Patient Data
What finding(s) are cues for a respiratory problem? Select all that apply.
Sitting upright
Tightness in the chest
Medication compliance
Respirations of 28 breaths/minute
Restlessness
Dyspnea
Pulse oxygenation of 85%
Correct Answer : A,B,D,E,F,G
A. Patients with respiratory distress often prefer to sit upright or in a tripod position to ease breathing by allowing maximal lung expansion. Sitting upright helps relieve pressure on the diaphragm and allows better air exchange in the lungs.
B. Chest tightness is a common symptom of various respiratory conditions, such as asthma, chronic obstructive pulmonary disease (COPD), or pneumonia. It can result from bronchoconstriction, inflammation, or accumulation of mucus in the airways, leading to difficulty breathing.
D. An increased respiratory rate (tachypnea) may indicate respiratory distress or difficulty breathing. Tachypnea is a compensatory mechanism to increase oxygen intake or remove carbon dioxide from the body when lung function is compromised.
E. Restlessness can be a cue for a respiratory problem. Patients experiencing respiratory distress may exhibit restlessness due to hypoxia (low oxygen levels), discomfort, or anxiety related to difficulty breathing.
F. Dyspnea, or shortness of breath, is a significant cue for a respiratory problem. It is a common symptom of various respiratory conditions, including asthma, COPD, pneumonia, and pulmonary embolism. Dyspnea may range from mild to severe and can significantly impact the patient's quality of life and functional status.
G. A pulse oxygenation level of 85% indicates hypoxemia (low blood oxygen levels) and is a significant cue for a respiratory problem. Hypoxemia can result from various respiratory conditions or inadequate ventilation and may lead to tissue hypoxia and organ dysfunction if left untreated.
C. Medication compliance is not directly indicative of a respiratory problem. However, it may be relevant to managing respiratory conditions if the patient requires medications such as bronchodilators or corticosteroids to control symptoms or prevent exacerbations.
H. While an elevated heart rate (tachycardia) can be associated with respiratory distress, it is not specific to respiratory problems and may occur in response to other stressors or medical conditions.
I. Body mass index (BMI) is a measure of body fat based on height and weight and is not directly indicative of a respiratory problem. However, obesity is a risk factor for respiratory conditions such as obstructive sleep apnea and obesity hypoventilation syndrome.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
B. Acute pancreatitis is inflammation of the pancreas that can cause severe upper abdominal pain, which may radiate to the back, fever, and vomiting. Elevated serum amylase and lipase levels are characteristic laboratory findings in acute pancreatitis, indicating pancreatic injury or inflammation. The client's symptoms and laboratory results are consistent with acute pancreatitis.
A. Hepatorenal failure, also known as hepatorenal syndrome, is a serious complication of advanced liver disease where there is progressive renal failure in the setting of liver dysfunction. While hepatorenal syndrome can present with symptoms such as abdominal pain, fever, and vomiting, it is not typically associated with significantly elevated serum amylase and lipase levels.
C. Biliary duct obstruction occurs when there is a blockage in the bile ducts, leading to impaired flow of bile from the liver to the small intestine. While biliary duct obstruction can cause symptoms such as upper abdominal pain and vomiting, it is not typically associated with significantly elevated serum amylase and lipase levels.
D. While surgical site infection is a potential complication following cholecystectomy (gallbladder removal surgery), it typically presents with symptoms such as wound redness, swelling, warmth, and purulent drainage from the incision site.
Correct Answer is C
Explanation
C. The DASH eating plan emphasizes consumption of fruits, vegetables, low-fat dairy products, whole grains, lean proteins, and limited amounts of saturated fats, cholesterol, and sodium. Therefore, enjoying fat-free yogurt as an occasional snack food aligns with the principles of the DASH eating plan.
A. is a good practice for food safety but does not specifically indicate adherence to the DASH eating plan. The DASH plan encourages consumption of fruits and vegetables but does not require meticulous cleaning or peeling.
B. may be suitable for individuals with lactose intolerance but is not a specific requirement of the DASH eating plan. The DASH plan recommends low-fat or fat-free dairy products but does not specify lactose-free products.
D. The DASH plan encourages consumption of whole grains as part of a balanced diet and recommends incorporating whole grains such as whole wheat, brown rice, and oats.
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