such as pneumonia or pleurisy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
C. The priority during a seizure is to protect the patient from harm, particularly from aspiration if they vomit or have excessive saliva production. Turning the client to a lateral position helps maintain an open airway and prevents aspiration. This action should be taken immediately after lowering the client to the floor to ensure their safety.
A. Providing oxygen is important for a patient experiencing a seizure. However, it's not the first action to take. The priority is to ensure the patient's safety and protect them from injury during the seizure.
B. Administering anticonvulsant medication during an active seizure is not appropriate. Anticonvulsants are typically prescribed as maintenance therapy to prevent seizures or to manage seizure disorders in a controlled manner, not during an acute seizure episode.
D. Monitoring oxygen saturation is important but it's not the first action to take during an active seizure. Ensuring the patient's safety and protecting them from injury take precedence. Oxygen saturation can be assessed once the patient is in a safe position.
Correct Answer is A
Explanation
A. This is a common postictal manifestation after a generalized tonic-clonic seizure. Following the intense muscle activity and convulsions during the seizure, the child may experience exhaustion and feel sleepy. The postictal state often involves a period of drowsiness or even brief loss of consciousness.
B. Restlessness is less likely to be observed immediately after a generalized tonic-clonic seizure. Instead, the child is more likely to exhibit fatigue and lethargy as the body recovers from the seizure activity.
C. Anxiety may occur during or immediately after the seizure due to the sudden and frightening nature of the event. However, in the postictal period, anxiety typically diminishes as the child becomes more oriented and aware of their surroundings.
D. Nausea is not a typical postictal manifestation after a generalized tonic-clonic seizure. While some individuals may experience nausea or vomiting during the seizure (ictal phase), it is less common in the postictal period.
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