Respiratory Assessment EAQs

The nurse expects which test will be prescribed for a patient following a transthoracic needle aspiration (TTNA)? a) chest x-ray b) lung biopsy c) MRI of lungs d) CT of the lungs

A A percutaneous or TTNA biopsy involves inserting a needle through the chest wall, usually under bedside ultrasound or CT guidance. Because of the risk for a pneumothorax, a chest x-ray is done after TTNA to check for air in the pleura. A chest x-ray is sufficient to diagnose pneumothorax, so a lung biopsy, MRI, or CT of lungs is not required.

Which factors may cause the pulse oximeter to have an inaccurate reading in an African patient who was rescued from a fire? Select all that apply. a) The patient has darker skin. b) The patient has methemoglobinemia. c) The patient has an Hgb level of 8.0 mg/dL. d) The patient has soft, pink-colored fingernails. e) The patient has a blood sugar level of 120 mg/dL.

A B C Pulse oximetry helps to measure arterial oxygen saturation (SpO2) through a probe, which can be placed on the finger, toe, ear, or bridge of the nose. SpO2 readings may be inaccurate in a patient with dark skin because the skin color can interfere with transmission of signals from the pulse oximeter to the body tissues. Methemoglobinemia can occur as a result of breathing gases during fire accidents. This form of hemoglobin has less capacity for carrying oxygen and may interfere with the results of the oximeter. An Hgb level of 8.0 mg/dL indicates anemia, which may interfere with the results of pulse oximetry because there would be lower levels of the hemoglobin protein to carry oxygen. Soft, pink fingernails are a normal finding in patients, regardless of skin tone, and should not interfere with the SpO2 results. Nails with thick acrylic fingernail polish, however, may not yield accurate results. Blood sugar levels do not interfere with SpO2 results.

The nurse must perform which intervention for a patient receiving a pulmonary function test? a) Schedule the test to occur after a meal. b) Assess the patient for respiratory distress. c) Provide a rest period before the procedure. d) Give a bronchodilator an hour before the test

B Continually assessing a patient for respiratory distress is the most important nursing intervention to perform for a patient receiving a pulmonary function test. The nurse should avoid scheduling the procedure after a meal and giving a bronchodilator an hour before the test. The nurse should also encourage rest after the test and not necessarily before it.

Why might a patient with lung cancer develop a pleural effusion? a) allergic reaction to chemotherapy b) lymphatic drainage blocked by malignant cells c) bacterial infection due to compromised immunity d) increased Bp due to malignancy

B The most common cause for the development of pleural effusion in the patient suffering from malignancy is lymphatic drainage blocked by malignant cells. An allergic reaction may not lead to pleural effusion. Bacterial infection is unlikely in the absence of other signs. Malignancy is not the cause of raised BP.

In which pattern will the nurse auscultate the chest of a patient with shortness of breath and a respiratory rate of 28 breaths/min? a) starting at apices b) starting at the lung bases c) listening to the entire left side and then the right side d) listening to two complete inspiratory and expiratory cycles

B The patient is in respiratory distress. Starting at the lung bases is the preferred method in a patient in respiratory distress, because the increased respiratory rate and shortness of breath may tire the patient easily, limiting patient tolerance for the assessment. Generally, auscultation should proceed from the lung apices to the bases, comparing opposite areas of the chest, unless the patient is in respiratory distress or will tire easily. During any auscultation, the nurse listens to at least one cycle of inspiration and expiration with each placement of the stethoscope.

Which chest palpation finding is a medical emergency? a) Increased tactile fremitus b) trachea moved to the left c) decreased tactile fremitus d) diminished chest movement

B Tracheal deviation is a medical emergency when it is caused by a tension pneumothorax. Tactile fremitus increases with pneumonia or pulmonary edema and decreases in pleural effusion or lung hyperinflation. Diminished chest movement occurs with barrel chest, restrictive disease, and neuromuscular disease.

A patient with pulmonary edema will likely present with which mucous characteristics? a) Foul-smelling sputum b) Clear, whitish, or yellow sputum c) Large amounts of frothy, pink-tinged sputum d) Clear to gray sputum with occasional specks of brown

C Large amounts of frothy, pink-tinged sputum support the diagnosis of pulmonary edema, which is characterized by a persistent cough. Foul-smelling sputum indicates an infection. Clear, whitish, or yellow sputum is often found in patients diagnosed with chronic obstructive pulmonary disease, especially in the early morning hours. Clear to gray sputum with brown specks indicates the patient is a smoker.

Which action should the nurse take when administering and reading the tuberculosis (TB) skin test? a) Ensure that the injection is given subcutaneously. b) Do not use a pen around the test area to mark the site. c) Include the reddened flat areas on the skin when measuring the induration. d) Draw a diagram of the forearm and hand and label the injection sites in the patient's chart.

D When a skin test is administered for TB bacilli, the nurse should chart the site of administration by drawing a diagram of the forearm and hand and labeling the injection sites. The nurse should ensure that the injection is given intradermally. The nurse should circle the area with a pen and instruct the patient not to remove the mark. The diameter of the induration should be measured for reading the test. The reddened flat area is not included in the measurement.

In which order will the nurse hear these sounds from percussion of the anterior chest over the clavicle, then the lung field, then the liver, and finally over the stomach? a) flatness b) dullness c) tympani d) resonance

ORDER: A - D - B - C The nurse would hear flatness with percussion over the clavicle, followed by resonance over the lung field. Dullness would be heard over the liver, and then tympany with percussion over the stomach.

In which order will the nurse place the stethoscope on the anterior chest to auscultate breath sounds? a) at the nipple line b) below the clavicle c) above the clavicle d) below the nipple line e) above the nipple line

ORDER: C - B - E - A - D The nurse would auscultate the anterior chest on bilateral locations, starting at the apices of the lungs above the clavicles. The stethoscope would then be moved below the clavicles for auscultation. The nurse would continue to move down the chest, placing the stethoscope above the nipple line, then at the nipple line, and finally below the nipple line.

The nurse would expect which assessment finding in a patient with pulmonary fibrosis? a) normal percussion b) prolonged expiration c) egophony over effusion d) fremitus over affected area

A Patients with pulmonary fibrosis have normal percussion findings. Inspection would reveal tachypnea, and palpation would show movement. Auscultation shows crackles or sounds like Velcro being pulled apart. Prolonged expiration occurs with asthma. Egophony over effusion often occurs with pleural effusion. Fremitus over the affected area occurs with pneumonia.

Which assessment finding will the nurse expect in a patient who is diagnosed with a mass on the right side of the neck? a) tracheal deviation to the left b) tracheal deviation to the right c) asymmetrical chest expansion d) dysfunctional diaphragm contraction

A A mass in the neck may cause tracheal diversion to the opposite side of the mass. Therefore if the patient has a neck mass in the right side, the nurse is likely to find tracheal deviation to the left side, away from the mass, during palpation. The tracheal deviation would be to the right side, or toward the mass, in the case of lobar atelectasis. The nurse is not likely to see any effect on the patient's chest expansion or diaphragm movement because a neck mass would be at a higher anatomical level. Chest expansion would be asymmetrical in instances of atelectasis or a collapsed lung. The diaphragm would be dysfunctional in the instance of phrenic nerve injury.

Which condition would the nurse associate with decreased breath sounds in a patient who is postoperative day one following abdominal surgery? a) atelectasis b) pneumonia c) pneumothorax d) pleural effusion

A Following abdominal surgery, the patient is at risk for atelectasis related to the effects of anesthesia as well as restricted breathing from pain. This condition is associated with a decrease in breath sounds on auscultation. Without deep breathing to stretch the alveoli, surfactant secretion to hold the alveoli open is not promoted. Pneumonia is a risk several days after surgery but is not typical on postoperative day one. Pneumothorax is associated with absent breath sounds. Pleural effusion occurs because of blockage of lymphatic drainage or an imbalance between intravascular and oncotic fluid pressures, which is not expected in this case.

The nurse expects to note which type of fremitus in a patient with a pneumothorax? a) absent b) normal c) increased d) decreased

A In a patient with pneumothorax, the nurse would find absent fremitus. Increased fremitus is found in pneumonia, in lung tumors, with thick bronchial secretions, and above a pleural effusion. As the patient's voice moves through a dense tissue or fluid-filled lungs, the vibration is increased. Decreased fremitus may be found in pleural effusion when the hand is farther from the lung, and in barrel chest where the lung is hyperinflated.

Which nursing action is the priority for a patient immediately following a bronchoscopy? a) monitor the patient for laryngeal edema b) monitor and manage the patient's level of pain c) assess the patient's level of consciousness (LOC) d) Assess the patient's heart rate and BP

A Priorities for assessment are the patient's airway and breathing, both of which may be compromised after bronchoscopy by laryngeal edema. The nurse should keep patient NPO until gag reflex returns and monitor for recovery from sedation. Blood-tinged mucus is not abnormal. Airway and breathing assessment supersedes the importance of LOC, pain, heart rate, and BP, although the nurse should be assessing these also.

INSPECTION - tachypnea and cyanosis PALPATION - increased tactile emits left lower lobe PERCUSSION - dullness over left lower lobe AUSCULTATION - bronchial sounds A patient may be sent for which test based on the following respiratory assessment information? a) chest x-ray b) pulmonary angiogram c) positron emission test d) ventialtion perfusion scan

A These assessment findings indicate early pneumonia, which can be imaged looking for consolidation on a chest x-ray. Pulmonary angiogram and ventilation perfusion scanning are done when pulmonary embolism is suspected. Positron emission testing is done for cancer.

Which early manifestations of distress will the nurse expect in a patient whose arterial blood gas results show the partial pressure of oxygen (PaO2) at 65 mm Hg and the arterial oxygen saturation (SaO2) at 80%? a) Restlessness, tachypnea, tachycardia, and diaphoresis b) Unexplained confusion, dyspnea at rest, hypotension, and diaphoresis c) Combativeness, retractions with breathing, cyanosis, and decreased output d) Coma, accessory muscle use, cool and clammy skin, and unexplained fatigue

A With inadequate oxygenation, early manifestations include restlessness, tachypnea, tachycardia, diaphoresis, decreased urinary output, and unexplained fatigue. The unexplained confusion, dyspnea at rest, hypotension, diaphoresis, combativeness, retractions with breathing, cyanosis, decreased urinary output, coma, accessory muscle use, cool and clammy skin, and unexplained fatigue occur as later manifestations of inadequate oxygenation.

Which breath sounds would the nurse consider normal? Select all that apply. a) Loud, high-pitched sounds resembling air blowing through a hollow pipe b) Soft, low-pitched, gentle, rustling sounds heard over all lung areas except the major bronchi c) Medium-pitched sounds heard anteriorly over the mainstem bronchi on either side of the sternum d) The patient repeats the phrase "ninety-nine," and the words are easily understood and are clear and loud through the chest. e) The patient whispers "one-two-three," and the almost inaudible voice is transmitted clearly and distinctly.

A B C Bronchial, vesicular, and bronchovesicular sounds are normal breath sounds. Bronchial sounds are loud and high-pitched and resemble air blowing through a hollow pipe. Vesicular sounds are soft, low-pitched, gentle, rustling sounds heard over all lung areas except the major bronchi. Bronchovesicular sounds are medium-pitched sounds heard anteriorly over the mainstem bronchi on either side of the sternum. Bronchophony is an abnormal breath sound and is considered positive (abnormal) if the patient repeats the phrase "ninety-nine" and the words are easily understood and are clear and loud. Whispered pectoriloquy is also an abnormal breath sound and is considered positive (abnormal) when the patient whispers "one-two-three," and the almost inaudible voice is transmitted clearly and distinctly.

Which sputum characteristics, if present in the patient, may need further evaluation for a patient who is a smoker and has chronic obstructive pulmonary disease (COPD)? SATA a) frothy b) foul odor c) pink tinged d) brown specks e) yellowish color

A B C COPD may result in whitish to yellowish sputum; however, any change in the baseline characteristics of the sputum should be reported. Frothy sputum may indicate pulmonary edema and needs further evaluation. A foul odor in the sputum indicates presence of infection and needs immediate medical intervention. Pink-tinged sputum may indicate pulmonary edema and the patient may need further evaluation. Sputum with brown specks is a common finding in a person who smokes. Yellowish sputum is a normal finding in COPD.

Which cognitive changes are characteristic of a patient experiencing hypoxia? Select all that apply. a) restlessness b) apprehension c) improved mood d) memory changes e) pursed lip breathing f) improved concentration

A B D A patient who is hypoxic may have neurologic symptoms that include apprehension, restlessness, irritability, and memory changes. Mood will worsen rather than improve. Pursed lip breathing is not a cognitive symptom. Concentration will be poor with hypoxia rather than improved.

Which information does the nurse need to obtain and document in the admission assessment on a patient who uses oxygen (O2) at home? Select all that apply. a) Liter flow b) Home safety practices c) Method of payment for oxygen services d) What agency supplies the oxygen services e) Method and effectiveness of administration f) Fractional inspired oxygen concentration (FIO2)

A B E F If the patient is using O2 for a breathing problem, record the FIO2, flow rate (liters per minute), method of administration, number of hours used per day, and effectiveness of the therapy. Assess safety practices, including the patient's cognitive and physical ability related to using O2 and any metered-dose inhalers. What oxygen service the patient uses and the patient's method of payment are not necessary to determine in the admission assessment.

Which conditions may cause a false-negative reaction in a tuberculin test? Select all that apply. a) Anergy/immunosuppression b) Intravenous drug abuse (IVDA) c) Overwhelming tuberculosis (TB) infection d) TB infection within 8 to 10 weeks of exposure e) Recent contact with a person who had TB f) Recent antibiotic therapy for methicillin-resistant Staphylococcus aureus (MRSA)

A C D False-negative reactions may occur in people who have anergy or are immunosuppressed, those who had a TB infection within 8 to 10 weeks of exposure, those with overwhelming TB infection, and patients who had a recent live virus vaccination, such as one for measles or chickenpox. Positive reactions are more likely to occur in IVDA patients and in patients who had recent contact with a person who had TB. Recent antibiotic therapy for MRSA has no direct effect on tuberculin test results.

An older adult may present with which respiratory assessment findings? SATA a) thicker mucus b) normal partial pressure of oxygen (PaO2) and arterial oxygen saturation (Sa)2) c) decreased chest wall movement d) increased breath sound sin the lung apices e) diminished breath sounds, particularly at lung bases

A C E Changes in the respiratory system in the older adult include thickened mucus, decreased chest wall movement, and diminished breath sounds, especially at the lung bases. The PaO2 and SaO2levels are decreased.

Which questions should the nurse ask when assessing a patient's sleep/rest pattern related to respiratory health? Select all that apply. a) "Do you have trouble falling asleep?" b) "Do you need to urinate during the night?" c) "Do you awaken abruptly during the night?" d) "Do you sleep more than eight hours per night?" e) "Do you need to sleep with the head elevated?"

A C E The patient with sleep apnea may have insomnia or abrupt awakenings. Patients with cardiovascular disease (e.g., heart failure that may affect respiratory health) may need to sleep with the head elevated on several pillows (orthopnea). Sleeping more than eight hours per night or needing to urinate during the night is not indicative of impaired respiratory health.

Following a bronchoscopy, a patient must present with which assessment finding before beginning oral intake of food and fluids? a) stable vital signs b) return of gag reflex c) brisk pupil reaction to light d) clear bilateral breath sounds

B A patient who is given food or fluid before the gag reflex returns may aspirate food or drink and possibly experience respiratory distress as a result. Vital signs, pupil reaction, and breath sounds are routine assessments after a procedure such as a bronchoscopy, but they are secondary to assessing the patient for the return of the gag reflex.

Following a bedside thoracentesis, the nurse will continue to assess the patient for signs and symptoms of which condition? a) bronchospasm b) pneumothorax c) pulmonary edema d) respirator acidosis

B Because thoracentesis involves the introduction of a catheter into the pleural space, there is a risk of pneumothorax. Thoracentesis does not carry a significant potential for causing bronchospasm, pulmonary edema, or respiratory acidosis.

Which test can determine the efficiency of air transfer in lung and tissue oxygenation in a patient in respiratory distress? a) chest x-ray b) pulse oximetry c) respiratory rate d) sputum analysis

B Pulse oximetry and the analysis of arterial blood gases (ABGs) are the two methods used to determine how well air is transferred. A chest x-ray has no direct effect on the transfer of air effectiveness. A patient's respiratory rate does not affect air transfer. Sputum analysis can help diagnose many respiratory conditions but is not involved in assessment of air transfer.

A patient diagnosed with asthma who is experiencing airway irritation may present with which assessment finding? a) hemoptysis b) dry, hacking cough c) harsh, bark cough d) loose-sounding cough

B A dry, hacking cough indicates the patient is experiencing airway irritation or obstruction. Hemoptysis often occurs with tuberculosis and does not indicate airway irritation. A harsh, barky cough suggests upper airway obstruction. A loose-sounding cough indicates secretions.

The nurse must perform which intervention for a patient receiving a pulmonary function test? a) schedule the test to occur after a meal b) assess the patient for respiratory distress c) provide a rest period before the procedure d) give a bronchodilator an hour before the test

B Continually assessing a patient for respiratory distress is the most important nursing intervention to perform for a patient receiving a pulmonary function test. The nurse should avoid scheduling the procedure after a meal and giving a bronchodilator an hour before the test. The nurse should also encourage rest after the test and not necessarily before it.

A positron emission tomography (PET) scan is used for which respiratory assessment? a) to assess ventilation and perfusion of lungs b) to distinguish benign and malignant nodules c) to visualize pulmonary vasculature and locate obstruction d) to diagnose lesions difficult to see by CT scan

B PET scans use an IV radioactive glucose preparation to demonstrate increased uptake of glucose in malignant lung cells. A ventilation/perfusion (VQ) scan is used to assess ventilation and perfusion of lungs. A pulmonary angiogram is used to visualize pulmonary vasculature and locate obstruction. An MRI test is used to diagnose lesions difficult to assess by CT scan.

In which pattern will the nurse auscultate the chest of a patient with shortness of breath and a respiratory rate of 28 breaths/min? a) starting at the apices b) starting at the lung bases c) listening at the lung bases d) listening to two complete inspiratory and expiatory cycles

B The patient is in respiratory distress. Starting at the lung bases is the preferred method in a patient in respiratory distress, because the increased respiratory rate and shortness of breath may tire the patient easily, limiting patient tolerance for the assessment. Generally, auscultation should proceed from the lung apices to the bases, comparing opposite areas of the chest, unless the patient is in respiratory distress or will tire easily. During any auscultation, the nurse listens to at least one cycle of inspiration and expiration with each placement of the stethoscope.

Which nursing action is the priority for a patient admitted to the hospital with cyanosis, dyspnea, and tachycardia and who is sweating and has cold, clammy skin? a) start a glucose drip b) start oxygen therapy c) administer IV mannitol d) administer antihistamines

B The patient is showing signs and symptoms of inadequate oxygenation. Therefore the first thing that the nurse must do is start oxygen therapy immediately. All the other actions are secondary and performed only if required. Glucose drips are given to increase the intravascular volume. Mannitol should be administered if the intracranial pressure (ICP) is raised. Antihistamines are administered if there is an allergy.

Which patient findings indicate inadequate oxygenation? Select all that apply. a) anemia b) cyanosis c) tachypnea d) diaphoresis e) hypertension

B C D The symptoms of inadequate oxygenation in the patient include cyanosis, diaphoresis, and tachypnea. Cyanosis indicates inadequate perfusion due to compromised oxygenation. Diaphoresis and tachypnea occur due to sympathetic stimulation to compensate for inadequate oxygenation. Anemia occurs gradually and does not suddenly cause inadequate oxygenation. Hypertension does not indicate inadequate oxygenation in the patient.

Which assessment findings would the nurse expect in a patient in acute respiratory distress? Select all that apply. a) Cyanosis b) Tripod position c) Kussmaul respirations d) Accessory muscle use e) Increased anterior-posterior (AP) diameter

B D Tripod position and accessory muscle use indicate moderate to severe respiratory distress. Cyanosis may be related to anemia, decreased oxygen transfer in the lungs, or decreased cardiac output and is an unreliable indicator of respiratory distress. Kussmaul respirations occur when the patient is in metabolic acidosis to increase CO2 excretion. Increased AP diameter occurs with lung hyperinflation from chronic obstructive pulmonary disorder (COPD), cystic fibrosis, or with advanced age.

Which questions will the nurse ask when assessing the effects of a patient's respiratory diagnosis on activity-exercise patterns? Select all that apply. a) "Are you ever incontinent of urine when you cough?" b) "Do you have trouble walking due to shortness of breath?" c) "Does your spouse wake you in the middle of the night due to snoring?" d) "How many flights of stairs can you walk up before you are short of breath?" e) "Do you ever feel full very quickly when eating due to your breathing issues?"

B D When assessing the effects that a respiratory diagnosis has on activity-exercise patterns, the nurse will ask the patient if walking is impacted by dyspnea and how many flights of steps the patient can walk up before dyspnea occurs. Asking the patient about urinary incontinence with coughing is appropriate when assessing elimination patterns. Asking the patient if the spouse wakes him or her up in the middle of the night due to snoring will assess sleep-rest patterns. Asking the patient if he or she feels full quickly when eating assesses the patient's nutritional-metabolic pattern.

A sputum study will help diagnose which condition? a) asthma b) lung cancer c) bacterial lung infection d) chronic obstructive pulmonary disease

C A sputum study is often used to diagnose bacterial lung infection via culture and sensitivity results. Sputum studies are not used to diagnose asthma, lung cancer, or chronic obstructive pulmonary disease.

A patient with a suspected pulmonary embolism should be evaluated with which radiology study? a) chest x-ray b) pulmonary angiogram c) CT d) MRI

C CT scans are used in the diagnosis of lesions that are difficult to assess by conventional x-ray studies. Typically, CT scans are helical or spiral. Spiral CT is the primary radiologic test used to diagnose pulmonary embolism. A chest x-ray is used to screen, diagnose, and evaluate changes in the respiratory system. A pulmonary angiogram is most commonly used to visualize vasculature and to provide therapeutic intervention. MRIs are used for diagnosis of lesions that are difficult to assess by CT scan, such as within the lung apex.

Which diagnostic study is used to distinguish benign and cancerous lung nodules? a) thoracentesis b) pulmonary angiogram c) positron emission tomography (PET) d) CT scan of the patient's chest

C PET is used to distinguish benign and malignant pulmonary nodules. Because malignant lung cells have an increased uptake of glucose, the PET scan (which uses an IV radioactive glucose preparation) can demonstrate increased uptake of glucose in malignant lung cells. This differentiation cannot be made using a thoracentesis, pulmonary angiogram, or CT.

Which nursing action would be appropriate for a patient who presents with gray-colored sputum with specks of brown and has a history of smoking? a) inform the health care provider b) administer oxygen therapy to the patient c) assess oxygen saturation through pulse oximetry d) no action is required because it is considered normal

D Gray-colored sputum with specks of brown is a normal finding in an individual who smokes, so no action is required. Administering oxygen therapy, assessing oxygen saturation, and informing the health care provider are not necessary for this patient.

INSPECTION - barrel chest, pursed-lip breathing PALPATION - diminished excursion PERCUSSION - hyper resonance AUSCULTATION - distant crackles and wheezing Which diagnosis does the nurse expect based on the following respiratory assessment findings? a) pneumonia b) pleural effusion c) pulmonary edema d) chronic obstructive pulmonary disease (COPD)

D These assessment findings indicate COPD. With pneumonia, pleural effusion, and pulmonary edema, percussion would be dull over the affected areas, not hyperresonant.

Which laboratory parameter indicates that it is unsafe for a patient to undergo a CT scan? a) Hematocrit 50% b) PaCO2 40 mm Hg c) Hemoglobin 14.0 g/dL d) Serum creatinine 3.0 mg/dL

D CT scans may be often performed with contrast medium. These contrast media are excreted through urine; therefore it is important for the patient to have optimal renal function to prevent accumulation of the contrast media in the body. The normal range of serum creatinine level is 0.6 to 1.3 mg/dL; therefore a serum creatinine level of 3.0 mg/dL is very high and indicates renal dysfunction. As a result, the diagnostic test should not be performed on the patient. Hematocrit of 50%, PaCO2 of 40 mm Hg, and hemoglobin of 14.0 g/dL are within normal ranges

Which nursing action is the priority for a patient with lung cancer immediately following a lung biopsy through transthoracic needle aspiration (TTNA)? a) allow the patient to take a rest b) measure oxygen saturation levels c) instruct the patient to do deep breathing d) send the patient for a chest x-ray as prescribed

D Following a lung biopsy through TTNA, the patient should be sent for chest x-ray to rule out a pneumothorax, which is a common complication of the procedure. Only after the chest x-ray is done can the patient can be told to rest or do deep breathing exercises. Oxygen saturation levels are generally monitored throughout the procedure.

Which test will be conducted to confirm the diagnosis of tuberculosis (TB) for a patient experiencing a chronic cough? a) widal test b) lepromin test c) Benedict's test d) tuberculin test

D The nurse recommends the tuberculin skin test to check for TB. A lepromin test is done to check for leprosy. A Widal test is useful for diagnosing typhoid infection. A Benedict's test is performed to check urine glucose.

Which condition is associated with wheezing? a) atelectasis b) pleural effusion c) pulmonary edema d) chronic obstructive pulmonary disease

D Wheezes are continuous high-pitched squeaking sounds produced by the rapid vibration of the bronchial walls. The rapid vibration is caused by a blockage in the airways, which often occurs with chronic obstructive pulmonary disease. Fine crackles are heard with atelectasis. Diminished breath sounds are heard in pleural effusion. Fine or coarse crackles are heard in patients with pulmonary edema.

Which physiologic response is expected for a patient experiencing metabolic acidosis secondary to type 1 diabetes mellitus? a) vomiting b) increased urination c) decreased heart rate d) rapid respiratory rate

D When a patient with type 1 diabetes has hyperglycemia and ketonemia causing metabolic acidosis, the physiologic response is to increase the respiratory rate and tidal volume to blow off the excess CO2. Vomiting and increased urination may occur with hyperglycemia, but not as physiologic responses to metabolic acidosis. The heart rate will increase.