The nurse is caring for a client with a diagnosis of emphysema of five years. Which of the following findings should the nurse expect to see during the morning assessment? (Select all that apply)
Barrel chest
Edema
Productive cough
Dyspnea
Clubbed fingers
Correct Answer : A,D,E
Choice A reason: Barrel chest develops in emphysema from chronic air trapping, overexpanding lungs and flattening the diaphragm, altering thoracic shape over years.
Choice B reason: Edema relates to right heart failure from cor pulmonale, a late emphysema complication, not a direct or universal finding after five years.
Choice C reason: Productive cough is typical in chronic bronchitis, not emphysema, which features alveolar destruction and minimal mucus, leading to dry cough instead.
Choice D reason: Dyspnea in emphysema results from alveolar loss reducing oxygen exchange, forcing compensatory rapid breathing, a core symptom even after five years.
Choice E reason: Clubbed fingers occur in chronic hypoxia from emphysema, as poor oxygenation over years triggers nail bed angiogenesis, a common late finding.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B"]
Explanation
Choice A reason: Calcium carbonate supplements increase serum calcium by providing exogenous calcium, worsening hyperparathyroidism’s already elevated levels from excessive PTH-driven bone resorption and gut absorption.
Choice B reason: A low calcium diet reduces intake, limiting absorption, while high fiber binds calcium in the gut, enhancing fecal excretion, countering PTH’s hypercalcemic effect in hyperparathyroidism.
Choice C reason: Parathyroidectomy removes overactive glands, directly stopping excessive PTH production, which drives calcium release from bones and reabsorption in kidneys, effectively normalizing calcium levels.
Choice D reason: Furosemide, a loop diuretic, increases renal calcium excretion by inhibiting reabsorption in the loop of Henle, reducing serum calcium elevated by PTH in hyperparathyroidism.
Choice E reason: Fluid restriction raises calcium concentration by reducing dilution, worsening hypercalcemia in hyperparathyroidism, where PTH already increases calcium reabsorption, making this counterproductive.
Correct Answer is D
Explanation
Choice A reason: Working in undeveloped areas increases general infection risk, but hepatitis B specifically requires blood or fluid exposure, less likely without direct contact.
Choice B reason: Attending a conference poses low hepatitis B risk, as it’s not spread by casual contact, requiring blood or sexual transmission, not typical here.
Choice C reason: Assisting in birth involves fluid exposure, but two weeks is too short for hepatitis B symptoms; incubation is 45-180 days, so unlikely.
Choice D reason: Tattooing with unsterile needles risks hepatitis B via bloodborne transmission, matching the 90-day incubation period, the most likely risk here.
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