A client who recently underwent a routine surgical procedure made a dinic appointment. To elicit the most information, which question is best for the nurse to ask this client?

"What brought you to the clinic?"

"Are you having any pain?"

"What type of surgery did you have?"

"When did your surgery take place?"

Answer and Explanation

The Correct Answer is A

A.   This open-ended question allows the client to describe the reason for their visit in their own words, which can provide a broad range of information about their current concerns or symptoms. It encourages the client to share specific issues or problems they are experiencing since the surgery, which could include pain, complications, or other concerns.
B.   While this question is important for assessing one aspect of the client’s postoperative condition, it is somewhat narrow. It focuses specifically on pain, which is only one possible postoperative issue. This question does not capture other potential concerns such as functional problems, wound healing, or systemic symptoms.
C.   Knowing the type of surgery is important for understanding the client’s medical background and specific postoperative considerations. However, this question may not provide immediate information about the client’s current condition or why they are seeking follow-up care.
D.   This question helps establish a timeline and can be useful for understanding the postoperative phase and assessing healing progress. However, it does not directly address the client's current symptoms or concerns. Knowing the timing of the surgery alone does not provide comprehensive information about the client's present condition or reasons for the visit.

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Correct Answer is C

Explanation

A. A standing position leaning over the exam bed may not provide the best view or allow for thorough examination of the perianal area. This position is less commonly used and may not be ideal for a focused assessment of hemorrhoids.
B. Finding out if the client uses over-the-counter preparations for hemorrhoids provides useful information about the management and treatment approach being used. However, while this information is valuable, it does not directly involve the physical assessment of the hemorrhoids themselves.
C. The left lateral position (also known as the Sims' position) is commonly used for the examination of the perianal area. It provides optimal access for visual inspection of hemorrhoids, fissures, or other abnormalities in the anal region. This position allows the nurse to examine the area more thoroughly and comfortably, making it the most appropriate choice for a focused assessment of hemorrhoids.

D. Asking about the duration of discomfort provides valuable information about the history and progression of the condition. Understanding how long the client has been experiencing symptoms can help in assessing the chronicity and possible treatment history of the hemorrhoids.

A. Notify the healthcare provider. B. Observe for eye opening to a painful stimulus. C. Check the pupillary response to light. D. Ask the client to open his eyes.

Correct Answer is B

Explanation

A. While notifying the healthcare provider is important if there are significant changes in the client's level of consciousness, it should not be the immediate next step. Before alerting the provider, the nurse needs to perform additional assessments to determine the extent of the client's unresponsiveness and gather more information about their neurological status.
B. Observing for eye opening in response to a painful stimulus is a critical step in assessing the depth of unconsciousness. This response helps determine the client's level of consciousness and can provide information about the severity of their condition.
C. Checking the pupillary response to light is important in evaluating neurological function and can provide information about brainstem activity and potential neurological deficits. However, it is secondary to checking for responses to stimuli like painful stimuli if the client is not opening their eyes spontaneously. Pupillary response should be assessed as part of a comprehensive neurological exam.
D. Asking the client to open his eyes might not be effective if the client is unresponsive or has impaired consciousness. If the client is not responding spontaneously, it is likely that verbal commands will also be ineffective. This step is less useful when assessing levels of consciousness compared to more objective assessments like responses to painful stimuli.

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A client who recently underwent a routine surgical procedure made a dinic appointment. To elicit the most information, which question is best for the nurse to ask this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing a female client who states that her hemorrhoids are inflamed and hurt constantly. Which intervention is best for the nurse implement to complete a focused assessment?

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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