During an admission assessment of a client with COPD and emphysema complaining of a frequent productive cough and shortness of breath, what assessment finding should the nurse anticipate?

Correct Answer: B

Rationale: The correct answer is B: Increased anteroposterior diameter of the chest. In COPD and emphysema, the lungs lose their elasticity, causing the chest to become barrel-shaped with an increased anteroposterior diameter. This occurs due to hyperinflation of the lungs. This finding is known as "barrel chest" and is a classic sign of advanced COPD. A: Respiratory alkalosis is not typically associated with COPD and emphysema. C: An oxygen saturation level of 96% is within the normal range and does not specifically relate to the assessment findings in COPD and emphysema. D: Petechiae on the chest are not typically associated with COPD and emphysema; they may be indicative of other conditions such as bleeding disorders.

Correct Answer: A

Rationale: The correct answer is A: Stridor. Stridor is a high-pitched, harsh respiratory sound that indicates airway obstruction, which can be life-threatening post endotracheal tube removal. Copious oral secretions (B), hoarseness (C), and sore throat (D) are common after endotracheal tube removal but do not indicate immediate airway compromise. Reporting stridor is crucial for prompt intervention to prevent respiratory distress.

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.