A nurse is caring for a client who had a myocardial infarction 5 days ago. The client has a sudden onset of shortness of breath and begins coughing frothy, pink sputum. The nurse auscultates loud, bubbly sounds on inspiration. Which of the following adventitious breath sounds should the nurse document?

Correct Answer: A

Rationale: The correct answer is A: Coarse crackles. Coarse crackles are associated with fluid-filled airways, commonly seen in conditions like heart failure. In this scenario, the client's history of myocardial infarction and symptoms of shortness of breath, frothy pink sputum, and loud bubbly sounds on inspiration indicate pulmonary edema, leading to coarse crackles. Fine crackles are heard in conditions like pneumonia. Wheezes are associated with airway constriction in conditions like asthma. Rhonchi are caused by secretions in the large airways. Therefore, in this case, coarse crackles are most appropriate.

Correct Answer: D

Rationale: The correct answer is D because salicylates do not have antihypertensive actions. Salicylates, like aspirin, are known for their anti-inflammatory, analgesic, and antipyretic properties. They work by inhibiting prostaglandin synthesis. Antihypertensive medications work differently to lower blood pressure and are not a characteristic action of salicylates. Salicylates can even cause adverse effects on blood pressure in some individuals. This makes choice D incorrect.

Correct Answer: A

Rationale: The correct answer is A: Methotrexate. Methotrexate is an immunosuppressive agent commonly used to treat autoimmune diseases by suppressing the immune system's response. It inhibits the production of certain cells involved in the immune response, making it effective in managing conditions like rheumatoid arthritis and psoriasis. Hydroxychloroquine, Celecoxib, and Diclofenac are not immunosuppressive agents; they are used for other purposes such as treating malaria (Hydroxychloroquine), pain and inflammation (Celecoxib, Diclofenac).

Correct Answer: A

Rationale: Step-by-step rationale: 1. Probenecid is a medication used to treat gout by increasing the excretion of uric acid. 2. Common side effects include nausea and rash, which are important to monitor in patients. 3. Nausea can affect adherence to treatment, while rash may indicate an allergic reaction. 4. Retinal damage (B), bone marrow suppression (C), and hepatotoxicity (D) are not associated with probenecid use. 5. Therefore, monitoring for nausea and rash (A) is crucial for patient safety and treatment effectiveness.

Correct Answer: A

Rationale: The correct answer is A: Colchicine. Colchicine is used for acute management of gout by reducing inflammation and pain caused by gout attacks. It works by inhibiting the inflammatory response to urate crystals in the joint. Allopurinol, Febuxostat, and Probenecid are not used for acute gout attacks; they are used for long-term management to lower uric acid levels and prevent future gout attacks.