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 A
Explanation
Choice A reason: Mucolytics (e.g., acetylcysteine) break disulfide bonds in mucus, thinning it to ease expectoration, directly aiding secretion clearance in respiratory conditions.
Choice B reason: Glucocorticoids reduce inflammation in airways, not liquefying mucus; they address swelling, not viscosity, so they don’t facilitate expulsion directly.
Choice C reason: Calcium channel blockers relax vascular smooth muscle for hypertension, not affecting mucus consistency or respiratory secretions, irrelevant to this goal.
Choice D reason: Bronchodilators open airways, improving airflow, but don’t alter mucus viscosity, aiding breathing, not secretion liquefaction or removal specifically.
Correct Answer is A
Explanation
Choice A reason: ESRD impairs fluid excretion, causing hypervolemia, leading to edema, crackles from pulmonary fluid, and hypertension from increased vascular volume, matching these symptoms.
Choice B reason: Hypovolemia, low fluid volume, causes hypotension and dry tissues, not swelling, crackles, or high blood pressure, which indicate excess fluid, not deficit.
Choice C reason: Hyperkalemia elevates potassium, causing arrhythmias or muscle issues, not directly linked to crackles, edema, or hypertension, which are fluid-related in ESRD.
Choice D reason: Hyponatremia, low sodium, may cause neurological symptoms, but crackles, edema, and hypertension point to fluid overload, not sodium imbalance primarily.
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