Which of the following is a characteristic of wheezing in a narrowed airway pathophysiology?
High-pitched musical sound
Crackling noise
Low-pitched rumbling sound
Silent breathing
The Correct Answer is A
Rationale:
A. Wheezing occurs when airflow passes through narrowed or obstructed airways, as seen in conditions like asthma, chronic bronchitis, or bronchiolitis. The turbulence created by bronchospasm, inflammation, or mucus accumulation produces a characteristic high-pitched, musical sound, typically heard during expiration, although severe obstruction can produce wheezing during both inspiration and expiration.
B. Crackles (rales) are intermittent, popping sounds caused by the sudden opening of small, fluid-filled airways in conditions such as pulmonary edema, pneumonia, or interstitial lung disease. They are not associated with airway narrowing from bronchospasm.
C. This description corresponds to rhonchi, which are caused by airflow through larger airways obstructed with thick secretions. Rhonchi are different from wheezing, which is high-pitched and usually occurs in smaller bronchioles.
D. Silent breathing indicates severe airway obstruction or near-complete airway closure, which is a medical emergency. While it may occur in extreme cases of asthma, it is not a characteristic feature of wheezing in narrowed airways.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Increase fluid intake is the primary prevention strategy for calcium-based kidney stones. Adequate hydration dilutes urine, reducing the concentration of calcium, oxalate, and other stone-forming substances. This decreases supersaturation and crystal formation in the urinary tract, significantly lowering the risk of stone development. Clients are generally advised to consume enough fluids to produce at least 2–2.5 liters of urine per day unless contraindicated.
B. Increase calcium-rich foods is incorrect as a prevention strategy. While dietary calcium in normal amounts may help bind oxalate in the gut and prevent stone formation, excessive calcium supplementation without medical guidance can increase the risk of calcium-based stones. The key is balance, not simply increasing intake.
C. Restrict protein intake may help reduce uric acid stones and decrease urinary calcium to some extent, but it is not the primary prevention measure for calcium-based stones. Over-restriction of protein can lead to nutritional deficiencies.
D. Decrease fluid intake is incorrect. Reduced fluid intake concentrates urine and increases the risk of kidney stone formation. Maintaining adequate hydration is essential for prevention of all types of stones.
Correct Answer is B
Explanation
Rationale:
A. Recurrent urinary frequency may occur as a symptom of urinary tract obstruction or irritation, but it is a relatively minor and common manifestation. While uncomfortable for the client, urinary frequency itself is not the most serious or life-threatening complication of hydronephrosis.
B. Renal failure is the primary concern in a client with hydronephrosis caused by an untreated kidney stone. Hydronephrosis occurs when urine flow is obstructed, leading to increased pressure within the renal pelvis and calyces. This pressure compresses renal tissue, impairs blood flow, and damages nephrons. If the obstruction persists, it can result in progressive kidney damage and potentially irreversible renal failure. The longer the obstruction remains untreated, the higher the risk of permanent loss of renal function, making renal failure the most serious and concerning complication.
C. Diabetic nephropathy is a form of chronic kidney disease caused by long-term diabetes mellitus. It is unrelated to hydronephrosis from urinary obstruction. While clients with diabetes may have an increased risk of kidney disease, diabetic nephropathy is not a direct complication of untreated kidney stones.
D. Orthostatic hypotension is a drop in blood pressure upon standing, often caused by dehydration, autonomic dysfunction, or certain medications. It is not a direct complication of hydronephrosis and is less clinically urgent than the risk of renal failure in this context.
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