During a routine physical examination of a client, chest palpation is determined to be normal except for a 2 inch (5.1 cm) diameter area of crepitus over the upper right anterior chest. Which interpretation is the most accurate for this finding?

Trapped subcutaneous air causing crepitus will be absorbed, so the finding is not significant.

Since this client has only a small area of crepitus, it probably is not a significant finding.

Crepitus is always abnormal and should be followed-up with a more detailed assessment.

Since a fractured rib often creates crepitus, a chest x-ray should be scheduled immediately.

Answer and Explanation

The Correct Answer is C

A. Trapped subcutaneous air causing crepitus will be absorbed, so the finding is not significant. While trapped air can be absorbed, crepitus can indicate underlying issues such as a pneumothorax or other trauma, so it should not be dismissed as insignificant.

B. Since this client has only a small area of crepitus, it probably is not a significant finding. The size of the area does not necessarily correlate with the severity of the underlying condition. Even a small area of crepitus should be investigated.

C. Crepitus is always abnormal and should be followed-up with a more detailed assessment. This is the most accurate interpretation. Crepitus indicates the presence of air in the subcutaneous tissues, which is always abnormal and warrants further investigation.

D. Since a fractured rib often creates crepitus, a chest x-ray should be scheduled immediately. While a chest x-ray can be part of the assessment, stating that a fractured rib "often" creates crepitus might be misleading. Crepitus can arise from other conditions, and a thorough assessment is needed before determining the exact cause.

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Correct Answer is D

Explanation

A. Absolute dullness: This typically indicates fluid or a mass in the abdomen and is not a normal finding.

B. Absent sounds: Complete absence of bowel sounds can be a sign of an obstruction or ileus.

C. Pain: Pain during percussion suggests inflammation or irritation in the underlying organs.

D. Musical and drum like sounds: These are normal bowel sounds produced by gas and fluid movement within the intestines.

A. Open-ended question. B. Clarification. C. Empathizing. D. Paraphrasing.

Correct Answer is C

Explanation

A. Open-ended question. This response is not an open-ended question. Open-ended questions typically invite the client to share more information or elaborate on their thoughts and feelings. Instead, the nurse's response acknowledges the client's feelings and demonstrates empathy without directly soliciting more information.

B. Clarification. This response is not clarification. Clarification involves seeking clarification or additional information to ensure understanding. The nurse's response does not seek clarification but rather acknowledges the client's emotions.

C. Empathizing. This response is empathizing. Empathizing involves recognizing and understanding the client's emotions and expressing empathy. The nurse's response acknowledges the client's difficult situation and validates their feelings of distress, demonstrating empathy and understanding.

D. Paraphrasing. This response is not paraphrasing. Paraphrasing involves restating the client's message in the nurse's own words to confirm understanding. The nurse's response does not restate the client's message but rather expresses empathy and validation of the client's emotions.

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During a routine physical examination of a client, chest palpation is determined to be normal except for a 2 inch (5.1 cm) diameter area of crepitus over the upper right anterior chest. Which interpretation is the most accurate for this finding?

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Naxlex Comprehensive Predictor Exams

The nurse completes percussion of the abdomen on an adult client. Which finding is considered normal?

Correct Answer is D

Explanation

Correct Answer is C

Explanation

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