Adaptive Quiz Chapter 12 questions and answers well illustrated.

Adaptive Quiz Chapter 12 questions and answers well illustrated. In documenting assessment findings, which are examples of objective data? - correct answers.Redness and swelling of feet If a light is shined in the eyes of the patient during the physical assessment and the pupils are noted to be equal, round, and reactive to light and accommodation, which system is being tested? - correct answers.Neurologic system The LPN/LVN is working on a medical floor and assisting the registered nurse (RN) with patient assessments. A new patient is admitted to the floor, and the RN takes a health history and performs an assessment. What is this considered the first step of? - correct answers.The nursing process Following an assessment and interview, the nurse suggests that the patient place two pillows below the head while sleeping to help elevate the head. What would be the probable reason for giving such advice? - correct answers.The patient has orthopnea. Mr. S. is complaining of pain in his chest, difficulty breathing, and a cough. What are these reports by the patient considered? - correct answers.Subjective data The nurse is caring for a patient who is a chronic alcoholic. The nurse finds that the patient's vomitus is "coffee-ground." What would the nurse infer from this? - correct answers.The patient has a bleeding stomach. A nurse performing an examination pinches the tips of the patient's fingers for 5 seconds, monitors the blood return, and estimates the speed at which the blood returns. The blanching of the fingers is less than 3 seconds. What can the nurse conclude from this test? - correct answers.The arterial blood flow is normal A patient's lower legs are noticeably edematous. When the nurse presses on the leg near the ankle with a finger, the imprint remains for 30 seconds before the leg returns to the original state. How would the nurse characterize the edema? - correct answers.3+ A patient comes into the clinic for an appointment. What data if collected by the nurse can indicate the patient is experiencing problems with the cardiovascular system? - correct answers.The jugular vein in the neck is swollen. The licensed practical nurse (LPN) assists a registered nurse (RN) during an admission assessment and data collection interview. The LPN considers the assessment of a patient complete at the end of the interview. Why does the LPN's thought about assessment indicate a need for further teaching? - correct answers.Assessment is an ongoing process. The nurse has been assigned to auscultate the lungs of a patient. What instruction does the nurse provide to the patient? - correct answers.Breath in and out through the mouth. The nurse is reviewing a patient's database record. Identify the data that reflects an interaction between the patient and the environment. - correct answers.Cultural factors Lifestyle factors The nurse is gathering supplies in preparation to perform a physical examination. Identify the uses of a stethoscope during a physical examination. - correct answers.Listening to lung sounds Assessing heart sounds Listening to bowel sounds A patient with a history of gastrointestinal problems comes to the clinic for an appointment. The patient complains of abdominal discomfort, nausea, vomiting, and a feeling of fullness. The nurse auscultates each quadrant for 30 seconds and hears no bowel sounds. What should be the nurse's next step? - correct answers.Continue to listen for bowel sounds. A student nurse is performing a physical assessment of a patient. What action should the student nurse take to decrease anxiety in the patient? - correct answers.Explaining what will occur before touching the patient A nurse performs a neurologic assessment of a patient. The nurse finds that the patient's eyes open only with painful stimuli, the patient's speech is incomprehensible, and decorticate posture is noted. What score would this patient receive on the Glasgow Coma Scale? Record your answer using a whole number. - correct answers.7 While assessing a newly admitted patient, the registered nurse (RN) delegates the task of collecting patient data to a practical nurse (PN). Which task belongs to the data collection step of the assessment phase? - correct answers.Measuring the height of the patient. The nurse is palpating the patient's lymph nodes. Which part of hand should the nurse use to perform this assessment? - correct answers.Pads of fingers In performing a physical assessment, which findings would indicate a deviation from normal? - correct answers.Jaundice Apical heart rate of 110 Erythema of lower extremities Cyanosis of the fingers and toes A nurse is performing a physical assessment of an elderly patient. Which question(s) might the nurse ask to assess the patient's level of orientation? - correct answers.What is today's date?" "Can you state your name?" "Where you are right now?" The nurse observes that a patient has difficulty in breathing while sleeping. The patient tells the nurse, "I don't have this difficulty when I sit or stand for a long time." What does the nurse interpret from the assessment? - correct answers.The patient may have orthopnea. A patient arrives at the clinic for a scheduled appointment. The patient is complaining of pain in the right leg. When assessed, the pulse is absent and the leg is hairless, blue in color, and cool to touch. What should the nurse suspect based on these findings? - correct answers.There may be a problem with circulation in the right leg. The nurse finds that a patient has reduced muscle tone and absence of pupillary reflex. The primary health care provider instructs the nurse to place the patient on ventilation. What can the nurse infer about the health status of the patient? - correct answers.The patient may be in stage IV coma. The nurse is assessing a patient using the Glasgow Coma Scale (GCS). The nurse documents and rates the patient's eye response as 3 and verbal as 3. Which motor response rating on the GCS scale would have made the nurse suspect brain injury in a patient? - correct answers.2 A patient reports pain in his knee during a routine office visit. How does the nurse examine this patient? - correct answers.Examine the joint's range of motion The nurse is teaching a group of nursing students about the role of a licensed practical nurse (LPN) in caring for a patient with tuberculosis. Which statement by the nurse indicates effective teaching? - correct answers."The LPN should collect a sputum sample from the patient." An adult female patient has a scheduled appointment for an assessment. During the interview it is found that the patient does not perform a monthly breast self-examination. What is the best intervention in response to this finding? - correct answers.While assessing the lungs, perform and teach the patient about monthly breast self-examination. While a nurse is performing a physical assessment, the patient complains of dyspnea. This symptom indicates a problem with which body system? - correct answers.Respiratory The nurse is preparing to assess the hip extension movement in a patient in the prone position. What question should be most important question to be asked before the assessment? - correct answers."Do you have difficulty breathing?" While assessing the six cardinal fields, the nurse notes the presence of jerky eye movements. What does the nurse document this finding as? - correct answers.Nystagmus