Patient Data

Exhibits

Nurse analyzes the findings.

Which can the nurse do to mitigate artifacts when performing auscultation? Select all that apply.

Document the roaring and crackles

Wet the chest hair before auscultating

Keep the examination room warm, and warm the stethoscope

Reach under a gown to listen and take care that no clothing rubs on the stethoscope

Ensure the room is as quiet as possible

Answer and Explanation

Correct Answer : B,C,D,E

A.   Documenting the roaring and crackles is important to note any abnormal findings. However, this does not directly mitigate artifacts, which may interfere with the accuracy of the sounds heard through auscultation.
B.   Wetting the chest hair is a useful technique to reduce the sound interference caused by chest hair rubbing against the stethoscope. This helps eliminate some of the unwanted sounds and improves the clarity of auscultation.
C.   Ensuring the room is warm and the stethoscope is warmed before use is important because cold stethoscopes can cause discomfort to the client and may lead to muscle tensing, making it harder to hear clear heart and lung sounds.
D.   Reaching under the gown ensures that no clothing creates friction on the stethoscope, which can produce unwanted sounds during auscultation. This helps in obtaining clear and accurate heart or lung sounds.
E.   A quiet environment is crucial for auscultation, as background noise can obscure important sounds. Ensuring that the room is free from distractions and noise will significantly improve the quality of auscultation.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is A

Explanation

A. Skin tenting is a sign of dehydration. It occurs when the skin, after being pinched, does not quickly return to its normal position. This is often seen in areas with loose skin such as the subclavicular region.
B. Loss of skin elasticity is a normal aging process and not specifically indicative of dehydration. It can be seen in older adults regardless of hydration status.
C. Warm and dry skin can be a sign of dehydration. Dehydration leads to reduced sweating, which can result in dry skin, and it may also increase the body temperature, making the skin feel warm.
D. Thinning hair, especially in the lower extremities, is typically associated with circulatory issues or aging. It is not a direct sign of dehydration.

A. "Count backwards by 7, starting with 100." B. "What does, "The early bird catches the worm," mean?" C. "Has anyone come to visit you today?" D. "In what year were you born?"

Correct Answer is B

Explanation

A. This tests the client’s ability to perform mathematical tasks but does not specifically assess abstract
thinking. It is more of a concrete cognitive task.

B. This question assesses abstract thinking because it requires the client to interpret a proverb, which involves understanding symbolic meaning beyond the literal words.
C. This question is assessing more of the client’s orientation and memory rather than abstract thinking. It does not test higher-level cognitive abilities.
D. This is an orientation question, assessing the client’s ability to recall personal facts, but it does not
assess abstract reasoning skills.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Patient Data Exhibits Nurse analyzes the findings. Which can the nurse do to mitigate artifacts when performing auscultation? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When assessing an older adult client, which finding is most indicative of dehydration?

Correct Answer is A

Explanation

The nurse plans to assess a client's ability to think abstractly. Which question or statement is likely to provide the best information about the client's abstract thinking?

Correct Answer is B

Explanation

While auscultating for bowel sounds in an adult client, the nurse notes a series of gurgles that last about 3 seconds and occur every 5 to 10 seconds in all quadrants. How should the nurse document this finding?

When assessing an older adult client, which finding is most indicative of dehydration?

A nurse performs a Tinetti assessment on an older adult client and calculates a balance score of 12 and a gait score of 8. Which do these results indicate?

While conducting a physical assessment, the nurse shines a pen light into a client's right eye and moves the light source to check the client's left eye. Which finding indicates the need for further evaluation?

A client states, "I am legally blind." Which assessment technique should the nurse use to obtain subjective data to support the client's statement?

When assessing the left foot planter reflex of an adult client, the nurse observes an extension of the great toe and fanning of other toes. Which interpretation of this finding is accurate?

In assessing an adult client, the nurse calculates the body mass index (BMI) as 14 kg/m2. Which nursing problem should be included in this client's plan of care? Reference Range: Body mass index (BMI) [normal 18.0 to 24.9 kg/m2]

When the nurse is obtaining health history during an annual physical examination, the client reports having difficulty with erections for the past 8 months. Which information in the client's history should the nurse consider as a potential reason for erectile dysfunction?

Patient Data

Exhibits

Nurse analyzes the findings.

Which can the nurse do to mitigate artifacts when performing auscultation? Select all that apply.