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Questions 158

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Question 1 of 5

Which of the following would the nurse expect to find following respiratory assessment of a client with advanced emphysema?

Correct Answer: A

Rationale: Distant breath sounds are characteristic of emphysema due to increased anteroposterior chest diameter, overdistention, and air trapping.

Question 2 of 5

When a client arrives on the labor and delivery unit, she informs the nurse that she has been having contractions for the last 5 hours. Now the pain is constant and not cyclical as it was earlier. The nurse considers the possibility of uterine rupture. Which of the following symptoms would be consistent with a uterine rupture?

Correct Answer: C

Rationale: In the event of a uterine rupture, an abdominal examination would likely reveal rigidity or tenderness, indicating a serious complication.

Question 3 of 5

Which of the following describes the language development of a two-year-old?

Correct Answer: C

Rationale: A two-year-old typically can combine three or four words to form simple sentences (e.g., 'Me want milk'). They understand basic concepts like 'yes' and 'no,' but not all words. Repeatedly asking 'why?' is more common in older preschoolers.

Question 4 of 5

The nurse is caring for a client with a diagnosis of gestational hypertension. Which complication is most likely to occur?

Correct Answer: A

Rationale: Gestational hypertension can progress to preeclampsia characterized by proteinuria and other systemic symptoms and is the most likely complication. Preterm labor and macrosomia are less directly related.

Question 5 of 5

A child with croup is placed in a cool, high-humidity tent connected to room air. The primary purpose of the high-humidity tent is to:

Correct Answer: D

Rationale: High-humidity tents in croup moisten airways, liquefying secretions and relieving laryngeal spasms, easing breathing. Oxygen levels are not necessarily 30%, and dehydration or fever is secondary.

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