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. Request social services to make a home visit. This is important but not the immediate priority. It can be part of the long-term intervention plan once the immediate safety and health of the client are ensured.
B. Interview the client privately without the adult child present. This is the highest priority. It allows the nurse to assess for potential abuse or neglect without the influence or intimidation of the accompanying adult, ensuring the client can speak freely.
C. Complete a neurological and musculoskeletal assessment. This is important to assess the extent of the injuries and the client's overall physical health, but it follows the immediate need to ensure the client's safety and ability to speak freely about their situation.
D. Ask the client if an assisted living facility is an option for safety concerns. While exploring living arrangements is important for long-term safety, it is not the highest priority. Ensuring the client's immediate safety and obtaining accurate information about their situation takes precedence.
Correct Answer is B
Explanation
A. Suggest that the parent read aloud to the child at bedtime. Reading aloud to the child is a beneficial practice that can enhance language development, vocabulary, and communication skills. It provides the child with exposure to language in a meaningful context and can stimulate spontaneous speech.
B. Discuss with the parent the need for a hearing screening. A hearing screening is a prudent intervention as hearing issues can significantly impact speech development. Ensuring the child has normal hearing is a critical first step in addressing delayed speech. Once hearing issues are ruled out, reading aloud and other strategies can be more effectively implemented.
C. Recommend that the parent enroll the child in preschool. Enrolling the child in preschool can provide a language-rich environment and opportunities for social interaction, which can stimulate speech and language development. However, this may not be the first step without ruling out other issues like hearing problems.
D. Encourage the parent to tell the child to ask for what he wants. Encouraging the child to use words to express needs is helpful for language development. It promotes verbal communication and helps the child learn to articulate desires and needs. This strategy, combined with other interventions, can be effective.
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