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A nurse in an emergency department (ED) is admitting a client.

Exhibits

Select 3 objective findings in the client's medical record that may be indicative of pneumonia.

decreased urine output

headache

respiratory assessment

Chest X-ray

Religion

Bowel sounds

perception of needles

Answer and Explanation

Correct Answer : A,C,D

A. Decreased urine output: While not a direct sign of pneumonia, decreased urine output can be an objective finding indicative of dehydration, which often accompanies infections like pneumonia.

B. Headache: Although the client has a headache, it is a subjective symptom rather than an objective finding and is not a primary indicator of pneumonia.

C. Respiratory assessment: The respiratory assessment reveals shortness of breath, crackles in the right lower lobe, and tachypnea, which are commonly associated with pneumonia.

D. Chest X-ray: The chest X-ray shows areas of increased density and infiltrates in the right lower lobe, a hallmark finding that indicates pneumonia.

E. Religion: This does not relate to the clinical findings associated with pneumonia.

F. Bowel sounds: Normal bowel sounds are not indicative of pneumonia.

G. Perception of needles: This is irrelevant to the diagnosis of pneumonia.

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Correct Answer is C

Explanation

A. Response to verbal stimuli does not directly assess the function of cranial nerves III, IV, and VI.

B. Affect, feelings, or emotions are related to the assessment of other neurological functions and do not evaluate the ocular cranial nerves specifically.

C. Eye movements are the primary function of cranial nerves III (oculomotor), IV (trochlear), and VI (abducens), which control eye movement and provide essential information about their function.

D. Insight, judgment, and planning relate more to cognitive function and do not directly assess the function of the cranial nerves in question.

A. Conjunctivitis B. Cataract C. Glaucoma D. Macular degeneration

Correct Answer is F

Explanation

A. This is the correct answer as conjunctivitis, commonly known as pink eye, is characterized by redness, swelling, and discharge from the eye, which is likely what the image shows.

B. Cataracts typically present as clouding of the lens of the eye, leading to blurred vision but do not present with redness or discharge like conjunctivitis.

C. This condition often involves increased intraocular pressure and can lead to vision loss, but it does not usually cause the symptoms depicted in the image of conjunctivitis.

D. This is primarily associated with central vision loss and does not produce the external symptoms of redness or discharge typical of conjunctivitis.

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A nurse in an emergency department (ED) is admitting a client. Exhibits Select 3 objective findings in the client's medical record that may be indicative of pneumonia.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is performing a neurological assessment on a client and is assessing the function of cranial nerves III, IV, and VI. Assessment of which aspect of function will yield the best information about these cranial nerves?

Correct Answer is C

Explanation

Which abnormality is depicted in the image below?

Correct Answer is F

Explanation

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A nurse is assessing a client's cranial nerves as part of a neurological examination. Which action should the nurse take to assess cranial nerve III?

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A nurse in an emergency department (ED) is admitting a client.

Exhibits

Select 3 objective findings in the client's medical record that may be indicative of pneumonia.