The nurse provides care for a client diagnosed with bronchitis. Which statement is most significant during the assessment of a client diagnosed with chronic bronchitis?
"I was short of breath when I walked around the block yesterday."
"I have a loose sounding cough every day when I get up in the morning."
"My respiratory secretions are greenish-yellow colored today."
"My feet are swollen and painful at the end of the afternoon."
The Correct Answer is B
Choice A reason: "I was short of breath when I walked around the block yesterday." is not the most significant statement because it is a common symptom of chronic bronchitis, but it does not indicate the severity or the progression of the condition. Shortness of breath is caused by the inflammation and narrowing of the airways, which reduce the airflow and oxygen delivery to the lungs.
Choice B reason: "I have a loose sounding cough every day when I get up in the morning." is the most significant statement because it indicates the presence of excessive mucus production, which is a hallmark of chronic bronchitis. Mucus traps bacteria and other irritants, which can lead to infections and further inflammation of the airways. A chronic cough is defined as a cough that lasts for at least three months in two consecutive years.
Choice C reason: "My respiratory secretions are greenish-yellow colored today." is not the most significant statement because it is a sign of a possible infection, but it does not necessarily indicate chronic bronchitis. Greenish-yellow colored sputum can be caused by various respiratory conditions, such as pneumonia, tuberculosis, or cystic fibrosis.
Choice D reason: "My feet are swollen and painful at the end of the afternoon." is not the most significant statement because it is a sign of a possible complication of chronic bronchitis, but it does not directly relate to the condition. Swollen and painful feet can be caused by right-sided heart failure, which can result from chronic bronchitis. Chronic bronchitis can increase the pressure in the pulmonary arteries, which can strain the right ventricle and cause it to fail. This can lead to fluid retention and edema in the lower extremities.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Uric acid is the most common type of renal calculi in clients with gout because it is a condition where the blood has a high level of uric acid, which is a waste product that results from the breakdown of purines, which are substances found in some foods and drinks, such as meat, seafood, and beer. Uric acid can form crystals in the joints, causing inflammation and pain, which is known as gout. Uric acid can also form crystals in the urine, causing kidney stones, which are hard deposits of minerals and salts that can block the urinary tract and cause symptoms such as severe pain, blood in the urine, nausea, and fever.
Choice B reason: Struvite is not the most common type of renal calculi in clients with gout because it is a condition where the urine has a high level of ammonia, which is a chemical that results from the breakdown of urea, which is a waste product that is produced by the liver and excreted by the kidneys. Ammonia can form crystals in the urine, along with magnesium, phosphate, and carbonate, creating struvite stones, which are large and staghorn-shaped stones that can fill the entire kidney or the ureter. Struvite stones are usually associated with urinary tract infections, which are caused by bacteria that produce enzymes that increase the urine pH and the ammonia level.
Choice C reason: Cystine is not the most common type of renal calculi in clients with gout because it is a condition where the urine has a high level of cystine, which is an amino acid that is a building block of proteins. Cystine can form crystals in the urine, causing kidney stones, which are rare and hereditary. Cystine stones are caused by a genetic disorder that affects the transport of cystine and other amino acids in the kidneys, resulting in excessive excretion of cystine in the urine.
Choice D reason: Calcium oxalate is not the most common type of renal calculi in clients with gout because it is a condition where the urine has a high level of calcium and oxalate, which are substances that are normally present in the diet and the body. Calcium and oxalate can form crystals in the urine, causing kidney stones, which are the most common type of kidney stones in the general population, but not in clients with gout. Calcium oxalate stones can be caused by various factors, such as dehydration, high intake of animal protein, low intake of fluids, and certain medications.
Correct Answer is B
Explanation
Choice A reason: Weight gain is not a common complication of Crohn's disease because Crohn's disease causes inflammation and ulceration of the digestive tract, which can lead to malabsorption, diarrhea, and weight loss.
Choice B reason: Perianal fistula is a common complication of Crohn's disease because Crohn's disease can cause deep ulcers that penetrate the bowel wall and create abnormal connections between the bowel and the skin around the anus. Perianal fistulas can cause pain, bleeding, infection, and fecal incontinence.
Choice C reason: Vomiting after meals is not a common complication of Crohn's disease because Crohn's disease mainly affects the small intestine and the colon, not the stomach. Vomiting after meals can be a sign of gastric ulcers, gastritis, or gastroparesis.
Choice D reason: Urinary tract infections are not a common complication of Crohn's disease because Crohn's disease does not directly affect the urinary system. However, some people with Crohn's disease may develop enterovesical fistulas, which are abnormal connections between the bowel and the bladder. Enterovesical fistulas can cause urinary tract infections, hematuria, and pneumaturia.
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