A patient arrives in the ED after an automobile accident. Which of the following clinical manifestations leads the nurse to suspect a pneumothorax? (Select all that apply)
(Select All that Apply.)
Pulse oximetry 98%
Diminished breath sounds over painful chest area
Respiratory rate 34
ABG pH level of 7.38
Asymmetrical chest movements, especially on inspiration
Correct Answer : B,C,E
A. Pulse oximetry 98%: A pulse oximetry reading of 98% indicates adequate oxygen saturation, which does not strongly suggest a pneumothorax. Patients with a pneumothorax may have lower oxygen saturation levels, but this reading alone is not indicative of the condition.
B. Diminished breath sounds over painful chest area: Diminished breath sounds are a significant clinical manifestation of pneumothorax, as air in the pleural space prevents normal lung expansion and decreases airflow to the affected side.
C. Respiratory rate 34: An elevated respiratory rate (tachypnea) is often observed in patients with pneumothorax as they may struggle to breathe effectively. This clinical manifestation indicates respiratory distress and is consistent with the condition.
D. ABG pH level of 7.38: A pH level of 7.38 indicates acidosis, which may occur in cases of pneumothorax due to impaired gas exchange and respiratory distress. This abnormal finding on arterial blood gases supports the suspicion of pneumothorax.
E. Asymmetrical chest movements, especially on inspiration: Asymmetrical chest movements are a classic sign of pneumothorax, where the affected lung does not expand as fully as the unaffected lung during inspiration, leading to visible differences in chest wall movement.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Myocardial ischemia: Myocardial ischemia contributes to ventricular remodeling by causing damage to the heart muscle, leading to changes in the size, shape, and function of the ventricles. The process involves cellular and molecular alterations in response to ischemic injury, ultimately resulting in adverse remodeling that can exacerbate heart failure.
B. Right ventricular failure: Right ventricular failure may occur as a consequence of other cardiac conditions but is not a direct contributor to ventricular remodeling. Instead, it is often a result of left-sided heart failure or pulmonary hypertension, making it secondary to the primary pathologic changes.
C. Left ventricular hypertrophy: Left ventricular hypertrophy can occur as a response to chronic pressure overload (such as hypertension) but is a result of ventricular remodeling rather than a direct contributor to the remodeling process itself. It may indicate underlying issues rather than cause them.
D. Contractile dysfunction: Contractile dysfunction reflects impaired heart muscle contraction but does not directly cause ventricular remodeling. While it can be a consequence of remodeling due to conditions like ischemia or heart failure, it does not initiate the remodeling process itself.
Correct Answer is A
Explanation
A. Actually, people who have the latent form of the disease won't be sick and can't spread it either: This response is accurate because individuals with latent tuberculosis infection (LTBI) do not exhibit symptoms and are not infectious. They carry the bacteria in their body, but it remains dormant and does not spread to others. Only those with active tuberculosis disease are capable of transmitting the infection through respiratory droplets.
B. Many people do manage to fight off the infection, but you are right: they can still spread it by coughing or sneezing: This statement is misleading because it implies that individuals with LTBI can spread the disease, which is not the case. Only those with active TB are contagious.
C. There isn't any real risk of them spreading it, but we would like to vaccinate everyone who's had any contact with it in the past: This response downplays the importance of understanding the difference between latent and active TB and could create confusion. Vaccination for tuberculosis (BCG vaccine) is not routinely given in the United States, and exposure alone does not necessitate vaccination.
D. If someone has been previously exposed to tuberculosis, they are particularly infectious because they are often unaware of the disease: This statement is incorrect, as individuals who have been exposed but have LTBI are not infectious. It is only those with active TB who pose a risk of spreading the infection.
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