The Certified Registered Nurse Anesthetist (CRNA) is examining a patient after surgery with general anesthesia in the post- anesthesia care unit (PACU). The CRNA notes an audible high pitched inspiratory whistling, and is concerned for upper airway obstruction. How is this abnormal physical exam finding best described?
Rhonchi
Crackles
Wheezing
Stridor
The Correct Answer is D
A. Rhonchi is incorrect because rhonchi are low-pitched, snoring or gurgling sounds typically heard during expiration and are caused by secretions in larger airways, such as in chronic bronchitis or pneumonia. They do not indicate upper airway obstruction.
B. Crackles is incorrect because crackles (rales) are discontinuous, popping sounds heard on inspiration, usually due to alveolar fluid, pulmonary edema, or atelectasis. Crackles are not high-pitched nor typically audible without a stethoscope.
C. Wheezing is incorrect because wheezing is a high-pitched, musical sound heard primarily during expiration caused by lower airway narrowing, as in asthma or bronchospasm. Wheezing generally reflects bronchial constriction rather than obstruction of the upper airway.
D. Stridor is correct because stridor is a high-pitched, inspiratory sound that occurs due to partial obstruction of the upper airway, such as the larynx or trachea. It is often audible without a stethoscope and is a medical emergency because it can indicate significant airway compromise, especially in post-anesthesia patients who may have laryngospasm, edema, or retained secretions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Drug addict is incorrect because this term labels the person by their condition, which can perpetuate stigma and negative stereotypes. Person-first language focuses on the individual, not the diagnosis or behavior.
B. Schizophrenic is incorrect because this term defines the person by their mental illness, rather than recognizing them as a person who happens to have schizophrenia. It is stigmatizing and can contribute to discrimination.
C. Person with disabilities is correct because it uses person-first language, emphasizing the individual before their condition. This approach promotes respect, dignity, and reduces stigma by recognizing that a disability does not define the person.
D. AIDS victim is incorrect because the word “victim” carries negative connotations and frames the individual as suffering or helpless. Person-first language would be person living with HIV/AIDS, which is neutral and respectful.
Correct Answer is A
Explanation
A. Wernicke aphasia is correct because it is characterized by fluent, rapid speech that is often nonsensical, includes neologisms (invented words), and the patient demonstrates impaired comprehension of both spoken and written language. The patient cannot follow simple commands or understand questions, which is consistent with a receptive language deficit caused by damage to Wernicke’s area in the posterior superior temporal gyrus of the dominant hemisphere (usually the left).
B. Dysphonia is incorrect because it refers to disorders of vocal quality, pitch, or volume, typically due to laryngeal or vocal cord pathology. Dysphonia affects speech production but does not impair language comprehension or content.
C. Dysarthria is incorrect because it refers to impaired articulation of speech due to motor deficits (e.g., weakness, incoordination, or paralysis of the speech muscles). Dysarthric speech is often slurred, slow, or effortful, but comprehension is preserved, unlike in Wernicke aphasia.
D. Broca aphasia is incorrect because it involves nonfluent, effortful speech with relatively preserved comprehension. Patients often speak in short, broken phrases and omit small words (agrammatism), which is the opposite of the fluent but meaningless speech described in this patient.
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