The nurse is completing an admission assessment of a client who is admitted to milieu. Which piece of information obtained from the client during the assessment would require immediate investigation from the nurse regarding the client’s use of complementary and alternative therapies?

Choice A Reason:

Wheezes are continuous, high-pitched, musical sounds that occur when air flows through narrowed or obstructed airways1. They can be heard during both inspiration and expiration and are commonly associated with conditions such as asthma, chronic obstructive pulmonary disease (COPD), and bronchitis. Wheezes are a key indicator of airway obstruction and require prompt medical attention to address the underlying cause.

Choice B Reason:

Rhonchi are low-pitched, continuous sounds that resemble snoring or gurgling. They are typically caused by secretions or obstructions in the larger airways. Unlike wheezes, rhonchi are not high-pitched and do not have a musical quality. They are often heard in conditions like chronic bronchitis and can sometimes be cleared with coughing.

Choice C Reason:

Fine crackles are discontinuous, high-pitched popping sounds heard during inspiration. They are caused by the sudden opening of small airways and alveoli that are collapsed or filled with fluid. Fine crackles are often associated with conditions such as pneumonia, heart failure, and pulmonary fibrosis. They are not continuous sounds and do not have the musical quality of wheezes.

Choice D Reason:

Vesicular sounds are normal breath sounds heard over most of the lung fields. They are soft, low-pitched, and rustling in quality during inspiration and are fainter during expiration. Vesicular sounds indicate normal, unobstructed airflow through the small airways and alveoli. They are not continuous or high-pitched and do not have a musical quality.

The correct answer is d.

Choice A Reason:

The statement “Bureaucratic” is incorrect. Bureaucratic leadership is characterized by strict adherence to rules and procedures, with decisions made based on established policies. While this style ensures consistency and compliance, it does not typically involve the direct and decisive intervention seen in the scenario described. Bureaucratic leaders focus more on following protocols rather than making quick, authoritative decisions.

Choice B Reason:

The statement “Laissez-Faire” is incorrect. Laissez-Faire leadership is a hands-off approach where leaders provide minimal direction and allow team members to make their own decisions. This style is the opposite of what is demonstrated in the scenario, where the nurse takes immediate control of the situation. Laissez-Faire leaders typically avoid intervening directly and prefer to let issues resolve themselves.

Choice C Reason:

The statement “Democratic” is incorrect. Democratic leadership involves participative decision-making, where leaders seek input and feedback from team members before making decisions. In the scenario, the nurse does not seek input from the group but instead makes a unilateral decision to handle the matter and move on. This approach is not characteristic of democratic leadership, which values collaboration and consensus.

Choice D Reason:

The statement “Autocratic” is correct. Autocratic leadership is characterized by individual control over decisions, with little input from group members. The nurse’s behavior in the scenario—taking charge of the situation and making a quick decision without consulting the group—is indicative of an autocratic leadership style. Autocratic leaders are decisive and often make decisions independently, focusing on efficiency and control.