The nurse assesses brisk reflexes in a client. The nurse would document this finding as which of the following?
4+
2+
1+
3+
The Correct Answer is D
A. 4+: This indicates very brisk reflexes with possible clonus, which is more than just brisk reflexes.
B. 2+: This indicates normal reflexes, not brisk.
C. 1+: This indicates diminished or hypoactive reflexes, not brisk.
D. 3+: This indicates brisk reflexes, which are faster than normal but without evidence of clonus.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D"]
Explanation
Rationale:
A. Blood pressure pattern: Monitoring blood pressure patterns is essential for evaluating cardiovascular health as it provides information on hypertension or hypotension, which are significant for heart function.
B. Dyspnea: Dyspnea (difficulty breathing) can indicate cardiovascular issues such as heart failure, making it a relevant aspect of cardiovascular assessment.
C. Vision Acuity: While vision acuity is important for overall health, it is not directly related to cardiovascular assessment and does not provide specific information about heart or vascular health.
D. Peripheral Edema: Peripheral edema (swelling in the extremities) can be a sign of cardiovascular problems like heart failure or venous insufficiency, thus important for cardiovascular assessment.
E. Constipation: Although constipation affects general health, it does not directly relate to cardiovascular assessment and is not typically included in this context.
Correct Answer is C
Explanation
A. Ectropion: This condition involves the eyelid turning outward, not drooping.
B. Presbyopia: This is age-related loss of near vision, not related to eyelid position.
C. Ptosis: Ptosis refers to drooping of the upper eyelid, which is the correct term for the described finding.
D. Entropion: This condition involves the eyelid turning inward, not drooping.
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