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."

Answer and Explanation

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.

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Correct Answer is C

Explanation

Choice A reason: Hemothorax is not the correct explanation because it is a condition where blood accumulates in the pleural space, which is the area between the lungs and the chest wall. Hemothorax can cause low blood pressure, rapid breathing, and reduced breath sounds, but it does not cause tracheal deviation, which is a sign of increased pressure in the chest.

Choice B reason: Absorption atelectasis is not the correct explanation because it is a condition where the alveoli, which are the tiny air sacs in the lungs, collapse due to lack of oxygen. Absorption atelectasis can cause reduced breath sounds, but it does not cause low blood pressure, rapid breathing, or tracheal deviation, which are signs of a life-threatening emergency.

Choice C reason: Tension pneumothorax is the correct explanation because it is a condition where air leaks into the pleural space and creates a one-way valve that prevents the air from escaping. This causes the pressure in the chest to increase, which compresses the lung, the heart, and the great vessels. Tension pneumothorax can cause low blood pressure, rapid breathing, absent breath sounds, and tracheal deviation, which are signs of a medical emergency that requires immediate treatment.

Choice D reason: Hypovolemic shock is not the correct explanation because it is a condition where the body loses a large amount of blood or fluid, which reduces the blood volume and the blood pressure. Hypovolemic shock can cause low blood pressure and rapid breathing, but it does not cause absent breath sounds or tracheal deviation, which are signs of a chest injury.

A. Increased serum hydrostatic pressure B. Increased kidney filtration pressure C. Decreased capillary osmotic pressure D. Intracellular dehydration

Correct Answer is C

Explanation

Choice A reason: Increased serum hydrostatic pressure is not the best explanation for the edema because it is caused by fluid overload, not malnutrition. Fluid overload can result from heart failure, kidney failure, or excessive fluid intake.

Choice B reason: Increased kidney filtration pressure is not the best explanation for the edema because it is caused by increased blood flow to the kidneys, not malnutrition. Increased blood flow to the kidneys can result from hypertension, diabetes, or renal artery stenosis.

Choice C reason: Decreased capillary osmotic pressure is the best explanation for the edema because it is caused by low plasma protein levels, which are common in malnutrition. Low plasma protein levels reduce the force that pulls fluid back into the capillaries from the interstitial space, leading to fluid accumulation in the tissues.

Choice D reason: Intracellular dehydration is not the best explanation for the edema because it is caused by loss of water from the cells, not malnutrition. Loss of water from the cells can result from hypernatremia, hyperglycemia, or osmotic diuresis.

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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?

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