What classic sign would the nurse, auscultating breath sounds of a child hospitalized for an asthma attack, expect to find?
Expiratory Wheezing
Fine Crackles
Coarse rhonchi
Decreased breath sounds at the lung bases
The Correct Answer is A
A. Expiratory Wheezing: Expiratory wheezing is a classic sign of an asthma attack. It occurs due to narrowing and inflammation of the airways, which causes turbulent airflow during exhalation. Wheezing typically gets louder during expiration as the airways are more constricted during this phase of breathing.
B. Fine Crackles: Fine crackles are often heard in conditions like pneumonia or heart failure, where fluid is present in the lungs. They are not a hallmark of asthma.
C. Coarse Rhonchi: Coarse rhonchi are low-pitched sounds often associated with mucous secretions in the larger airways, but they are not the classic finding in asthma, where wheezing predominates.
D. Decreased Breath Sounds at the Lung Bases: Decreased breath sounds can indicate severe respiratory distress or a condition like pleural effusion or atelectasis. However, in asthma, breath sounds are usually more prominent during wheezing and are not typically decreased in the absence of complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D","G"]
Explanation
- A. Provide oxygen at 6 L/min via nasal cannula: Oxygen is only used if the patient has hypoxemia (O2 saturation below 92%), which is not indicated in this scenario.
B. Perform passive ROM exercises: Not appropriate during a sickle cell crisis due to the risk of exacerbating pain.
C. Administer IV fluids: Essential to reduce blood viscosity and prevent further sickling.
D. Obtain consent for a blood transfusion: Necessary in severe anemia (e.g., hemoglobin of 5 g/dL).
E. Restrict fluid intake to 1,400 mL/day: Fluid restriction is contraindicated; hydration is key to management.
F. Administer meperidine IV: Meperidine is generally avoided due to the risk of neurotoxicity; other opioids (e.g., morphine) are preferred.
G. Encourage bedrest: Reduces oxygen demand during a crisis.
Correct Answer is C
Explanation
A. A 12-year-old client who had an appendectomy and refuses to ambulate: Refusal to ambulate post-appendectomy may be concerning for complications like constipation or post-operative discomfort, but it is not an immediate emergency unless accompanied by other signs of complications like infection or bleeding.
B. An 18-month-old client who had a cleft palate repair and is crying in pain: Pain is expected following surgery, and while it should be addressed promptly, it does not constitute an immediate emergency unless there are signs of distress or complications.
C. An 8-year-old client who had a tonsillectomy and is swallowing frequently: Frequent swallowing after a tonsillectomy can indicate bleeding, which is a potential complication requiring immediate attention. It is important to assess for signs of bleeding, such as increased swallowing or a change in respiratory status.
D. A 15-year-old client who has an IV infusion and reports pain at the insertion site: Pain at the IV insertion site could indicate a complication like infiltration or phlebitis, but it is not an immediate emergency unless associated with other severe symptoms (e.g., swelling or systemic infection).
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