An adult male client informs the nurse that he came to the clinic to see if, "Maybe I have lung cancer or something," and wants to get checked out since, "I can't seem to get rid of this body-wracking dry cough that has been hanging around for the last six weeks." Which computer documentation of this client's concerns should the nurse enter?

An adult male presents with fears that he has "lung cancer."

Describes having a body-wracking dry cough" of 6 weeks duration.

Expresses concern of "lung cancer" symptoms for last 6 weeks.

Presents with a hacking non-productive cough of 6 weeks duration.

Answer and Explanation

The Correct Answer is B

Choice A Reason:
An adult male presents with fears that he has "lung cancer." Is appropriate. This choice accurately captures the client's expressed fear of having lung cancer. However, it lacks specificity regarding the duration of symptoms (six weeks) and the nature of the symptom (dry cough). Therefore, while it acknowledges the client's concern, it does not provide comprehensive documentation of the client's reported symptoms.
Choice B Reason:
This option accurately captures the client's primary concern, which is the persistent dry cough lasting for six weeks. It avoids assuming a diagnosis (such as lung cancer) and instead focuses on the client's reported symptom. This type of documentation allows for an objective record of the client's statement while avoiding speculation about specific diagnoses. It also provides important information that can guide further assessment and diagnostic evaluation by healthcare providers.
Choice C Reason:
This option documents the client's expressed concern about having symptoms consistent with lung cancer for the past six weeks. While it accurately reflects the client's fear, it may lead to premature assumptions about the diagnosis before a thorough assessment and diagnostic workup are conducted. It's important for documentation to focus on the client's reported symptoms rather than presumptive diagnoses to maintain objectivity and guide appropriate evaluation and management..
Choice D Reason:
Presents with a hacking non-productive cough of 6 weeks duration. This choice accurately describes the client's reported symptom of a "hacking non-productive cough" and includes the duration of the symptom (six weeks). However, it does not explicitly mention the client's expressed fear of having lung cancer, which is an important aspect of the client's presentation that should be documented. Additionally, the term "hacking" may not fully capture the severity or character of the client's reported cough, as the client described it as "body-wracking." Therefore, while it provides some relevant information, it does not fully capture the client's concerns and presentation.

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Correct Answer is B

Explanation

Choice A Reason:
Coronary heart disease is incorrect. Coronary heart disease is primarily associated with cardiovascular symptoms such as chest pain, shortness of breath, and fatigue. While some nail changes may occur in individuals with coronary heart disease due to decreased oxygenation, brittle, concave nails are not a typical manifestation of this condition. Therefore, this option is less likely to explain the appearance of the nails.
Choice B Reason:
Iron deficiency anemia is correct. Iron deficiency anemia is characterized by a lack of iron in the body, leading to decreased production of hemoglobin and red blood cells. One of the classic nail findings associated with iron deficiency anemia is koilonychia, which presents as brittle, concave nails with a spoon-like appearance. This is due to structural changes in the nails caused by the deficiency of iron. Therefore, this option is the most likely explanation for the observed nail changes.
Choice C Reason:
Diabetes mellitus is incorrect. Diabetes mellitus can lead to various dermatologic manifestations, including nail changes such as thickening, discoloration, and slow nail growth. However, brittle, concave nails with a spoon-like appearance are not typically associated with diabetes mellitus. Therefore, while diabetes mellitus may affect the nails, it is less likely to explain the specific appearance observed in this case.
Choice D Reason:
Recent candida infection is incorrect. Candida infections, particularly in the nail folds (paronychia), can lead to changes in the nails such as discoloration, thickening, or separation from the nail bed. However, brittle, concave nails with a spoon-like appearance are not typical findings of candida infections. Therefore, while recent candida infection may affect the nails, it is less likely to explain the specific appearance observed in this case.

A. Jugular venous distension. B. Peripheral edema. C. Dyspnea. D. Intercostal retractions. E. Headaches.

Correct Answer is ["A","B","C"]

Explanation

Choice A Reason:
Jugular venous distension is correct. Jugular venous distension is a common sign of fluid overload and increased central venous pressure, which occur during exacerbations of heart failure. It indicates impaired cardiac function and elevated systemic venous pressure.
Choice B Reason:
Peripheral edema is correct. Peripheral edema, particularly in the lower extremities, is a classic manifestation of fluid retention and congestion in heart failure exacerbations. It results from increased capillary hydrostatic pressure and impaired fluid reabsorption by the kidneys.
Choice C Reason:
Dyspnea is correct. Dyspnea, or shortness of breath, is a hallmark symptom of heart failure exacerbations. It occurs due to pulmonary congestion resulting from fluid accumulation in the lungs, impairing gas exchange and leading to difficulty breathing.
Choice D Reason:
Intercostal retraction is not typically associated with exacerbations of heart failure. Intercostal retractions indicate increased work of breathing and respiratory distress, which may occur in conditions such as severe respiratory infections or asthma exacerbations, but are not specific to heart failure exacerbations.
Choice E Reason:
Headaches are not typically associated with exacerbations of heart failure. Headaches can have various causes, including tension, migraines, or sinus congestion, but they are not commonly observed as a direct manifestation of heart failure exacerbations.

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Naxlex Comprehensive Predictor Exams

The nurse observes the presence of brittle, concave curves to the nails of a client on assessment. Which information should the nurse obtain from the client that may explain the appearance of the nails?

Correct Answer is B

Explanation

An older adult client with a history of heart failure (HF) is brought to the clinic by a family member. Which finding(s) confirm to the nurse that the client is experiencing an exacerbation of the HF? Select all that apply.

Correct Answer is ["A","B","C"]

Explanation

In assessing a client's level of consciousness, what should the nurse assess first?

When inspecting the client's skin, the nurse observes several areas of ecchymosis on the trunk and extremities. Which information in the client's history requires additional follow-up by the nurse?

An adult client exhibits an allergic reaction to an Insect bite. The nurse should observe the client's skin for which finding?

Patient Data Exhibits During the assessment, the nurse notes that the areas are filled with a fluid-like substance. Which of the following primary skin lesions contain fluid? Select all that apply.

The client is a 35-year-old male with no history of any medical conditions is in the clinic for an annual physical. Exhibits Nurse analyzes the findings. What can the nurse do to mitigate artifacts when performing auscultation? Select all that apply.

The nurse is assessing a client with gallstones for jaundice. Which action should the nurse perform to confirm this information?

The nurse notes an enlarged, visible lymph node on the client's neck. Which action should the nurse take next?

The nurse is obtaining a health history for a client prior to a scheduled cholecystectomy. While interviewing the client, which assessment technique should the nurse use when asking about the client's use of illegal drugs and alcohol?