In the context of asthma exacerbation, what does a 'silent chest' indicate?

A complete absence of wheezing and breath sounds due to severe airway obstruction

Reduced pulmonary congestion leading to clearer breath sounds

An improvement in asthma symptoms due to effective bronchodilation

A temporary condition that resolves without treatment

Answer and Explanation

The Correct Answer is A

Rationale:
A. A 'silent chest' is a medical emergency in asthma. It occurs when severe airway obstruction prevents air movement, resulting in little or no audible wheezing or breath sounds. This indicates critical respiratory distress and requires immediate intervention.
B. Reduced pulmonary congestion does not cause a silent chest; asthma involves bronchospasm, not fluid overload.
C. Improvement due to bronchodilation would produce clearer breath sounds but not a complete absence of sound.
D. A temporary condition that resolves without treatment is incorrect; a silent chest is life-threatening and will not resolve without immediate medical intervention.

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Correct Answer is A

Explanation

Rationale:
A. Obtaining a sputum culture is essential to identify the causative pathogen and guide appropriate antibiotic or antifungal therapy in a client with recurring pneumonia and immunocompromised status.
B. Positioning the head of the bed at 10 degrees is insufficient; a semi- to high-Fowler’s position (30–90 degrees) is recommended to promote lung expansion and reduce aspiration risk.
C. Coughing and deep breathing every 8 hr is inadequate; these interventions should be performed every 1–2 hr while awake to effectively mobilize secretions.
D. Encouraging only 1500 mL/day of fluids may be insufficient; clients with pneumonia generally require adequate hydration to help thin secretions, unless restricted for another medical reason.

A. Isosorbide dinitrate B. Fluticasone C. Captopril D. Carvedilol

Correct Answer is D

Explanation

Rationale:
A. Isosorbide dinitrate is a nitrate used to reduce preload and manage heart failure symptoms; it is safe for clients with asthma.
B. Fluticasone is an inhaled corticosteroid used to manage asthma and does not worsen heart failure.
C. Captopril is an ACE inhibitor that treats heart failure and is safe for clients with asthma.
D. Carvedilol is a non-selective beta-blocker. Non-selective beta-blockers can exacerbate asthma by causing bronchoconstriction. In clients with asthma, beta-blocker therapy should be clarified, and cardioselective options are generally preferred.

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In the context of asthma exacerbation, what does a 'silent chest' indicate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is implementing a plan of care for a client who has AIDS with recurring pneumonia. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

The nurse is caring for a client who has heart failure and a history of asthma. The nurse reviews the provider's orders and recognizes that clarification is needed for which of the following medications?

Correct Answer is D

Explanation

Which of the following patients is at the highest risk for developing pneumonia?

A nurse is admitting a client who is having an exacerbation of his asthma. When reviewing the provider's orders, the nurse recognizes that clarification is needed for which of the following medications?

A nurse in a provider's office is assessing a client. The nurse should identify that which of the following findings are manifestations of pulmonary tuberculosis? (Select all that apply)

A nurse is caring for a client who has pneumonia and a prescription for oxygen therapy at 5 L/min via nasal cannula. Which of the following actions should the nurse take?

The nurse is teaching a patient recently diagnosed with coccidioidomycosis. Which patient statement indicates a need for further teaching? (Select All that Apply.)

A patient with suspected coccidioidomycosis is admitted to the hospital, which of the following infection control measures should the nurse prioritize?

Which of the following are the most common manifestations of COPD? (Select all that apply.)

A nurse is assessing a client for hypoxemia during an asthma attack. Which of the following manifestations should the nurse expect?