1. B. Oxygen saturation.
2. B. Use of accessory muscles.
3.D. Note the amount and appearance of any sputum.
4.B. "What activities cause you to feel short of breath?"
5.C. Advise the client to rest in the bed while the nurse performs a physical assessment of the client.
6.C. Barrel chest.
7.A. Color of palms and soles.
E. Shapes of the fingers and fingertips.
8.D. Second rib.
9.A. Ask the client to inhale deeply.
10.B. Document the normal finding on the assessment record.
11.B. Increased fremitus over areas of consolidation.
12.D. Ask the client to repeat a phrase aloud.
13.C. Locate the client's first intercostal space.
14.A. Compare this finding with the location of the client's pneumonia seen on x-ray.
15.A. Move the diaphragm across to the apex of the right lung posteriorly.
16.D. Auscultate the lower lung fields to determine the presence of any adventitious sounds.
17.A. Document the presence of wheezes in the upper lobes and complete the assessment.
18.C. Chart what was heard both anteriorly and posteriorly.
19.A. Calculate the client's body mass index (BMI).
20. 60kg
21.C. Note the texture of the client's hair.
22.B. Auscultate breath sounds bilaterally.
23.D. Respiratory effort.
24.C. Crackles heard bilaterally in the middle and lower lung fields posteriorly.
25. C. Compare the current assessment of the client to the data obtained during the admission assessment of the client.
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