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?

Obtain a drug urine screen to verify legitimacy of client's stated history.

Use the term illegal or illicit to describe street drugs.

Allow the client to decline answering social questions.

Ask specifically about alcohol, marijuana, cocaine, heroin, and amounts.

Answer and Explanation

The Correct Answer is D

A. Obtain a drug urine screen to verify the legitimacy of the client's stated history. This may be necessary but is not the initial approach for obtaining a health history.

B. Use the term illegal or illicit to describe street drugs. Using stigmatizing terms may make the client uncomfortable and less likely to disclose information.

C. Allow the client to decline answering social questions. The nurse should encourage open communication, but also respect the client's right to privacy.

D. Ask specifically about alcohol, marijuana, cocaine, heroin, and amounts. This is the correct approach. Specific questions about substances and quantities help obtain accurate information.

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Correct Answer is D

Explanation

A. Have the client lay flat while listening to the anterior surface of the chest. This position may not allow optimal lung expansion and can cause discomfort, especially in clients with respiratory issues. It is generally better to assess lung sounds with the client in an upright position.

B. Shave all chest hair that may distort sounds heard through the diaphragm. While chest hair can sometimes interfere with sound transmission, shaving is not a practical or necessary step. Pressing the stethoscope firmly can usually mitigate this issue.

C. Use the bell of the stethoscope to listen to the lung fields over lower lobes. The bell is more sensitive to low-pitched sounds, like heart murmurs, and not ideal for lung auscultation. The diaphragm is preferred for assessing lung sounds.

D. Press the stethoscope's diaphragm firmly on the skin over each lung field. This is the best choice because the diaphragm of the stethoscope is more effective at transmitting high-frequency sounds, which are common in lung auscultation. Pressing firmly ensures better contact and clearer sounds.

A. Increased pigmentation and coarse skin. B. Flap of tissue at sphincter. C. Hypotonic tone of the anal sphincter. D. Dimpled area above anus.

Correct Answer is A

Explanation

A. Increased pigmentation and coarse skin. This is a typical finding in the perianal area, reflecting normal anatomical variation.

B. Flap of tissue at sphincter.This may indicate the presence of a skin tag or hemorrhoid, which is not considered a normal finding.

C. Hypotonic tone of the anal sphincter. This suggests decreased muscle tone, which can be abnormal and may indicate underlying pathology.

D. Dimpled area above anus. A dimpled area could indicate a pilonidal sinus or other abnormality, which is not normal.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A male client arrives at the clinic for follow-up health assessment after recent antibiotic treatment for pneumonia without hospitalization. Which technique should the nurse implement to assess for adventitious lung sounds?

Correct Answer is D

Explanation

While completing an admission assessment for a client with gastrointestinal bleeding, the nurse inspects the perianal area and anus. Which findings indicate a normal appearance of the anus?

Correct Answer is A

Explanation

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?

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