The nurse hears crackles when auscultating a client's lung sounds. Which is an accurate description of the sound of crackles?
A bubbling sound heard during inspiration and expiration in the central airways.
A crowing noise heard during inspiration over the trachea.
Popping, nonmusical sounds heard in the lung bases, usually during inspiration.
Superficial squeaking or grating sounds heard during inspiration and expiration.
The Correct Answer is C
A. A bubbling sound heard during inspiration and expiration in the central airways: This description is accurate. Crackles (also called rales) are often heard in conditions like pulmonary edema or pneumonia.
B. A crowing noise heard during inspiration over the trachea: This description refers to stridor, not crackles. Stridor occurs due to upper airway obstruction.
C. Popping, non-musical sounds heard in the lung bases, usually during inspiration: This description is accurate for crackles. They occur due to fluid or secretions in the alveoli.
D. Superficial squeaking or grating sounds heard during inspiration and expiration: This description refers to wheezes, not crackles. Wheezes are associated with narrowed airways.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Auscultate the lymph node for the presence of a bruit.
Auscultating for a bruit over a lymph node may not be the most immediate or relevant action in this situation. While it could provide additional information about blood flow, it may not necessarily explain the cause of the enlarged lymph node.
B. Ask the client about any localized tenderness at the site.
This is an appropriate action. Localized tenderness at the site of an enlarged lymph node could indicate inflammation or infection. Gathering information about tenderness can help in understanding the possible cause of the lymphadenopathy.
C. Cover the inflamed area and notify the healthcare provider.
This is a reasonable action. Covering the inflamed area can help protect it from further irritation or infection. Notifying the healthcare provider is important because they can assess the lymph node, gather additional history, and determine if further evaluation or treatment is necessary.
D. Record this normal finding in the assessment record.
This option is incorrect. An enlarged, visible lymph node is not considered a normal finding. It could indicate underlying infection, inflammation, or another health issue. Recording it as a normal finding could lead to overlooking potential health concerns.
Correct Answer is B
Explanation
A. Adduction, abduction, and rotation. These movements are more relevant to the hip joint. While rotation can apply to the knee, adduction and abduction do not. These are not the primary movements for assessing knee range of motion.
B. Extension, flexion, and hyperextension. These are the primary movements used to assess the range of motion in the knee joint. Extension and flexion measure the ability of the knee to straighten and bend, respectively. Hyperextension assesses the extent to which the knee can move beyond its normal straight position.
C. Internal and external rotation. While the knee does have some rotational capacity, these movements are limited and not typically used as primary measures of knee range of motion. They are more applicable to hip joint assessments.
D. Pronation and supination. These terms refer to movements of the forearm and wrist, not the knee. They describe the rotational movement of the forearm where the palm turns up (supination) or down (pronation).
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