While assessing a client with pulmonary tuberculosis, which of the following findings should the nurse expect?

Correct Answer: A

Rationale: The correct answer is A: Lethargy. In pulmonary tuberculosis, lethargy is common due to systemic symptoms like fatigue and weakness. High-grade fever is also common but not specific to pulmonary tuberculosis. Weight loss, not weight gain, is a classic symptom due to decreased appetite. Dry cough is a common symptom, but not as specific as lethargy in pulmonary tuberculosis.

Correct Answer: B

Rationale: The correct answer is B: Flail chest. Flail chest occurs when a segment of the rib cage is detached from the rest of the chest wall, causing paradoxical chest movement. In this case, the inward movement during inspiration and outward bulging during expiration are classic signs of flail chest, as the detached segment moves in the opposite direction of the rest of the chest wall. Atelectasis (choice A) refers to collapsed lung tissue, not paradoxical chest movement. Hemothorax (choice C) is the accumulation of blood in the pleural space, which does not cause paradoxical chest movement. Pneumothorax (choice D) is the presence of air in the pleural space, which can cause chest pain and dyspnea but does not result in paradoxical chest movement.

Correct Answer: A

Rationale: The correct answer is A: Loud, scratchy sounds. Pleurisy is inflammation of the pleura, causing friction between layers of the lung lining, resulting in loud, scratchy sounds known as pleural friction rubs. Squeaky, musical sounds (B) are indicative of wheezing in conditions like asthma. Popping sounds (C) can be heard in conditions like atelectasis or pneumonia. Snoring sounds (D) are typically associated with upper airway obstruction, not pleurisy. Therefore, in the context of pleurisy, the healthcare professional should expect to hear loud, scratchy sounds during auscultation.

Correct Answer: A

Rationale: The correct answer is A: Provide the client with supplemental oxygen at 5 L/min via facemask. In cardiogenic pulmonary edema, the priority intervention is to improve oxygenation. Supplemental oxygen helps increase oxygen levels and alleviate respiratory distress, reducing the workload on the heart. This intervention addresses the client's dyspnea and anxiousness by improving oxygen delivery. Choice B is incorrect as placing the client in high-Fowler's position with legs in a dependent position can help with breathing but does not address the immediate need for oxygenation. Choice C is incorrect as sublingual nitroglycerin is typically used for angina and not the priority intervention for cardiogenic pulmonary edema. Choice D is incorrect as morphine sulfate IV may be indicated for pain relief and anxiety, but it is not the priority intervention to address the client's oxygenation needs in cardiogenic pulmonary edema.

Correct Answer: C

Rationale: The correct answer is C: Confirming the gag reflex. Immediately following a bronchoscopy, the nurse must prioritize confirming the gag reflex to ensure the client can protect their airway. This is crucial to prevent aspiration and respiratory complications. Observing for confusion (choice A) is important but not the priority in this situation. Auscultating breath sounds (choice B) is also important but confirming the gag reflex takes precedence. Measuring blood pressure (choice D) is not directly related to the immediate post-bronchoscopy monitoring.