On auscultation of a patient’s lungs, the nurse hears low-pitched, bubbling sounds during inhalation in the lower third bilaterally. How should the nurse document this finding?

Correct Answer: A

Rationale: The correct answer is A: Inspiratory crackles at the bases. Crackles are abnormal lung sounds caused by air passing through fluid in the alveoli or small airways. In this case, the low-pitched bubbling sounds heard during inhalation in the lower third bilaterally indicate the presence of inspiratory crackles at the bases. This finding suggests fluid accumulation in the lungs, commonly seen in conditions such as pneumonia or heart failure affecting the bases. The other choices are incorrect because expiratory wheezes typically indicate asthma or COPD, abnormal lung sounds in the apices suggest conditions like tuberculosis, and pleural friction rub is characterized by a grating sound heard during both inspiration and expiration, commonly associated with pleurisy or pleural inflammation, not fluid-filled alveoli.

Correct Answer: C

Rationale: The correct answer is C. Prior to total laryngectomy, the nurse should assist the client to choose a communication method as the client will lose their ability to speak post-surgery. This step is crucial for the client's psychosocial well-being and quality of life. Assessing airway patency, breathing, and circulation (A) is important but is typically done as part of routine preoperative assessment and not specific to laryngectomy. Administering pain medication (B) is important but is not the priority before surgery, as the client may not be in pain at that moment. Ambulating the client (D) is not necessary before laryngectomy and does not address the client's communication needs.

Correct Answer: C

Rationale: Rationale: Choice C is correct because individuals with CF require a well-balanced, nutritious diet to support their overall health and manage their condition. This includes adequate intake of calories, protein, vitamins, and minerals. A balanced diet can help improve lung function, maintain a healthy weight, and support the body's immune system. Choices A, B, and D are incorrect. Taking antibiotics daily may not be necessary for all CF patients, genetic screening is important but not directly related to dietary needs, and exercise recommendations should be individualized based on the client's health status.

Correct Answer: B

Rationale: The correct answer is B because a blood pressure reading of 146/88 mmHg indicates hypertension, which is a common comorbidity with type 1 diabetes. Hypertension increases the risk of cardiovascular complications in diabetic patients. Choices A, C, and D are within normal ranges and do not directly indicate the need for a change in therapy for a 28-year-old active male with type 1 diabetes.

Correct Answer: D

Rationale: The correct answer is D: Cardiac-specific troponin. Troponin is a highly specific marker for myocardial injury, especially in diagnosing acute myocardial infarction (AMI). It is released into the bloodstream when there is damage to the heart muscle. Monitoring troponin levels helps in confirming the diagnosis of AMI. A: Myoglobin is less specific and can also be elevated in skeletal muscle injury. B: Homocysteine is a marker for cardiovascular risk but not specific to AMI. C: C-reactive protein is a marker for inflammation and not specific to AMI. In summary, monitoring cardiac-specific troponin levels is crucial in diagnosing AMI due to its high specificity for myocardial injury compared to the other options.