A 70-year-old patient is being seen in the clinic for severe exacerbation of his heart failure. Which of these findings is the nurse most likely to observe in this patient?
a. Shortness of breath, orthopnea, paroxysmal nocturnal dyspnea, and ankle edema
b. Rasping cough, thick mucoid sputum, wheezing, and bronchitis
c. Productive cough, dyspnea, weight loss, anorexia, and tuberculosis
d. Fever, dry nonproductive cough, and diminished breath sounds
Question 2A patient comes to the clinic complaining of a cough that is worse at night but not as bad during the day. The nurse recognizes that this cough may indicate:
a. Pneumonia.
b. Postnasal drip or sinusitis.
c. Exposure to irritants at work.
d. Chronic bronchial irritation from smoking.
Question 3During auscultation of breath sounds, the nurse should correctly use the stethoscope in which of the following ways?
a. Listening to at least one full respiration in each location
b. Listening as the patient inhales and then going to the next site during exhalation
c. Instructing the patient to breathe in and out rapidly while listening to the breath sounds
d. If the patient is modest, listening to sounds over his or her clothing or hospital gown
Question 4A woman in her 26th week of pregnancy states that she is not really short of breath but feels that she is aware of her breathing and the need to breathe. What is the nurse's best reply?
a. The diaphragm becomes fixed during pregnancy, making it difficult to take in a deep breath.
b. The increase in estrogen levels during pregnancy often causes a decrease in the diameter of the rib cage and makes it difficult to breathe.
c. What you are experiencing is normal. Some women may interpret this as shortness of breath, but it is a normal finding and nothing is wrong.
d. This increased awareness of the need to breathe is normal as the fetus grows because of the increased oxygen demand on the mother's body, which results in an increased respiratory rate.
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