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 the legitimacy of the client's stated history.

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

Use the term illegal or illicit to describe street drugs.

Allow the client to decline answering social questions.

Answer and Explanation

The Correct Answer is B

A. While a drug urine screen may be part of preoperative testing, it is not appropriate as the primary method for gathering a client's substance use history. Trust and accuracy in self-reporting should be encouraged.
B. Asking specifically about alcohol, marijuana, cocaine, heroin, and amounts helps the nurse gather detailed information on the client's substance use, which is critical for safe anesthesia and surgical planning. Using specific terms rather than general or stigmatizing language promotes open communication.
C. The terms "illegal" or "illicit" might carry stigma, potentially leading the client to withhold information. Using neutral, non-judgmental language is more effective.
D. While clients can decline to answer, the nurse should explain the importance of accurate health information for their safety and care. Encouraging open dialogue is better than allowing clients to skip important questions without understanding the implications.

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Correct Answer is A

Explanation

A. The epigastric region is located in the upper central part of the abdomen, just below the xiphoid process. Pain in this area is often associated with conditions affecting the stomach, such as gastritis or peptic ulcers.
B. The umbilical region is the central part of the abdomen around the navel and does not correspond to the area described by the client.
C. The hypochondriac regions are located on the upper sides of the abdomen, near the lower ribs, and are not relevant to the area described.
D. The hypogastric region is the lower central part of the abdomen, below the umbilicus, and is unrelated to the client's described pain.

A. Monitor urinary output B. Obtain an electrocardiogram C. Restrict activity to bed rest D. Initiate NPO status

Correct Answer is D

Explanation

A. Monitoring urinary output is important for assessing kidney function and hydration status, but it is not the immediate priority in this situation. The abrupt cessation of inhalation during palpation suggests acute abdominal pathology that requires immediate attention.
B. Obtaining an electrocardiogram (ECG) is necessary in cases of suspected cardiac issues, but the symptoms described are more indicative of an acute abdominal condition, such as peritonitis or cholecystitis, rather than a cardiac event.
C. Restricting activity to bed rest may help prevent further discomfort or complications, but it is not the most critical immediate action. The client’s acute symptoms suggest the need for more urgent interventions.
D. Initiating NPO (nothing by mouth) status is the most important action because the client may require surgical intervention or further diagnostic testing for an acute abdominal condition. NPO status is essential to prepare the client for potential surgery and to prevent further complications.

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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 client reports experiencing stomach pain, and it is localized in the middle section of the abdomen below the xiphoid process. The nurse should describe the pain as occurring in which region of the abdomen?

Correct Answer is A

Explanation

During an abdominal assessment, a client with a temperature of 103° F (39.4° C) experiences pain and abruptly stops inhaling during deep palpation. Which prescription is most important for the nurse to implement?

Correct Answer is D

Explanation

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