The nurse is caring for an individual whose respiratory rate of 14 is even and easy; breath sounds are normal. Which terms should the nurse use in this patient's narrative note? (Select all that apply.)
a. Apnea
b. Eupnea
c. Rhonchi
d. Bradypnea
e. Clear to auscultation
f. Inspiratory crackles
ANS: B, E
Normal breathing is eupnea. Normal breath sounds are clear to auscultation. A. Apnea is no breathing. F. Inspiratory crackles indicate fluid in the airways. D. Bradypnea is slow breathing. C. Rhonchi are heard with bronchoconstriction.
You might also like to view...
Mr. Deere has an IV of morphine 2 mg/h that has been infusing since 2000 hours yesterday. It is currently 0700 hours. The concentration of morphine isĀ NS. How much solution has he received?
A. 44 mL B. 22 mL C. 50 mL D. 440 mL
Which cranial nerve is assessed when a nurse asks a patient to stick out the tongue and move it side to side?
a. Vagus nerve (CN X) b. Facial nerve (CN VII) c. Abducens nerve (CN VI) d. Hypoglossal nerve (CN XII)
A patient asks the health care provider about good sources of biotin in the diet. Which foods should be included in a response?
a. Carrots and sweet potatoes b. Apples and peaches c. Liver and egg yolk d. Beef and lamb
Which of the following statements would be most important for the nursing staff to consider when planning delirium management for a client?
1. Provide education for family members as needed 2. Decrease all stimulation in the client's room 3. Sensory deprivation and over stimulation can worsen symptoms 4. Ask the family to involve the client in all conversations and interactions