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The nurse is performing an initial assessment of a client who has an expressionless facial affect, slurred speech, and red conjunctivae. Which question should the nurse ask first? "Have you..."

been sleeping well?"

been depressed lately?"

had anything to eat in the last 24 hours?"

ever had problems with your blood sugar?"

None

Answer and Explanation

The Correct Answer is A

Answer: A. "Have you been sleeping well?"

Rationale:

A) "Have you been sleeping well?": Sleep deprivation can lead to symptoms such as an expressionless facial affect, slurred speech, and red conjunctivae. Assessing for sleep patterns is a priority to rule out this common and reversible cause of the client's symptoms. Sleep deprivation can also exacerbate other underlying conditions.

B) "Have you been depressed lately?": While depression could explain the expressionless affect, it does not typically cause slurred speech or red conjunctivae. Depression can be assessed later if other immediate causes are ruled out.

C) "Have you had anything to eat in the last 24 hours?": Poor nutritional intake could contribute to fatigue or weakness but is less likely to cause all the observed symptoms (expressionless affect, slurred speech, and red conjunctivae). This question is important but not the first priority.

D) "Have you ever had problems with your blood sugar?": Blood sugar imbalances, particularly hypoglycemia or hyperglycemia, can cause neurological changes. However, the symptoms described are less specific to blood sugar issues and more indicative of sleep or neurological concerns, making this question less immediately relevant.

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Correct Answer is B

Explanation

The symptoms described, including gnawing epigastric pain that worsens when hungry and improves after eating, are classic manifestations of peptic ulcer disease (PUD). Peptic ulcers are erosions in the mucosal lining of the stomach or duodenum, often caused by Helicobacter pylori infection or nonsteroidal anti-inflammatory drugs (NSAIDs). The pain typically occurs when the stomach is empty and is relieved by food intake due to the buffering effect of food on gastric acid. This pattern of pain is known as "hunger pain" or "meal-related pain" and is characteristic of PUD.

A. Esophagitis:
Esophagitis refers to inflammation of the esophagus, often due to reflux of gastric contents into the esophagus. Symptoms may include heartburn, difficulty swallowing, and chest pain, but the pain is typically not related to hunger and food intake as described in the scenario.

C. Gastroesophageal reflux (GERD):
GERD involves the reflux of gastric contents into the esophagus, leading to symptoms such as heartburn, regurgitation, and chest pain. While GERD can cause epigastric discomfort, the described pattern of pain worsening with hunger and improving after eating is more indicative of PUD.

D. Chronic pancreatitis:
Chronic pancreatitis is characterized by inflammation and irreversible damage to the pancreas, leading to persistent abdominal pain, often radiating to the back. While epigastric pain is a feature of chronic pancreatitis, the relief of pain after eating is not typically seen, making it less likely in this scenario.

A. Obese, serious threat to well-being. B. Appropriate weight for height, good general health. C. Extreme obesity, at risk for multiple co-morbidities. D. Undernutrition, at risk for malnutrition.

Correct Answer is A

Explanation

A) Obese, serious threat to well-being: A BMI of 32 kg/m² places the client in the category of obesity (BMI ≥ 30 kg/m²). Obesity is a significant health concern associated with increased risks for various conditions such as cardiovascular disease, diabetes, hypertension, and certain cancers. The client's BMI indicates that she is obese, which poses a serious threat to her overall well-being and health.

B) Appropriate weight for height, good general health: This is incorrect because a BMI of 32 kg/m² does not fall within the normal range of 18.5 to 24.9 kg/m². The client is not at an appropriate weight for her height and is not considered to be in good general health based on this BMI.

C) Extreme obesity, at risk for multiple co-morbidities: While a BMI of 32 kg/m² does indicate obesity, it does not reach the threshold for extreme obesity (BMI ≥ 40 kg/m²). Therefore, the client is not categorized as extremely obese, although she is still at risk for several co-morbidities associated with obesity.

D) Undernutrition, at risk for malnutrition: This is incorrect because a BMI of 32 kg/m² is indicative of excess weight, not undernutrition or malnutrition. The client's BMI suggests an over-nutrition status rather than undernutrition.

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The nurse is performing an initial assessment of a client who has an expressionless facial affect, slurred speech, and red conjunctivae. Which question should the nurse ask first? "Have you..."

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An adult client presents with gnawing epigastric pain. The pain is worse when the client is hungry and abates after eating something. Which problem do these symptoms suggest?

Correct Answer is B

Explanation

The nurse is assessing a young adult female who is 5 feet 5 inches (165 cm) and has a body mass index (BMI) score of 32 kg/m2. Based on this BMI, what should the nurse deduce about this client's general health? Reference Range: Body Mass Index (BMI) [Normal 18.5 to 24.9 kg/m2]

Correct Answer is A

Explanation

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