The practical nurse (PN) is assisting the nurse with the admission physical assessment of a client diagnosed with pneumonia. Which symptom(s) is/are this client likely to exhibit? (Select all that apply.)

Ankle edema.

Lung crackles.

Dyspnea.

Painful cough.

Bradycardia.

Answer and Explanation

Correct Answer : B,C,D

A. Ankle edema: Ankle edema is typically associated with fluid retention related to heart failure, kidney disease, or venous insufficiency. It is not a common symptom of pneumonia, which primarily affects the lungs and respiratory function.

B. Lung crackles: Crackles are indicative of fluid or exudate in the alveoli, a hallmark finding in pneumonia. These abnormal lung sounds are detected on auscultation and reflect the inflammation and consolidation occurring in the lungs.

C. Dyspnea: Shortness of breath occurs as pneumonia impairs gas exchange in the alveoli. Clients often experience increased work of breathing and a feeling of air hunger, particularly with exertion or in severe infection.

D. Painful cough: A productive or dry cough can be painful due to irritation of the inflamed lung tissue and pleura. Coughing is a common symptom as the body attempts to clear secretions and pathogens from the respiratory tract.

E. Bradycardia: Pneumonia is more often associated with tachycardia due to fever, hypoxia, or systemic infection. Bradycardia is uncommon and would generally indicate another underlying cardiac issue rather than the pulmonary infection itself.

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Correct Answer is A

Explanation

A. Sitting on side of bed with feet flat on the floor: Sitting upright with feet supported allows maximum lung expansion and diaphragmatic movement, facilitating effective deep breathing and coughing. This position also promotes airway clearance and reduces the risk of postoperative complications like atelectasis.

B. Left-lateral with pillow between flexed knees: Lateral positioning may be comfortable for rest but does not optimize lung expansion or coughing efficiency. It can limit diaphragmatic movement and the force generated during a cough.

C. Lying prone with the head turned to one side: The prone position restricts lung expansion and is uncomfortable for many postoperative clients. It is not conducive to effective coughing or deep breathing exercises.

D. Leaning forward over the bedside table: While this position may slightly assist in coughing, it does not provide as stable or effective support for diaphragmatic movement as sitting upright with feet flat, which promotes maximal lung expansion.

A. Insert an indwelling catheter to empty the bladder and contract the fundus. B. Return the client to bed and maintain bed rest until the lochial flow slows. C. Massage the fundus and avoid direct pressure on the cesarean incision. D. Check fundal consistency and continue to monitor the lochial flow amount.

Correct Answer is C

Explanation

A. Insert an indwelling catheter to empty the bladder and contract the fundus: While bladder distention can contribute to uterine atony, inserting a catheter alone does not directly address the immediate concern of active bleeding. The priority is to stimulate uterine contraction to control hemorrhage.

B. Return the client to bed and maintain bed rest until the lochial flow slows: Simply placing the client back in bed does not actively manage the bleeding. Postpartum hemorrhage requires prompt intervention to prevent hypovolemic complications.

C. Massage the fundus and avoid direct pressure on the cesarean incision: Fundal massage promotes uterine contraction, which helps control excessive postpartum bleeding. Avoiding pressure on the incision protects the surgical site while effectively addressing the immediate risk of hemorrhage from uterine atony.

D. Check fundal consistency and continue to monitor the lochial flow amount: Monitoring is important, but it is not the first action when a client presents with sudden gushes of blood and clots. Immediate fundal massage is necessary to stimulate contraction and reduce blood loss.

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The practical nurse (PN) is assisting the nurse with the admission physical assessment of a client diagnosed with pneumonia. Which symptom(s) is/are this client likely to exhibit? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

The practical nurse (PN) is assisting a client to cough and deep breathe following surgery. To facilitate effective coughing, the PN should assist the client to assume which position?

Correct Answer is A

Explanation

On the first day after a cesarean section, a client who is a primipara is being assisted to the bathroom for the first time. The client experiences a sudden gush of vaginal blood and notices that several blood clots are in the toilet. Which action should the practical nurse (PN) take?

Correct Answer is C

Explanation

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