The nurse is assessing the client and notes fine crackles throughout the lungs bilaterally. This assessment finding is often associated with:

Bronchitis

A pneumothorax

Asthma

Emphysema

Answer and Explanation

The Correct Answer is A

Choice A reason: Fine crackles are often associated with bronchitis, particularly chronic bronchitis. These sounds are caused by the presence of mucus in the airways, which creates a crackling noise when air passes through. Chronic bronchitis involves inflammation and increased mucus production in the bronchi, leading to these characteristic lung sounds.

Choice B reason: A pneumothorax, or collapsed lung, typically presents with absent or diminished breath sounds on the affected side rather than fine crackles. The absence of breath sounds is due to the lack of air movement in the collapsed portion of the lung. Fine crackles are not a common finding in pneumothorax.

Choice C reason: Asthma is characterized by wheezing, which is a high-pitched whistling sound caused by narrowed airways. While crackles can occasionally be heard in asthma, they are not the primary lung sound associated with this condition. Wheezing is more indicative of asthma due to bronchoconstriction and inflammation.

Choice D reason: Emphysema, a form of chronic obstructive pulmonary disease (COPD), typically presents with decreased breath sounds and prolonged expiration rather than fine crackles. The destruction of alveolar walls in emphysema leads to reduced lung sounds overall. Fine crackles are not a hallmark of emphysema.

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Correct Answer is B

Explanation

Choice A reason: Effective coughing after medication administration is not specifically required for the use of metered dose inhalers like albuterol and beclomethasone. While coughing can help clear mucus from the airways, it is not a necessary step in the administration of these medications. The primary focus should be on proper inhaler technique to ensure the medication reaches the lungs effectively.

Choice B reason: Rinsing the mouth after beclomethasone administration is crucial. Beclomethasone is an inhaled corticosteroid, and rinsing the mouth helps prevent oral thrush, a common side effect of inhaled steroids. Thrush is a fungal infection that can develop in the mouth and throat due to the residue of the medication. Proper rinsing and spitting out the water can significantly reduce the risk of this infection.

Choice C reason: Using beclomethasone as needed when breathing normally is incorrect. Beclomethasone is a maintenance medication that should be used regularly as prescribed, not on an as-needed basis. It helps control chronic inflammation in the airways and prevent asthma symptoms. Using it only when symptoms are not present would not provide the consistent anti-inflammatory effect needed to manage asthma effectively.

Choice D reason: Taking the beclomethasone first, followed by the albuterol, is incorrect. The correct sequence is to use the albuterol first. Albuterol is a bronchodilator that works quickly to open up the airways, making it easier for the beclomethasone to reach deeper into the lungs and be more effective

A. Administer oxygen per prescriber’s order to keep SpO2 greater than 96%. B. Place patient in Sims position to assist with airway clearance. C. Assess client use of a peak expiratory flow rate meter. D. Assist with coughing and deep breathing at least every 2 hours while awake.

Correct Answer is D

Explanation

Choice A reason:

Administering oxygen per the prescriber’s order to keep SpO2 greater than 96% is not typically recommended for clients with chronic bronchitis. High levels of oxygen can suppress the respiratory drive in clients with chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis. The target SpO2 for these clients is usually between 88% and 92%.

Choice B reason:

Placing the patient in the Sims position is not the most effective position for airway clearance. The Fowler’s or semi-Fowler’s position is generally preferred as it promotes better lung expansion and facilitates easier breathing.

Choice C reason:

Assessing the client’s use of a peak expiratory flow rate meter is important for monitoring the severity of bronchospasm and airflow obstruction. However, it is not a direct intervention for improving gas exchange.

Choice D reason:

Assisting with coughing and deep breathing at least every 2 hours while awake is an effective intervention for clients with chronic bronchitis. This helps to mobilize secretions, improve ventilation, and enhance gas exchange. Regular coughing and deep breathing exercises can prevent atelectasis and reduce the risk of respiratory infections.

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The nurse is assessing the client and notes fine crackles throughout the lungs bilaterally. This assessment finding is often associated with:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is diagnosed with asthma. The therapeutic regimen using metered dose inhalers includes albuterol 2 puffs and beclomethasone 2 puffs. The nursing plan of care must include teaching regarding:

Correct Answer is B

Explanation

The nurse has applied a client problem of ineffective gas exchange for a client diagnosed with chronic bronchitis. Which intervention would the nurse include in the plan of care?

Correct Answer is D

Explanation

What information would be important for the nurse to reinforce when teaching a pre-operative client about the correct use of the patient-controlled analgesia (PCA) device to achieve the best outcome?

The nurse is providing discharge teaching for a client diagnosed with right lower lobe pneumonia. What information should be provided for this client? (SELECT ALL THAT APPLY)

The nurse recognizes that the primary physiologic problem affecting clients with emphysema is:

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