The nurse is assessing the respiratory status of a client who has suffered a fractured rib. Which observation, if made by the nurse, would not be directly related to the fractured rib?

Pleural effusion on the unaffected side

Shallow breathing due to pain

Guarding behavior when taking deep breaths

Localized chest pain on inspiration

Answer and Explanation

The Correct Answer is A

A. Pleural effusion on the unaffected side is not directly related to a fractured rib. While rib fractures can lead to complications such as pneumothorax or hemothorax, pleural effusion on the opposite side is likely caused by another condition, such as infection or malignancy, and should be investigated separately.

B. Shallow breathing due to pain is a common response to a fractured rib, as the client may avoid deep breaths to minimize discomfort.

C. Guarding behavior when taking deep breaths is directly related to the pain caused by the fractured rib and is an expected observation.

D. Localized chest pain on inspiration is a hallmark symptom of a fractured rib, as the injury causes discomfort with chest wall movement during breathing.

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Correct Answer is D

Explanation

A. Fluticasone is an inhaled corticosteroid often used to manage asthma. It does not pose a direct risk to a client with heart failure and asthma, so clarification is not needed for this medication.

B. Amoxicillin is an antibiotic and does not directly affect asthma or heart failure. It is not contraindicated in clients with these conditions, so clarification is not necessary.

C. Isosorbide dinitrate is a nitrate used to treat heart failure by reducing cardiac workload and improving oxygen delivery. It does not affect asthma and does not require clarification.

D. Carvedilol is a beta-blocker that is commonly used to manage heart failure, but it is a non-selective beta-blocker, which can exacerbate asthma symptoms by causing bronchoconstriction. In clients with a history of asthma, beta-1 selective blockers are preferred, so clarification of this order is necessary.

A. Anxiety attack B. Pneumonia C. Pulmonary embolism D. Asthma exacerbation

Correct Answer is C

Explanation

A. While anxiety can cause rapid breathing and confusion, the patient's clinical presentation (dyspnea, confusion, tachycardia, hypotension, and oxygen desaturation) is more consistent with a serious physical condition, such as a pulmonary embolism, rather than an anxiety attack.

B. Pneumonia could cause dyspnea and confusion, but the rapid onset of symptoms, along with the patient's history of prolonged bed rest and risk factors, suggests a pulmonary embolism rather than pneumonia.

C. Pulmonary embolism (PE) is a life-threatening condition that can occur in patients on prolonged bedrest, especially after a pelvic fracture. The patient’s symptoms of dyspnea, confusion, tachycardia, hypotension, and oxygen desaturation are classic signs of PE. This requires immediate intervention, including anticoagulation and possibly thrombolytic therapy.

D. Asthma exacerbation typically presents with wheezing and difficulty breathing, but it would not typically cause the severe hypotension, confusion, and rapid oxygen desaturation seen in this patient.

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The nurse is assessing the respiratory status of a client who has suffered a fractured rib. Which observation, if made by the nurse, would not be directly related to the fractured rib?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who has heart failure and a history of asthma. The nurse reviews the provider's orders and recognizes that clarification is needed for which of the following medications?

Correct Answer is D

Explanation

A patient on prolonged bedrest following a pelvic fracture becomes dyspneic and confused. Pulse = 135 beats/minute, blood pressure = 90/50 mmHg, respirations = 36/minute, Oxygen saturation starts dropping rapidly. Which of the following conditions should the nurse prepare to treat for this patient?

Correct Answer is C

Explanation

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