The nurse is completing an admission assessment on a client diagnosed with asthma. What clinical manifestations are typical of the disorder?

Fever and bradypnea

Dyspnea and wheezing

Crackles and productive cough

Normal chest shape and orthopnea

Answer and Explanation

The Correct Answer is B

Choice A reason:

Fever and bradypnea are not typical manifestations of asthma. Fever is more commonly associated with infections, and bradypnea (abnormally slow breathing) is not a characteristic symptom of asthma.

Choice B reason:

Dyspnea (shortness of breath) and wheezing are hallmark symptoms of asthma. Asthma is characterized by inflammation and narrowing of the airways, which leads to difficulty breathing and a whistling sound (wheezing) when exhaling. These symptoms are often triggered by allergens, exercise, or respiratory infections.

Choice C reason:

Crackles and a productive cough are more indicative of conditions like pneumonia or chronic bronchitis rather than asthma. Asthma typically involves a dry cough rather than a productive one.

Choice D reason:

A normal chest shape and orthopnea (difficulty breathing when lying flat) are not specific to asthma. While some individuals with severe asthma may develop a barrel chest over time due to chronic overinflation of the lungs, this is not a typical early manifestation.

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Correct Answer is B

Explanation

Choice A reason: A decreased anteroposterior diameter of the chest is not typically associated with COPD and emphysema. In fact, patients with COPD often have an increased anteroposterior diameter, known as a “barrel chest,” due to hyperinflation of the lungs. This change in chest shape is a compensatory mechanism to accommodate the increased lung volume and is a common physical finding in advanced COPD.

Choice B reason: Oxygen saturation level below 95% is a common finding in patients with COPD and emphysema. These conditions impair the lungs’ ability to oxygenate the blood effectively, leading to lower oxygen levels. Chronic hypoxemia is a hallmark of COPD, and monitoring oxygen saturation is crucial in managing these patients. Normal oxygen saturation levels typically range from 95% to 100%, so levels below 95% indicate a need for supplemental oxygen or other interventions.

Choice C reason: Petechiae on the chest are not a typical finding in COPD or emphysema. Petechiae are small, red or purple spots caused by bleeding into the skin and are usually associated with conditions affecting blood clotting or platelet function. They are not related to the respiratory pathology seen in COPD and emphysema.

Choice D reason: Respiratory alkalosis is not commonly associated with COPD and emphysema. These conditions are more likely to cause respiratory acidosis due to chronic retention of carbon dioxide (CO2). In COPD, the damaged alveoli and airways lead to impaired gas exchange, resulting in elevated CO2 levels and a decrease in blood pH. Respiratory alkalosis, characterized by low CO2 levels and increased pH, is more often seen in conditions causing hyperventilation, such as anxiety or acute asthma attacks.

A. A 36-year-old male who had a minimally invasive appendectomy. The patient had community-acquired pneumonia a year ago. B. A 58-year-old female with a history of type 1 diabetes. The patient had an incision and drainage of an abscess with procedural sedation. C. A 19-year-old male having arthroscopic knee surgery under regional anesthesia. The patient has a history of exercise-induced asthma. D. A 65-year-old female who has a BMI of 32 and a long history of tobacco use. The patient had upper abdominal surgery under general anesthesia.

Correct Answer is D

Explanation

Choice A reason:

A 36-year-old male who had a minimally invasive appendectomy and a history of community-acquired pneumonia a year ago is at relatively low risk for postoperative respiratory complications. Minimally invasive surgeries typically have fewer complications, and a past episode of pneumonia does not significantly increase the risk unless there are ongoing respiratory issues.

Choice B reason:

A 58-year-old female with type 1 diabetes who had an incision and drainage of an abscess with procedural sedation has some risk factors for complications, such as diabetes, which can impair healing and immune response. However, the procedure was minor and performed under sedation, which poses less risk compared to general anesthesia.

Choice C reason:

A 19-year-old male undergoing arthroscopic knee surgery under regional anesthesia with a history of exercise-induced asthma has a low risk of respiratory complications. Regional anesthesia does not affect the respiratory system as much as general anesthesia, and exercise-induced asthma is generally well-controlled and less likely to cause complications in this context.

Choice D reason:

A 65-year-old female with a BMI of 32 and a long history of tobacco use who underwent upper abdominal surgery under general anesthesia is at the greatest risk for respiratory complications. Factors such as advanced age, obesity, smoking history, and the type of surgery (upper abdominal) significantly increase the risk of postoperative pulmonary complications. General anesthesia further exacerbates this risk due to its effects on respiratory function.

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The nurse is completing an admission assessment on a client diagnosed with asthma. What clinical manifestations are typical of the disorder?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse on a medical-surgical unit is performing an admission assessment of a client who has COPD with emphysema. The client reports that they have a frequent productive cough and shortness of breath. The nurse should anticipate which of the following assessment findings for this client?

Correct Answer is B

Explanation

Which of the following postoperative patients is at greatest risk for respiratory complications?

Correct Answer is D

Explanation

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