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Concepts for Nursing Practice (4TH Ed)

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Concepts for Nursing Practice (4TH Ed) Newest Update2025|Q&A

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Concepts for Nursing Practice

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Subido en
26 de marzo de 2025
Número de páginas
41
Escrito en
2024/2025
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Concepts for Nursing Practice (4TH Ed) Newest
Update2025|Q&A

A woman who is 8 months pregnant comments that she has noticed a change in her posture and is
having lower back pain. The nurse tells her that during pregnancy, women have a posture shift to
compensate for the enlarging fetus. What is the term for this shift in posture?

 lordosis

Which adjustment in the physical environment should the nurse make to promote the success of an
interview

 reduce noise by turning off television and radios

ensure privacy, avoid interruptions, "equal status" seating, appearance & comfort

The nurse is preparing to conduct a health history. Which of these statements best describes the
purpose of a health history?

 to provide a database of subjective information about the patient's past/current health &
objective data from the physical assessment

Which of these responses might the nurse expect during a functional assessment of a patient whose
leg is in a cast?
A. i'm able to transfer myself from the wheelchair to the bed without help
B. i broke my right leg in a car accident two weeks ago
C. the pain is decreasing, but i still need to take acetaminophen
D. i check the color of my toes every evening just like i was taught

 i'm able to transfer myself from the wheelchair to the bed without help

The nurse is asking a patient for his reason for seeking care and asks about the signs and symptoms he
is experiencing. Which of these is an example of a symptom?

a. Chest pain
b. Clammy skin
c. Serum potassium level at 4.2 mEq/L
d. Body temperature of 100 F

 chest pain (symptoms are subjective)

The nurse is assessing a patient's headache pain. which questions reflect one or more of the critical
characteristics of symptoms that should be assessed using?

 How often do the headaches occur
On a scale of 0 to 10, how bad is the pain
What makes the headache feel better

, Where is the pain


onset, location, duration, characteristics, aggravating/alleviating, radiation, time, severity

When examining an older adult, the nurse should use which technique
a. speak loudly and slowly because most aging adults have hearing deficits
b. avoid touching the patient
c. attempt to perform the entire physical examination during one visit
d. arrange the sequence of the exam to allow as few position changes as possible

 arrange the sequence of the exam to allow as few position changes as possible

When assessing a 70-year-old with asthma, the nurse notes that he assumes a tripod position, leaning
forward with arms braced on the chair. How should the nurse interpret these findings?

 recognize the tripod position is often used when a patient is having respiratory difficulties

During an assessment of an adult, the nurse has noted unequal chest expansion and recognizes that
this occurs in which situation?

 when part of the lung is obstructed or collapsed

The nurse is reviewing the characteristics of breath sounds. Which statement about bronchovesticular
breath sounds is true
a. similar to bronchial sounds except shorter in duration
b. expected near major airways
c. musical in quality
d. usually caused by a pathologic disease

 expected near major airways

The nurse is listening to the breath sounds of a patient with severe asthma. Air passing through
narrowed bronchioles would produce which of these adventitious sounds?
a. bronchophony
b. crackles
c. stridor
d. wheezes

 wheezes

The nurse is assessing the lungs of an older adult. Which of these changes are normal in the
respiratory system of an older adult?
a. severe dyspnea is experienced on exertion, resulting from changes in the lungs
b. respiratory muscle strength increases to compensate for a decreased vital capacity
c. lungs are less elastic and distensible, which decreases their ability to collapse and recoil
d. decrease in small airway closure occurs, leading to problems with atelectasis

 lungs are less elastic and distensible, which decreases their ability to collapse and recoil

,Crepitation

 crunching or grating sound accompanying movement, occurs when the articular surfaces in the
joints are roughened as with RA

When assessing muscle strength, the nurse observes that a patient has complete range of motion
against gravity with full resistance. What grade of muscle strength should the nurse record using a 0-5
point scale?

 5

After completing the health history, how should the nurse begin to assess the musculoskeletal
system?

a. feel for the presence of crepitus during joint movement
b. check active and passive range of motion
c. have the patient move the extremities against resistance
d. observe the patient's build & muscle configuration

 observe the patient's build & muscle configuration

inspection then palpation

The nurse is teaching the staff about informatics. Which information from the staff indicates the nurse
needs to follow up?

a. to be proficient in informatics, a nurse should be able to discover, retrieve, and use information in
practice
b. nursing informatics is a recognized specialty area of nursing practice
c. a nurse needs to know how to find, evaluate, and use information effectively
d. if a nurse has computer competency, the nurse is competent in informatics

 if a nurse has computer competency, the nurse is competent in informatics

A nurse is discussing the advantages of a nursing clinical information system, which advantage should
the nurse describe?

a. reduced error of omission
b. more time to read charts
c. increased hospital costs
d. varied clinical database

 reduced error of omission

The nurse completes a thorough assessment of a patient and analyzes the data to identify nursing
diagnoses, which step will the nurse take next in the nursing process?

a. assessment
b. implementation

, c. implementation
d. planning

 planning


nursing process: assessment, diagnosis, planning, implementation, and evaluation

When assessing the developmental milestones of a pediatric patient, the nurse should anticipate
assessing which of the following areas?

height and weight
gross motor skills
cognitive & adaptive skills
literacy skills
communication & social skills

 gross motor skills
cognitive & adaptive skills
communication & social skills

You are caring for a child that has a long history of hospitalization for multiple illnesses & surgeries,
what are some factors that may influence the child's reaction to this hospitalization?

current weight
cost of hospitalization
approach of the nursing staff
inclusion of the child in care delivery
developmental stage of the child

 approach of the nursing staff
inclusion of the child in care delivery
developmental stage of the child

The nurse is developing a care plan for a pediatric patient based on the Family Centered Care Model,
which of the following elements is supported as the nurse encourages the mother (who is a
nutritionist) to create a healthy, kid friendly meal plan

a. building on family strengths
b. honoring cultural diversity
c. celebrating successes
d. supporting the child in decision making

 building on family strengths

Which of the following situations is considered a "genetic red flag"

a. a male is diagnosed with breast cancer
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