While assessing breath sounds, a nurse hears crackles. What causes these lung sounds?

Moisture in air passages

Narrowed small air passages

Normal air passing through the airways

Narrowing of the upper airway

Answer and Explanation

The Correct Answer is A

The correct answer is choice A, moisture in air passages. Crackles, also known as rales, are abnormal lung sounds that can indicate a buildup of fluid in the lungs. The moisture in the air passages causes the sound of air moving through fluid or mucus, leading to a crackling sound. Crackles can be heard in conditions such as pneumonia, heart failure, and pulmonary fibrosis.

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Correct Answer is ["A","D","E"]

Explanation

correct answers are:

A. Avoid caffeine beverages at least 4 to 6 hours before bedtime.

D Maintain a regular sleep-wake cycle.

E Engage in a regular exercise routine at least 3 hours before going to bed.

The nurse would suggest the client avoid caffeine beverages because caffeine is a stimulant that can keep the client awake. The nurse would also recommend maintaining a regular sleep-wake cycle because the body responds to consistent sleep and wake times, which can help promote restful sleep. Engaging in a regular exercise routine at least 3 hours before going to bed can help promote sleep by reducing stress and anxiety, and improving physical health. However, the nurse would not recommend taking 2-hour naps during the day, as this can interfere with the ability to sleep at night, and obtaining a massage, although it may be relaxing, may not directly promote sleep.

A. Apply restraints to the hands or wrists to keep the patient in bed. B. Place a belt restraint on the client when they are sitting in a chair. C. Keep the bed in lowest position with all four side rails up. D. Educate the patient on using the call light and make sure the call light is within reach.

Correct Answer is D

Explanation

A. Apply restraints to the hands or wrists to keep the patient in bed:Restraints should only be used when absolutely necessary and as a last resort, and the client in this scenario is oriented and can follow instructions. Restraints can also increase the risk of injury, agitation, and further falls.

B. Place a belt restraint on the client when they are sitting in a chair:Belt restraints restrict movement and should only be used when other measures are insufficient to protect the client. Since the client is oriented and can follow directions, this intervention is not warranted and could cause harm.

C. Keep the bed in the lowest position with all four side rails up:
Incorrect. Raising all four side rails is considered a form of restraint and can increase the risk of injury. Clients may attempt to climb over the side rails, leading to falls. Keeping the bed in a low position is appropriate, but using all four side rails is not.

D. Educate the patient on using the call light and make sure the call light is within reach.This is the most appropriate action as the client is oriented and can follow directions. Educating the patient on how to use the call light and ensuring it is easily accessible encourages them to ask for assistance when needed, reducing the risk of falls.

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While assessing breath sounds, a nurse hears crackles. What causes these lung sounds?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is ["A","D","E"]

Explanation

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Correct Answer is D

Explanation

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