A patient has been admitted to the emergency department for a suspected drug overdose. His respirations are shallow, with an irregular pattern, at a rate of 12 respirations per minute. The nurse interprets this respiration pattern as which of the following?

Bradypnea

Agonal respirations

Chronic obstructive breathing

Hypoventilation

Answer and Explanation

The Correct Answer is D

A. Bradypnea: Characterized by a regular but abnormally slow respiratory rate, typically fewer than 12 breaths per minute in adults. While the patient’s respiratory rate is 12, the irregular pattern and shallow depth suggest a different pattern rather than simple bradypnea.

B. Agonal respirations: Marked by gasping, labored breaths often seen in severe hypoxia or nearing death. This pattern is typically irregular and associated with brainstem dysfunction, which is not described in this case.

C. Chronic obstructive breathing: Seen in patients with COPD, involving prolonged expiration due to airway obstruction. The patient’s case does not mention an obstructive pattern but rather shallow and irregular respirations.

D. Hypoventilation: Defined by shallow, irregular breathing that leads to inadequate alveolar ventilation, commonly caused by drug overdose, particularly opioids or sedatives. The patient’s presentation of shallow and irregular respirations fits this pattern.

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Correct Answer is A

Explanation

A. The purpose of the tubes is to decrease the pressure and allow for drainage: Tympanostomy tubes are placed in the tympanic membrane to facilitate drainage of middle ear fluid and equalize pressure. They help prevent recurrent otitis media and improve hearing in children prone to persistent effusions. The tubes create a temporary opening that allows air to enter the middle ear, reducing the risk of fluid accumulation and infection.

B. The tubes are permanently inserted during a surgical procedure: Tympanostomy tubes are not permanent; they usually fall out on their own within 6 to 12 months as the tympanic membrane heals. In some cases, if they do not extrude naturally, they may need to be removed by an ear, nose, and throat (ENT) specialist. Permanent tubes are rarely used and only in cases of severe chronic ear problems.

C. The tubes are placed in the inner ear: Tympanostomy tubes are inserted into the tympanic membrane (eardrum), which separates the outer ear from the middle ear. They do not enter the inner ear, which contains the cochlea and vestibular system. Placement in the inner ear would not be anatomically correct and could lead to serious complications.

D. The tubes are used in children with sensorineural loss: Tympanostomy tubes are not a treatment for sensorineural hearing loss, which results from damage to the inner ear or auditory nerve. They are used for conductive hearing issues caused by middle ear effusion, recurrent ear infections, or Eustachian tube dysfunction. Sensorineural hearing loss is typically managed with hearing aids or cochlear implants, not tympanostomy tubes.

A. XI; have patient shrug their shoulders against resistance. B. XI; palpate the anterior and posterior triangles. C. XII; assess for a positive Romberg sign. D. XII; percuss the sternomastoid and submandibular neck muscles.

Correct Answer is A

Explanation

A. XI; have patient shrug their shoulders against resistance: Cranial nerve XI, also known as the accessory nerve, is responsible for the innervation of the sternocleidomastoid and trapezius muscles. Damage to this nerve can lead to weakness in shoulder shrugging and difficulty turning the head. Asking the patient to shrug their shoulders against resistance allows the nurse to assess the function of this nerve effectively.

B. XI; palpate the anterior and posterior triangles: While palpating the anterior and posterior triangles of the neck can provide useful anatomical information, it does not specifically assess the function of cranial nerve XI. This action may not directly address the patient's complaints or evaluate nerve function adequately.

C. XII; assess for a positive Romberg sign: Cranial nerve XII, the hypoglossal nerve, is responsible for tongue movement. The Romberg test assesses balance and proprioception, not directly related to neck and shoulder pain or head movement. This option is not appropriate in this context.

D. XII; percuss the sternomastoid and submandibular neck muscles: Percussion is not a standard method for assessing cranial nerve function and would not provide useful information about nerve damage. This option also incorrectly identifies the relevant cranial nerve, as cranial nerve XII is not involved in neck and shoulder movement.

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A patient has been admitted to the emergency department for a suspected drug overdose. His respirations are shallow, with an irregular pattern, at a rate of 12 respirations per minute. The nurse interprets this respiration pattern as which of the following?

Nursing Test Bank

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