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

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.

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

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

Answer and Explanation

The Correct Answer is B

A.   The presence of crepitus, regardless of size, indicates air trapped in the subcutaneous tissue, which can be associated with various conditions including trauma, infection, or underlying lung issues. Therefore, it is important to evaluate the finding further rather than assuming it is insignificant.
B.   This is the most accurate interpretation. Crepitus is indeed an abnormal finding and warrants further investigation. Its presence can indicate underlying issues such as subcutaneous emphysema, which may be related to trauma, infections, or other conditions that need to be addressed. A more detailed assessment, including possible imaging or additional diagnostic tests, should be pursued to determine the cause and appropriate management.
C.   While it is true that subcutaneous air can be absorbed over time, the presence of crepitus is still an abnormal finding that needs to be evaluated. The underlying cause of the trapped air must be identified, as it may indicate an injury or other health issues that require intervention. Simply assuming that it will resolve on its own without further investigation could overlook a potentially serious condition.
D.   While a fractured rib can cause crepitus, this finding alone does not necessarily mean an immediate chest x-ray is required. The decision to order an x-ray should be based on a comprehensive assessment of the client’s symptoms, history, and physical examination findings. Although a rib fracture is a possible cause, other conditions such as subcutaneous emphysema or infections should also be considered.

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Correct Answer is {"A":{"answers":"D"},"B":{"answers":"B"}}

Explanation

Wrist: Able to bend wrist back toward forearm

Flexion: When the wrist bends back toward the forearm, it is an example of flexion. Flexion decreases the angle between the wrist and the forearm.

Elbow: Only able to straighten joint 30 degrees

Extension: The ability to straighten the elbow is indicative of extension. In this case, the client is only able to straighten the elbow to 30 degrees, which reflects limited extension.

A. Vital sign abnormalities. B. Presence of peripheral edema. C. White blood cell (WBC) count. D. Sputum characteristics.

Correct Answer is D

Explanation

A. Vital sign abnormalities can provide critical information about the client's overall condition and help determine if there is an acute or chronic issue that needs to be addressed. While important, this assessment might not provide specific details about the cause of the productive cough.
B. Peripheral edema is often related to cardiovascular or renal issues and might not be directly related to the cause of a productive cough. While edema can provide information about fluid balance and possible heart failure, it does not directly address the specific characteristics or causes of a cough.
C. A white blood cell count can help determine if there is an underlying infection or inflammatory process. Elevated WBC levels might indicate an infection, which could be a cause of the productive cough. This test is useful for diagnosing conditions like pneumonia or bronchitis but is not as immediately relevant as assessing the sputum characteristics in understanding the nature of the cough.
D. The characteristics of sputum (color, consistency, presence of blood, etc.) can provide valuable information about the cause of the productive cough. For instance, yellow or green sputum might suggest a bacterial infection, while clear sputum could be associated with viral infections or allergies.

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

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Naxlex Comprehensive Predictor Exams

Patient Data Exhibits

Correct Answer is {"A":{"answers":"D"},"B":{"answers":"B"}}

Explanation

While assessing a client, the nurse observes that the client has a frequent productive cough. What follow-up assessment should the nurse evaluate first?

Correct Answer is D

Explanation

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