A client is being evaluated for environmental allergies. While examining the client's nasal passage, which finding suggests to the nurse that the client is experiencing allergic rhinitis?

Purulent secretions from eyes and nares.

Snoring and bilateral, pale gray nodules.

Intranasal edema and swelling of turbinates.

Eye tearing and thick yellow nasal drainage.

Answer and Explanation

The Correct Answer is C

Choice A Reason:
Purulent secretions from eyes and nares is incorrect. Purulent secretions, which are thick and yellow or green in color, typically indicate the presence of a bacterial infection rather than allergic rhinitis. Allergic rhinitis is more commonly associated with clear nasal discharge, although it can sometimes be accompanied by a mild increase in nasal secretions.
Choice B Reason:
Snoring and bilateral, pale gray nodules is incorrect. Snoring and bilateral, pale gray nodules suggest adenoid hypertrophy rather than allergic rhinitis. Adenoid hypertrophy refers to enlargement of the adenoids, which are lymphoid tissue located in the back of the nasal cavity. Enlarged adenoids can lead to snoring and the presence of grayish nodules upon examination of the nasopharynx.
Choice C Reason:
Intranasal edema and swelling of turbinates are correct. Intranasal edema (swelling inside the nose) and swelling of turbinates are characteristic features of allergic rhinitis. Allergic rhinitis results from inflammation of the nasal mucosa in response to exposure to allergens, leading to nasal congestion and swelling of the turbinates.
Choice D Reason:
Eye tearing and thick yellow nasal drainage is incorrect. Eye tearing and thick yellow nasal drainage suggest the presence of sinusitis rather than allergic rhinitis. Sinusitis is characterized by inflammation of the sinuses, which can result in symptoms such as facial pain or pressure, thick nasal discharge, and eye tearing due to sinus pressure affecting the tear ducts.

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Correct Answer is B

Explanation

Choice A Reason:
Coronary heart disease is incorrect. Coronary heart disease is primarily associated with cardiovascular symptoms such as chest pain, shortness of breath, and fatigue. While some nail changes may occur in individuals with coronary heart disease due to decreased oxygenation, brittle, concave nails are not a typical manifestation of this condition. Therefore, this option is less likely to explain the appearance of the nails.
Choice B Reason:
Iron deficiency anemia is correct. Iron deficiency anemia is characterized by a lack of iron in the body, leading to decreased production of hemoglobin and red blood cells. One of the classic nail findings associated with iron deficiency anemia is koilonychia, which presents as brittle, concave nails with a spoon-like appearance. This is due to structural changes in the nails caused by the deficiency of iron. Therefore, this option is the most likely explanation for the observed nail changes.
Choice C Reason:
Diabetes mellitus is incorrect. Diabetes mellitus can lead to various dermatologic manifestations, including nail changes such as thickening, discoloration, and slow nail growth. However, brittle, concave nails with a spoon-like appearance are not typically associated with diabetes mellitus. Therefore, while diabetes mellitus may affect the nails, it is less likely to explain the specific appearance observed in this case.
Choice D Reason:
Recent candida infection is incorrect. Candida infections, particularly in the nail folds (paronychia), can lead to changes in the nails such as discoloration, thickening, or separation from the nail bed. However, brittle, concave nails with a spoon-like appearance are not typical findings of candida infections. Therefore, while recent candida infection may affect the nails, it is less likely to explain the specific appearance observed in this case.

A. Allow the client to decline answering social questions. B. Obtain a drug urine screen to verify legitimacy of client's stated history. C. Use the term illegal or illicit to describe street drugs. D. Ask specifically about alcohol, marijuana, cocaine, heroin, and amounts.

Correct Answer is D

Explanation

Choice A Reason:
Allowing the client to decline answering social questions is inappropriate. This approach respects the client's autonomy and privacy by giving them the option to decline answering questions they may feel uncomfortable or unwilling to discuss. However, for the purpose of ensuring comprehensive care and assessing potential risks associated with substance use, it's important for the nurse to gather relevant information about the client's use of illegal drugs and alcohol.
Choice B Reason:
Obtaining a drug urine screen to verify legitimacy of client's stated history is inappropriate. While obtaining a drug urine screen may provide objective information about recent drug use, it may not be indicated during the initial health history and may not accurately reflect the client's past substance use history. Additionally, relying solely on laboratory testing without actively engaging the client in open communication may hinder the development of trust and rapport between the client and the healthcare provider.
Choice C Reason:
Using the term illegal or illicit to describe street drugs is inappropriate. Using the terms "illegal" or "illicit" may carry negative connotations and could potentially stigmatize the client's substance use. This approach may create barriers to open communication and may not accurately capture the client's experiences or perceptions regarding their substance use. Additionally, it's important to use language that is respectful and nonjudgmental when discussing sensitive topics such as substance use.
Choice D Reason:
Asking specifically about alcohol, marijuana, cocaine, heroin, and amounts is appropriate. This approach is the most appropriate because it directly addresses the substances of concern and allows for comprehensive assessment of the client's substance use history. By asking specifically about commonly used substances and their amounts, the nurse ensures that key information is gathered in a respectful and nonjudgmental manner, facilitating open communication and accurate assessment of the client's needs.

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A client is being evaluated for environmental allergies. While examining the client's nasal passage, which finding suggests to the nurse that the client is experiencing allergic rhinitis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse observes the presence of brittle, concave curves to the nails of a client on assessment. Which information should the nurse obtain from the client that may explain the appearance of the nails?

Correct Answer is B

Explanation

The nurse is obtaining a health history for a client prior to a scheduled cholecystectomy. While interviewing the client, which assessment technique should the nurse use when asking about the client's use of illegal drugs and alcohol?

Correct Answer is D

Explanation

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