The nurse is obtaining a history of the patient's present illness. The PQRST system is being used for the interview. In this system the R is:

region

recent

random

Result

Answer and Explanation

The Correct Answer is A

A. Region – In the PQRST pain assessment method, R stands for Region (location of pain). It helps determine where the patient feels discomfort and whether it radiates.

B. Recent – "Recent" does not correspond to any category in the PQRST system.

C. Random – "Random" is not a part of the PQRST framework.

D. Result – The PQRST method does not include "Result"; instead, it focuses on the characteristics of pain.

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Correct Answer is C

Explanation

A. Press the skin over the client's ankle bone. – The skin over bony prominences does not provide an accurate assessment of turgor due to reduced subcutaneous tissue in elderly clients.

B. Lightly palpate the skin using the fingertips. – Light palpation assesses texture and moisture but does not evaluate skin turgor.

C. Grasp a fold of skin on the client’s forearm or near the sternum. – Skin turgor is best assessed by gently pinching the skin on the forearm or sternum. Delayed return to normal indicates dehydration or decreased skin elasticity due to aging.

D. Observe for non-blanching, pinpoint-size, red or purple spots on the skin of the abdomen. – This describes petechiae, which indicate capillary fragility or bleeding disorders, not skin turgor.

A. tachycardia B. tachypnea C. Bradycardia D. Apnea

Correct Answer is C

Explanation

A. Tachycardia. – Tachycardia refers to a heart rate above 100 beats per minute, not a slow heart rate.

B. Tachypnea. – Tachypnea describes rapid breathing, not a slow heart rate.

C. Bradycardia. – Bradycardia is a heart rate below 60 beats per minute. It may be normal in athletes but can indicate conduction abnormalities or medication effects in other individuals.

D. Apnea. – Apnea is the absence of breathing, not a slow heart rate.

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The nurse is obtaining a history of the patient's present illness. The PQRST system is being used for the interview. In this system the R is:

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Naxlex Comprehensive Predictor Exams

The elderly patient is being assessed for skin turgor. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

An abnormally slow heart rate, below 60 beats per minute is called:

Correct Answer is C

Explanation

A nurse is collecting data from a patient who has dehydration. Which findings should the nurse expect?

Listening for bowel sounds is done over all four quadrants of the abdomen using the diaphragm of the stethoscope. The normal rate of bowel sounds per minute is:

Redness or inflammation of the skin or mucous membranes resulting from dilation and congestion of superficial capillaries is termed:

When performing a physical examination of the patient, the nurse uses a technique that is particularly useful in identifying areas of tenderness. This technique is:

The protective response of body tissues to irritation, injury or pathogens is:

The nurse is meeting a patient for the first time. The initial step in initiating a nurse-patient relationship is for the nurse to:

During the nursing interview, several histories are taken. The history that involves data concerning habits and lifestyle patterns is called:

When the patient asked the nurse how long it would take to "get over" the diabetes, the nurse explained that she will have this disease throughout her life. Diabetes mellitus is considered a/an: