During an assessment in the emergency department, an older adult client with community-acquired pneumonia is found to be confused. Which of the following findings should the nurse expect?

Correct Answer: D

Rationale: The correct answer is D: Confusion. Confusion in an older adult with community-acquired pneumonia can indicate hypoxia or sepsis affecting the brain. It is a common manifestation in elderly patients with pneumonia due to impaired gas exchange and systemic inflammatory response. Unequal pupils do not typically relate to pneumonia. Hypertension is not a common finding in pneumonia; hypotension is more likely. Tympany upon chest percussion is associated with conditions like pneumothorax, not pneumonia. Therefore, confusion is the most relevant finding in this scenario.

Correct Answer: B

Rationale: The correct answer is B: 480 mL. For a client with an ideal weight of 60 kg, the tidal volume should be set at 6-8 mL/kg of ideal body weight. Therefore, for a 60 kg individual, the tidal volume should be between 360-480 mL. B falls within this range and is the most appropriate choice. A: 300 mL is too low and would not provide adequate ventilation for a client of this weight. C: 800 mL is too high and could lead to overventilation and potential lung injury. D: 950 mL is also too high and poses the same risks as option C. In summary, B is the correct choice as it falls within the appropriate tidal volume range based on the client's ideal weight, while the other options are either too low or too high.

Correct Answer: B

Rationale: The correct answer is B: Nausea. In acute respiratory failure (ARF), the body may compensate by increasing respiratory rate, leading to respiratory alkalosis. This can cause nausea due to the altered pH levels affecting the chemoreceptors in the brain. Severe dyspnea (choice A) is a common symptom of ARF but does not specifically relate to nausea. Decreased level of consciousness (choice C) may indicate severe hypoxemia but is not a direct manifestation of ARF. Headache (choice D) is more commonly associated with conditions like hypoxia, hypercapnia, or respiratory acidosis in ARF.

Correct Answer: B

Rationale: The correct answer is B: Resonance. When assessing a client with chronic bronchitis, the healthcare provider should expect to hear resonant percussion sounds. This is because chronic bronchitis is characterized by inflammation and excess mucus production in the bronchial tubes, leading to airway obstruction. Resonance indicates normal lung tissue and air-filled spaces. Dullness (A) may suggest consolidation or fluid in the lungs, which is not typically associated with chronic bronchitis. Tympany (C) is a drum-like sound that can be heard over air-filled structures like the stomach, not typically expected in a lung assessment. Flatness (D) is heard over solid structures like the liver and would not be expected in a lung assessment for chronic bronchitis.

Correct Answer: D

Rationale: The correct answer is D because the student being in the yellow zone indicates moderate symptoms, not severe enough to necessitate hospitalization. A: Using a quick-relief inhaler is appropriate for yellow zone symptoms. B: Yellow zone indicates asthma is not well controlled, supporting the need for action. C: Peak flow of 50% to 80% signals a reduction in lung function, requiring intervention but not immediate hospitalization. Thus, D is the incorrect choice because hospitalization is not warranted for yellow zone symptoms.