Why might a client with an acute asthma attack stop wheezing and have no audible breath sounds?

Correct Answer: B

Rationale: The correct answer is B because during an acute asthma attack, the airways become inflamed and swollen, making it difficult for air to pass through. This can result in a lack of audible breath sounds and the absence of wheezing. The swelling obstructs the flow of air, leading to decreased breath sounds. Choice A is incorrect as wheezing cessation does not necessarily indicate the end of an asthma attack. Choice C is incorrect because the swelling typically increases during an asthma attack. Choice D is incorrect as crackles are not associated with asthma attacks but may indicate other respiratory conditions like pneumonia.

Correct Answer: C

Rationale: The correct answer is C, Clinical Nurse Specialist (CNS). A CNS has specialized training and credentialing, allowing them to provide expert clinical care, education, research, and leadership in a specific area of nursing practice. They have advanced knowledge and skills to improve patient outcomes and influence healthcare delivery. A: A Primary Care Nurse typically provides general healthcare services to a variety of patients. B: Private Duty Nurse provides one-on-one care to individual patients in their homes. D: A Visiting Nurse provides care to patients in their homes, but without the specialized training and credentialing of a CNS. In summary, the expanded role of a nurse with specialized training and credentialing is best represented by a Clinical Nurse Specialist due to their advanced clinical expertise and ability to impact healthcare on a broader scale.

Correct Answer: A

Rationale: The correct answer is A: Give laxative as ordered. In renal failure, constipation is common due to fluid and electrolyte imbalances. Laxatives can help soften stools and promote bowel movements without increasing fluid intake, which is restricted in renal failure. Increasing fluid intake (B) may worsen fluid overload. Raw fruits and vegetables (C) high in potassium and phosphorus can be harmful. Increasing activity (D) may not directly address the constipation issue.

Correct Answer: B

Rationale: The correct answer is B: Prevent abdominal distention. A Salem Sump tube is a type of nasogastric tube used for decompression and drainage of the stomach. It helps prevent abdominal distention by removing air and fluids from the stomach. This is important in preventing complications such as vomiting, aspiration, and bowel obstructions. Choice A is incorrect because the purpose of a Salem Sump tube is not to apply internal pressure to the abdomen to prevent bleeding. Choice C is incorrect because a Salem Sump tube is not used to instill feedings into the stomach but rather to remove contents from the stomach. Choice D is incorrect because a Salem Sump tube is not used to help in the elimination of urine; it is specifically designed for gastric decompression.

Correct Answer: D

Rationale: The correct answer is D: Notify physician. Delay transfusion. Rationale: 1. Fever (temperature of 38.2 C) indicates possible infection or reaction to transfusion. 2. In a post-surgical patient, fever could be a sign of sepsis or transfusion reaction. 3. Delaying transfusion allows for further assessment and investigation by the physician. 4. Proceeding with transfusion without addressing the fever could worsen the patient's condition. Summary: - Choice A is incorrect because fever post-surgery is not normal and requires further evaluation. - Choice B is incorrect as administering anti-histamine does not address the underlying issue of fever. - Choice C is incorrect as giving Acetaminophen without further evaluation of the cause of fever is not appropriate.