Which assessment finding is most likely to be immediately life-threatening?

A. While mammograms are commonly used to evaluate breast tissue in women, they are not typically used for men. In men, gynecomastia is usually evaluated with a physical exam and sometimes ultrasound rather than mammography. A mammogram might be ordered if there is a suspicion of breast cancer, but this is less common and not the first step in evaluating gynecomastia.
B. This is a prudent and effective next step. Certain medications can cause gynecomastia as a side effect, including some antipsychotics, antidepressants, antiandrogens, and calcium channel blockers. Reviewing the medication list can help identify if the gynecomastia might be related to a drug the client is taking.
C. A breast biopsy is an invasive procedure used to diagnose breast cancer or other conditions when there is a concern about a mass or abnormality. If gynecomastia is the only finding and there are no concerning features such as a palpable mass or other symptoms, a breast biopsy would not be the first step.
D. While gynecomastia can occur as a normal part of aging, especially in older men due to hormonal changes, it is important to evaluate it thoroughly to rule out other causes. Simply dismissing it as a normal part of aging without further investigation might overlook an underlying condition or medication side effect.

A. Wheezes are high-pitched, continuous sounds that occur during expiration (and sometimes inspiration) due to narrowed airways, commonly seen in conditions like asthma or chronic bronchitis. They are not typically associated with pleural inflammation.
B. This description matches a pleural friction rub. A pleural friction rub is a low-pitched, grating or rubbing sound that occurs when inflamed pleural surfaces rub against each other. It is characteristic of pleural inflammation and is best heard during both inspiration and expiration. This sound results from the roughened pleural surfaces due to inflammation and is the expected finding in a patient with pleuritis.
C. Crackles (or rales) are discontinuous, high-pitched sounds heard typically during inspiration, caused by the opening of collapsed or fluid-filled alveoli. They are commonly associated with conditions like pneumonia, congestive heart failure, or pulmonary fibrosis, rather than pleural inflammation.
D. Gurgling is not a standard term for describing lung sounds. It may refer to rhonchi, which are low- pitched, continuous sounds heard due to mucus or fluid in the larger airways. Rhonchi can be heard in conditions like bronchitis or pneumonia but are not specifically associated with pleural inflammation.