The nurse is performing an initial assessment on a patient with respiratory difficulty. The nurse would anticipate documenting signs and symptoms such as:
excessive dryness.
regular respiratory pattern.
use of accessory muscles.
alteration in sensation.
The Correct Answer is C
A. Excessive dryness: This is not a primary sign of respiratory difficulty.
B. Regular respiratory pattern: A regular pattern is indicative of normal respiration, not difficulty.
C. Use of accessory muscles: Accessory muscle use is a hallmark sign of respiratory distress, indicating increased effort to breathe.
D. Alteration in sensation: This is more associated with neurological conditions rather than respiratory issues.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Making an entry in the primary care provider progress notes: This is not the appropriate place to document returned belongings.
B. Asking the unit secretary to place a note in the chart: Documentation must be done by the nurse responsible for returning the items.
C. Having the patient sign for them as per policy. Documenting with the patient’s signature provides a clear record that the items were returned and received by the patient, as per hospital policy.
D. Writing a note to the charge nurse: This does not create an official record of the return.
Correct Answer is ["A","C","D"]
Explanation
A. Cardiac pacemakers: MRIs use strong magnets that can interfere with pacemaker function.
B. Allergy to iodine: Iodine is used in contrast for CT scans, not MRI, so this is not a contraindication.
C. Automatic implantable cardiac defibrillators: Similar to pacemakers, these devices can malfunction or pose risks during MRI.
D. Metal hip prosthesis: Metal can become heated or shifted due to the magnetic field, posing a risk to the patient.
E. Bleeding tendencies: While bleeding tendencies are a concern for invasive procedures, they are not a contraindication for MRI.
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