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A client with an inability to read billboards while driving, arrives to the clinic for an eye examination. Which piece of equipment would the nurse use to evaluate the client's distant vision?

Snellen chart

Otoscope

Penlight

Rhine test

Answer and Explanation

The Correct Answer is A

A. The Snellen chart is the standard tool used to assess distant vision.

B. An otoscope is used to examine the ears, not vision.

C. A penlight is used for pupillary responses and not for vision testing.

D. The Rinne test assesses hearing, not vision.

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Correct Answer is C

Explanation

A. Documenting the findings is also important, but it should be noted as Mongolian blue spots rather than vernix caseosa.
B. Reporting the parents to the department of children and families would be inappropriate, as Mongolian blue spots are not a sign of abuse or neglect
C. Mongolian blue spots, also known as congenital dermal melanocytosis, are benign skin markings that are usually present at birth or appear shortly after. They are more common in individuals with darker skin tones and are not indicative of any disease or disorder.
D. While it is always prudent to notify the healthcare provider of any findings, in the case of Mongolian blue spots, no immediate medical intervention is necessary.

A. Reposition the client every 2 hours. B. Apply compression stockings. C. Ambulate the client at least once per shift. D. Perform hourly skin checks.

Correct Answer is A

Explanation

A. Repositioning every 2 hours is a standard intervention to prevent pressure ulcers and promote circulation.

B. Compression stockings are used for preventing DVTs but do not directly prevent skin breakdown.

C. Ambulation is not feasible for a quadriplegic client.

D. Hourly skin checks can be beneficial but are secondary to preventive measures like repositioning.

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A client with an inability to read billboards while driving, arrives to the clinic for an eye examination. Which piece of equipment would the nurse use to evaluate the client's distant vision?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse caring for a newborn in the maternal-newborn unit notes the objective finding shown in the diagram. What is the appropriate nursing intervention?

Correct Answer is C

Explanation

In caring for a quadriplegic client which action would the nurse implement to prevent skin breakdown?

Correct Answer is A

Explanation

The nurse receives four clients in the emergency department from triage at the same time. Which client requires the nurse's immediate attention?

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