An older adult client comes to the healthcare provider's office for a routine follow up exam for high blood pressure, osteoarthritis, constipation, and chronic sinusitis. The client recently had a cataract removed from the left eye. Which is most important for the nurse to address when obtaining this client's health history?

Conduct an assessment of functional capacity and environmental hazards.

Distinguish between symptoms caused by disease and those due to aging.

Obtain a medication history including prescription and non-prescription drugs.

Emphasize the need to place advance directives in the medical record.

Answer and Explanation

The Correct Answer is C

A. Functional capacity: While important for older adults, it's not the most pressing concern during this routine follow-up exam.

B. Distinguishing symptoms: This is an ongoing process, but not the most critical element for this visit.

C. Obtain a medication history including prescription and non-prescription drugs. Cataract surgery often involves medication changes or new medications to prevent infection or manage other post-operative needs. An updated medication history helps identify potential interactions or side effects.

D. Advance directives: While important for all adults, it might not be the most urgent topic for this specific follow-up exam focused on managing existing conditions and potential post-surgical medications.

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Correct Answer is A

Explanation

A. Fetal growth and gestational age. Ultrasound during pregnancy is commonly used to assess fetal growth, development, and gestational age. It allows healthcare providers to monitor the health and progress of the pregnancy, as well as detect any potential issues or abnormalities.

B. Lecithin-sphingomyelin ratio. This ratio is typically assessed in amniotic fluid samples to predict fetal lung maturity, but it's not the primary reason for a routine ultrasound during pregnancy.

C. Chromosomal abnormalities. While some prenatal screening tests, such as nuchal translucency ultrasound or cell-free DNA testing, can help assess the risk of chromosomal abnormalities, a routine ultrasound is not primarily conducted for this purpose.

D. Sex and size of the infant. While ultrasound can reveal the sex of the baby and provide estimates of fetal size, these are secondary to the primary goal of assessing fetal growth and gestational age.

A. Document the client's asymmetrical thoracic movement during inspiration. B. Assist the client to a position that helps the client breathe more easily. C. Provide the client an incentive spirometer to increase respiratory effort. D. Encourage the client to continue to breathe deeply to expand the lungs.

Correct Answer is B

Explanation

A. Documenting asymmetrical thoracic movement: While this might be a finding, it's not the most urgent action.

B. Assist the client to a position that helps the client breathe more easily. Sternocleidomastoid, trapezius, and abdominal muscle use: These muscles are accessory muscles that help with breathing when the diaphragm and intercostal muscles (primary muscles of respiration) are not functioning optimally. This use suggests laboured breathing. Priority action: The client's respiratory distress is the most pressing concern.

C. Incentive spirometer: This device helps improve lung expansion but is not the first-line intervention in this situation where the client is already struggling to breathe.

D. Encouraging deep breaths: This might further strain the respiratory muscles.

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Naxlex Comprehensive Predictor Exams

Gestational Ultrasound. In preparing the client for the procedure, the nurse should explain that the primary reason for conducting the ultrasound is to obtain which information?

Correct Answer is A

Explanation

While counting the respirations of an adult client who is bedfast, the nurse observes that the client uses the sternocleidomastoid, trapezius, and abdominal muscles during respirations. Which action should the nurse take in response to this finding?

Correct Answer is B

Explanation

In assessing a male client's level of consciousness, the nurse determines that the client does not open his eyes spontaneously. Which should the nurse do next?

While assisting a client to ambulate who has left hemiplegia due to a stroke, the nurse notices that the client is having difficulty walking in a straight line. Based on this assessment finding, it is most important to include which intervention in this client's plan of care?

In assessing tactile fremitus in the client with suspected pneumonia, the nurse should perform which action?

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The nurse is assessing the lung sounds of a preschooler. Which action should the nurse implement to ensure the child's cooperation?

While-interviewing an elderly client, the nurse observes that the client's hands tremble uncontrollably while reaching for a glass of water. How should the nurse document this finding?