A client is admitted to the hospital with a medical diagnosis of viral pneumonia. The nurse assesses for which of the following most frequent manifestations? Select all that apply.

Correct Answer: B

Rationale: Viral pneumonia features nonproductive cough (B) and normal/near-normal WBC (C), per document (2, 3). Viruses (e.g., influenza) cause dry cough (no consolidation) and leukopenia or normal counts (e.g., 4-11k), unlike bacterial spikes. Gohn's tubercle (A) is TB, not viral. Intermittent fever (D) fits TB, not viral's steady rise. Pleural effusion is bacterial. B's cough 50% cases flags viral etiology, distinguishing it from A's TB link.

Correct Answer: B

Rationale: When the diaphragm and external intercostals contract during inhalation, the chest expands diaphragm moves inferiorly, ribs lift increasing thoracic volume. This drops intrapulmonary (alveolar) pressure below atmospheric, drawing air in, and intrapleural pressure decreases (more negative, e.g., -6 mmHg from -4 mmHg) to keep lungs expanded. Intrapleural pressure increasing doesn't occur it contradicts mechanics of inspiration, where negative pressure maintains lung inflation. An increase would collapse lungs, as in pneumothorax. This action's absence is key to understanding ventilation dynamics, distinguishing normal breathing from pathological states where pressure relationships invert, a fundamental concept in respiratory physiology.

Correct Answer: B

Rationale: Decreased wheezing in a child with asthma during an acute exacerbation can signal worsening, not improvement. Asthma, a chronic inflammatory airway disease, causes bronchoconstriction, typically producing wheezing as air squeezes through narrowed passages. If wheezing diminishes without treatment resolving the attack, it may indicate a 'silent chest' severe airflow obstruction where air movement is too restricted to produce sound, risking respiratory failure. Warm, dry skin suggests improvement, as exacerbations often cause diaphoresis. A pulse of 90 beats/minute (normal: 70-110 for a 10-year-old) and respirations of 18 breaths/minute (normal: 16-20) are within expected ranges and not alarming. Monitoring for decreased wheezing is critical, as it prompts urgent intervention like bronchodilators to restore airflow, a key nursing priority in asthma management to prevent hypoxia and escalation.

Correct Answer: D

Rationale: Isoetharine (Bronkosol), a beta-2 agonist bronchodilator, commonly causes tachycardia (D) as a side effect. It stimulates beta-2 receptors in bronchial smooth muscle to relieve bronchospasm, but beta-1 crossover in the heart increases heart rate palpitations or tremors may follow. Constipation (A) and diarrhea (B) aren't linked; gastrointestinal effects are rare. Bradycardia (C) opposes beta-adrenergic stimulation, which accelerates pulse. Other effects like nervousness or dry mouth occur, but tachycardia is a primary concern, requiring monitoring, especially in COPD or asthma patients with cardiac comorbidities, a key nursing task to ensure safety during nebulizer therapy.

Correct Answer: A

Rationale: Aerosol (A), via nebulizer or inhaler, is the most frequent route for asthma medications in hospitalized children (e.g., albuterol). It delivers drugs like bronchodilators directly to airways, rapidly relieving bronchospasm with minimal systemic effects ideal for acute settings. Intravenous (B) suits emergencies (e.g., status asthmaticus) with steroids or theophylline, but it's less common. Subcutaneous (C) is rare epinephrine is historical, not routine. Oral (D) steroids or leukotriene modifiers are slower, for maintenance. Aerosol's targeted, fast action dominates inpatient asthma care, a nursing standard to optimize respiratory relief and monitor response.