A 29-year-old woman tells the nurse that she has “excruciating pain” in her back. Which would be an appropriate response by the nurse to the woman’s statement?

“That sounds terrible!” must be terrible. You probably pinched a nerve.”

“How does your family react to your pain?”

“I’ve had back pain myself, and it can be excruciating.”

“How would you say the pain affects your daily activities?”

Answer and Explanation

The Correct Answer is D

Choice A reason: Saying “That must be terrible” and suggesting a pinched nerve is dismissive and assumes a cause without assessment. Exploring the pain’s impact gathers critical data, so this is incorrect for an appropriate response.

Choice B reason: Asking about family reactions shifts focus from the patient’s experience and is less relevant initially. Assessing how the pain affects daily activities provides functional insight, so this is not the best response for pain assessment.

Choice C reason: Sharing personal experience can seem empathetic, but it this risks bias and doesn’t assess the patient’s pain. Asking about daily activity impact is more patient-centered, so this is incorrect for professional response.

Choice D reason: Asking how pain affects daily activities encourages the patient to describe the pain’s severity and impact, aiding assessment and planning. This open-ended, patient-focused response is therapeutic, making it the correct choice for the nurse’s reply.

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Correct Answer is C

Explanation

Choice A reason: Bronchial breath sounds are loud, high-pitched, with expiration longer than inspiration, typically heard over the trachea or in consolidated lung areas. The described soft, low-pitched sounds with longer inspiration in the posterior lower lobes do not match, making this incorrect.

Choice B reason: Sounds over the trachea are bronchial, characterized by loud, high-pitched sounds with expiration equal to or longer than inspiration. The soft, low-pitched sounds with longer inspiration in the posterior lower lobes indicate peripheral lung fields, not tracheal sounds, making this incorrect.

Choice C reason: Vesicular breath sounds are soft, low-pitched, with inspiration longer than expiration, heard over peripheral lung fields like the posterior lower lobes. These are normal findings, reflecting air movement in alveoli, making this the correct interpretation of the described sounds.

Choice D reason: Bronchovesicular sounds are medium-pitched with equal inspiration and expiration, typically heard near mainstem bronchi. The described low-pitched sounds with longer inspiration in the posterior lower lobes align with vesicular sounds, not bronchovesicular, making this incorrect.

A. Submandibular and occipital B. Parotid and jugulodigastric C. Occipital and submental D. Parotid and submandibular

Correct Answer is D

Explanation

Choice A reason: The submandibular glands are palpable below the mandible, but occipital glands do not exist as salivary glands. The occipital region relates to lymph nodes or muscles, not salivary structures, making this an incorrect pair for palpation.

Choice B reason: The parotid glands are palpable near the ears, but jugulodigastric refers to lymph nodes, not salivary glands. This misidentification of anatomical structures makes this pair incorrect for assessing salivary gland palpation.

Choice C reason: Occipital and submental regions do not contain salivary glands. Submental lymph nodes exist, but neither these nor occipital structures are salivary glands, making this pair anatomically incorrect for the nurse’s palpation assessment.

Choice D reason: The parotid glands, located anterior to the ears, and submandibular glands, below the mandible, are the two pairs of salivary glands accessible for palpation. Their anatomical positions allow external assessment, making this the correct choice.

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A 29-year-old woman tells the nurse that she has “excruciating pain” in her back. Which would be an appropriate response by the nurse to the woman’s statement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is D

Explanation

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