A nurse is collecting data from a client who has iron deficiency anemia. Which of the following locations should the nurse monitor for the clinical manifestation of cheilosis? (You will find hot spots to select in the art work below. Select only the hotspot that corresponds to your answer.)
A
B
C
The Correct Answer is B
Choice A: The lower eyelids
The lower eyelids are not typically associated with cheilosis. Cheilosis, also known as angular cheilitis, is an inflammatory condition that affects the corners of the mouth, not the eyelids.
Choice B: The corners of the mouth
Cheilosis, also known as angular cheilitis, is an inflammatory condition that affects the corners of the mouth. It typically presents as erythema, scaling, fissuring, and ulceration. In patients with iron deficiency anemia, angular cheilitis can be a clinical manifestation. Therefore, a nurse should monitor the corners of the mouth in a client who has iron deficiency anemia for the clinical manifestation of cheilosis.
Choice C: The anterior nares
The anterior nares (nostrils) are not typically associated with cheilosis. Cheilosis, also known as angular cheilitis, is an inflammatory condition that affects the corners of the mouth, not the nostrils.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: A stoma retracting into the abdominal wall may indicate ischemia or other complications that could compromise the stoma's viability and function.
Choice B reason: Scant red blood in the stool may be expected shortly after surgery, but persistent bleeding should be monitored and reported if it continues.
Choice C reason: Stool being a dark green color is normal shortly after ileostomy placement as the bowel adjusts.
Choice D reason: A cherry red stoma color is healthy and indicates good blood supply.
Correct Answer is B
Explanation
Choice A reason: Peripheral edema is not typically a sign of anaphylaxis; it is more commonly associated with other conditions such as heart failure or venous insufficiency.
Choice B reason: Pruritus, or itching, is a common symptom of an allergic reaction and can be an early sign of anaphylaxis.
Choice C reason: Pallor may occur during anaphylaxis, but it is not as specific a symptom as pruritus.
Choice D reason: Hypertension is not a symptom of anaphylaxis; in fact, hypotension is more commonly associated with this condition.
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