A client has sought care because of a sudden increase in the size of his scrotum after a cough. The nurse's assessment reveals the presence of a large scrotal mass. How can the nurse best assess for a scrotal hernia?

Auscultate the scrotum for bowel sounds

Inspect the femoral hernia while the patient coughs

Ask the client to stand up to see if the mass disappears

Palpate the abdomen for pain

Answer and Explanation

The Correct Answer is A

Choice A reason: Auscultating for bowel sounds in the scrotum detects an inguinal hernia, where intestines protrude after coughing. This confirms the mass’s nature, making it the best method to assess this sudden scrotal enlargement accurately and directly here.
Choice B reason: Inspecting femoral hernia focuses on the thigh, not scrotum. Scrotal masses from coughing suggest inguinal hernia, misaligning this with the primary site, rendering it less effective for this specific assessment entirely and fully here.
Choice C reason: Standing may reduce some hernias, but disappearance isn’t diagnostic. Cough-induced scrotal mass needs auscultation for bowel sounds to confirm hernia, making this less precise than listening for intestinal presence comprehensively here fully.
Choice D reason: Abdominal palpation for pain assesses tenderness, not hernia type. Scrotal mass from coughing points to inguinal hernia, where auscultation directly identifies bowel, making this less specific for the scrotal finding entirely here fully.

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Correct Answer is D

Explanation

Choice A reason: Acute otitis media shows a red, bulging tympanic membrane due to bacterial infection and pus. A pearly gray, shiny appearance contrasts this, indicating no acute inflammation or fluid, ruling out this active middle ear condition entirely.

Choice B reason: Serous otitis media presents with amber fluid behind a retracted or neutral tympanic membrane, not pearly gray and shiny. This suggests no sterile effusion, distinguishing it from the normal, healthy membrane observed in this inspection clearly.

Choice C reason: Scarring from past infections appears as white, opaque patches on the tympanic membrane, not uniform pearly gray shininess. This finding lacks the irregular, thickened look of scar tissue, pointing to an unscathed membrane instead here.

Choice D reason: A pearly gray, shiny tympanic membrane is normal, reflecting light off an intact, healthy eardrum. This lacks signs of infection or fluid, aligning with standard anatomy where the membrane’s cone of light confirms its integrity fully.

A. The client has a family history of cognitive disorders. B. The client has recently begun a new medication. C. The client's cognition has declined over a period of several months to a year. D. The client has a history of hypertension.

Correct Answer is B

Explanation

Choice A reason: Family history suggests dementia, not delirium. Dementia progresses slowly, unlike delirium’s acute onset, making this less indicative of the sudden cognitive shift typical of delirium, especially without a rapid trigger in this case fully here.
Choice B reason: New medication often causes delirium in older adults via anticholinergic effects or toxicity. This acute, reversible change aligns with delirium’s hallmark sudden onset, making it the most suggestive finding for this cognitive impairment accurately here.
Choice C reason: Decline over months to a year fits dementia, not delirium. Delirium is acute, not chronic, excluding this gradual progression as a sign of the rapid cognitive shift delirium presents in this assessment entirely and fully.
Choice D reason: Hypertension risks vascular dementia, not delirium. It’s a chronic factor, not an acute trigger, missing delirium’s sudden, reversible nature tied to immediate causes like drugs, rendering it less relevant here comprehensively and clearly.

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A client has sought care because of a sudden increase in the size of his scrotum after a cough. The nurse's assessment reveals the presence of a large scrotal mass. How can the nurse best assess for a scrotal hernia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

While inspecting the tympanic membrane the nurse notes a pearly gray and shiny appearance. What would this finding indicate?

Correct Answer is D

Explanation

An older adult client has been admitted due to decreased cognition. What assessment finding is most suggestive of delirium as the cause of the client's cognitive impairment?

Correct Answer is B

Explanation

The nurse has completed the assessment of the client's ears. A small/moderate amount of brown cerumen was found in both ears. Which action by the nurse is warranted?

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The nurse is conducting a focused neurologic assessment on an 81-year-old client. What finding below is an age-related neurologic change?