The nurse has just received a change of shift report on four patients. Which patient will the nurse assess first?

A post-operative patient after thyroid surgery preparing for discharge with a new medication

A patient diagnosed with Cushing's disease after insertion of a nasogastric tube

A patient scheduled for a chest radiograph who is anxious about their treatment

A patient with chronic obstructive pulmonary disease who requested a breathing treatment during the previous shift

Answer and Explanation

The Correct Answer is D

Choice A reason: While a post-operative patient preparing for discharge is important, they are stable enough to be considered for discharge and do not require immediate assessment.

Choice B reason: A patient with Cushing's disease after insertion of a nasogastric tube may need monitoring, but this is not as urgent as a patient with potential respiratory distress.

Choice C reason: A patient scheduled for a chest radiograph who is anxious about their treatment does not require immediate intervention compared to a patient experiencing respiratory issues.

Choice D reason: A patient with chronic obstructive pulmonary disease who requested a breathing treatment during the previous shift may be experiencing respiratory distress and requires immediate assessment and intervention to prevent further complications.

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Correct Answer is B

Explanation

Choice A reason: Hypoventilation is not a cause of respiratory alkalosis. Hypoventilation leads to respiratory acidosis due to the retention of carbon dioxide (CO2). Respiratory alkalosis occurs when there is excessive exhalation of CO2, leading to a higher pH (alkaline).

Choice B reason: Panic attacks can cause respiratory alkalosis due to hyperventilation. During a panic attack, a person may breathe rapidly and deeply, leading to excessive loss of CO2. This reduces the CO2 levels in the blood and increases the pH, resulting in respiratory alkalosis.

Choice C reason: Pneumonia is more likely to cause respiratory acidosis or metabolic acidosis rather than respiratory alkalosis. Pneumonia can impair gas exchange, leading to CO2 retention and decreased oxygen levels, which are not typical triggers for respiratory alkalosis.

Choice D reason: Congestive heart failure can lead to respiratory alkalosis, but it is more commonly associated with metabolic acidosis due to poor perfusion and anaerobic metabolism. Hyperventilation in heart failure patients can lead to respiratory alkalosis, but panic attacks are a more direct and common cause.

A. Bronchoconstriction B. Pulmonary edema C. Hemoptysis D. Pneumothorax

Correct Answer is A

Explanation

Choice A reason:

Bronchoconstriction is the hallmark of COPD. The narrowing of the airways produces wheezing that is heard throughout the lung fields, making this finding consistent with the patient’s condition.

Choice B reason:

Pulmonary edema usually causes crackles (rales), not widespread wheezing. It’s more related to fluid overload in the lungs rather than airway narrowing.

Choice C reason:

Hemoptysis involves coughing up blood. This symptom does not correlate with wheezing and would be noted as blood in the sputum, not an audible finding on auscultation.

Choice D reason:

Pneumothorax typically presents with diminished or absent breath sounds on the affected side, not diffuse wheezing. It is more associated with sudden chest pain and respiratory distress.

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The nurse has just received a change of shift report on four patients. Which patient will the nurse assess first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient with respiratory alkalosis. What will the nurse recognize as the potential cause of this acid-base imbalance?

Correct Answer is B

Explanation

The nurse is assessing a patient with chronic obstructive pulmonary disease (COPD) who is reporting dyspnea. The nurse auscultates the patient's chest and hears wheezing throughout the lung fields. What does this finding indicate to the nurse about this patient?

Correct Answer is A

Explanation

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