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 C
Explanation
Choice A reason: Crackles indicate pulmonary edema from left-sided heart failure, where fluid backs up into lungs, not right-sided failure, which affects systemic circulation instead.
Choice B reason: Orthopnea, dyspnea when lying flat, results from left-sided failure’s pulmonary congestion, not right-sided failure, which causes systemic venous pooling, not lung issues.
Choice C reason: Jugular venous distention occurs in right-sided heart failure as the right ventricle fails, backing blood into veins, elevating neck vein pressure visibly.
Choice D reason: Blood-tinged sputum suggests pulmonary edema or infarction, tied to left-sided failure or embolism, not right-sided failure’s systemic congestion pattern.
Correct Answer is B
Explanation
Choice A reason: Fever of 103°F may occur in thyroid storm, not goiter, which is simply thyroid enlargement without systemic hypermetabolism or infection necessarily.
Choice B reason: Goiter is defined by thyroid gland enlargement, often from iodine deficiency or hyperplasia, palpable as a neck mass, the core characteristic here.
Choice C reason: Fibrotic tissue in arterioles relates to vascular diseases, not goiter, which involves thyroid tissue growth, not arterial structural changes.
Choice D reason: Glycosaminoglycan deposits occur in myxedema (hypothyroidism), not goiter, which is enlargement alone, not skin or connective tissue alteration.
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