A home health nurse is reviewing messages from a group of clients. Which of the following clients should the nurse contact first?
A mother who reports that her son vomited after a dose of methylphenidate
A client who has COPD and reports an oxygen saturation of 90%
A client who reports that her new colostomy stoma appears purple
A client who reports feeling a vibration in his new internal arteriovenous graft for dialysis
The Correct Answer is C
The mother reporting vomiting in choice A may be concerning, but it is a known side effect of methylphenidate, and the client should be monitored for any further symptoms. A client who has COPD and reports an oxygen saturation of 90%. An oxygen saturation of 90% in COPD is within normal due to the chronic hypoxia.The purple appearance of a colostomy stoma in choice C may indicate ischemia or necrosis, and is an urgent concern.The feeling of a vibration in a new arteriovenous graft for dialysis in choice D may indicate an arterial steal syndrome, but it is not a medical emergency, and the client can be instructed to follow up with the provider. Therefore, the correct answer is choice B.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is C
Explanation
The mother reporting vomiting in choice A may be concerning, but it is a known side effect of methylphenidate, and the client should be monitored for any further symptoms. A client who has COPD and reports an oxygen saturation of 90%. An oxygen saturation of 90% in COPD is within normal due to the chronic hypoxia.The purple appearance of a colostomy stoma in choice C may indicate ischemia or necrosis, and is an urgent concern.The feeling of a vibration in a new arteriovenous graft for dialysis in choice D may indicate an arterial steal syndrome, but it is not a medical emergency, and the client can be instructed to follow up with the provider. Therefore, the correct answer is choice B.
Correct Answer is D
Explanation
The correct answer is Choice D because, "You should have a complete eye examination every 2 years until the age of 64." Women over 50 should have a complete eye exam every 2 years until the age of 64 to screen for age-related macular degeneration, cataracts, and glaucoma. Having hearing screened every 5 years (Choice A is wrong because) is recommended for adults over the age of 50. Having a fasting blood glucose level checked every 3 years (not every 6 years) (Choice B is wrong because) is recommended for adults aged 45 years and older. Testing stool for blood (Choice C is wrong because) is a screening test recommended for colorectal cancer starting at age 50.
Choice A is wrong because: Having hearing screened every 5 years is recommended for adults over the age of 50.
Choice B is wrong because: Having a fasting blood glucose level checked every 6 years is not correct. It is recommended every 3 years for adults aged 45 years and older.
Choice C is wrong because: Testing stool for blood is recommended for colorectal cancer starting at age 50.
Choice D is wrong because: Having a complete eye examination every 2 years until the age of 64 is recommended.
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