A nurse is auscultating the lungs of a client who has pleurisy. Which of the following adventitious breath sounds should the nurse expect to hear?
Popping sounds
Loud, gating sounds
Snoring sounds
Squeaky, musical sounds
The Correct Answer is B
Rationale:
A. Popping sounds, also known as crackles, are typically associated with fluid in the alveoli, often seen in conditions like pneumonia or heart failure, not pleurisy.
B. Loud, grating sounds, known as pleural friction rub, are characteristic of pleurisy. This sound is produced by the inflamed pleural surfaces rubbing together during respiration.
C. Snoring sounds, or rhonchi, are usually heard in conditions involving airway obstruction by mucus, such as bronchitis, rather than pleurisy.
D. Squeaky, musical sounds, or wheezing, are associated with airway narrowing, such as in asthma or chronic obstructive pulmonary disease (COPD), and are not typically heard in pleurisy.
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Correct Answer is ["A","B","D","E"]
Explanation
Rationale:
A. Purple striae (stretch marks) are common in Cushing's syndrome due to skin thinning and the redistribution of fat.
B. A "moon face" is a classic sign of Cushing's syndrome, caused by fat deposition in the face.
C. Bronze pigmentation is associated with Addison's disease, not Cushing's syndrome.
D. A "buffalo hump," or fat accumulation on the upper back, is another characteristic feature of Cushing's syndrome.
E. Poor wound healing is expected in Cushing's syndrome due to the effects of prolonged exposure to high cortisol levels, which impair immune function and tissue repair.
Correct Answer is ["A","B","C","D","E","F"]
Explanation
Rationale:
A: Inhale deeply and then exhale completely: This step helps to empty the lungs, making room for the medication to be inhaled effectively.
B: Place her lips firmly around the mouthpiece: Ensuring a tight seal around the mouthpiece prevents the medication from escaping and ensures proper delivery to the lungs.
C: Breathe in deeply over 2 to 3 seconds while pushing down on the canister: Coordinating the inhalation with the activation of the canister ensures that the medication is inhaled deeply into the lungs.
D: Hold her breath for 10 seconds: Holding the breath allows the medication to settle in the lungs and increase its effectiveness.
E: Exhale slowly through pursed lips: This helps to maintain the medication in the lungs for as long as possible and promotes better absorption.
F: Wait 60 seconds between each puff: Waiting between puffs allows time for the medication to take effect and ensures that the next dose will be more effective.
