The nurse reads in the patient chart the doctor's day round note. The doctor writes AOX3, the nurse knows this means the patient is oriented to: Select all that apply.

Background

Person

Situation

Place

Time

Answer and Explanation

Correct Answer : B,D,E

A) Background: Orientation to "background" is not a standard component of the "AOX3" (alert and oriented times three) assessment. Typically, orientation assessments focus on more specific elements such as person, place, and time, rather than background information.
B) Person: Orientation to "person" means that the patient is aware of who they are. This is a key aspect of the AOX3 assessment, which checks whether the patient can identify themselves correctly.
C) Situation: While awareness of the situation or current circumstances is important, "situation" is not included in the standard AOX3 assessment. The usual components are person, place, and time.
D) Place: Orientation to "place" means the patient knows where they are. This is a critical component of the AOX3 assessment, indicating that the patient can identify their current location.
E) Time: Orientation to "time" means that the patient is aware of the current date, day of the week, and time of day. This is another essential part of the AOX3 assessment, reflecting the patient's awareness of the temporal context.

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Correct Answer is ["B","C","D"]

Explanation

A) Sigmoid colon: The sigmoid colon is located in the Left Lower Quadrant (LLQ) of the abdomen. Therefore, a bulging area in the Right Lower Quadrant (RLQ) would not be associated with the sigmoid colon.
B) Appendix: The appendix is located in the Right Lower Quadrant and is a common site for abdominal masses, especially in cases of appendicitis. A bulging area in the RLQ could very well be related to issues with the appendix.
C) Right Fallopian Tube: The right fallopian tube is located in the RLQ of the abdomen. Conditions affecting the fallopian tube, such as an ectopic pregnancy or tubo-ovarian abscess, could cause a bulging area in this quadrant.
D) Ascending Colon: The ascending colon is also situated in the RLQ. A mass or bulge in this area could be related to conditions affecting the ascending colon, such as colonic obstruction or tumors.
E) Right kidney: The right kidney is located in the upper abdominal area and is more likely to cause tenderness or discomfort in the upper quadrants rather than a bulging mass in the RLQ.
F) Right side of the prostate: The prostate gland is located in the pelvic area, specifically in the male pelvis, and would not typically be associated with a bulging mass in the RLQ of a female patient.

A. Asymmetrical shape B. Diameter less than 6mm C. Color is uniform D. Borders well demarcated

Correct Answer is A

Explanation

A) Asymmetrical shape: One of the key "ABCD" characteristics of malignant melanoma is asymmetry. Melanomas often have an irregular shape where one half does not match the other, unlike benign moles, which are typically symmetrical. This characteristic helps in distinguishing malignant lesions from benign ones.
B) Diameter less than 6mm: Malignant melanomas are often larger than 6 mm in diameter, especially as they progress. While smaller lesions can still be malignant, a diameter less than 6 mm is not a distinguishing feature for melanoma. Typically, melanomas are identified as growing larger over time.
C) Color is uniform: Malignant melanomas usually exhibit multiple colors or uneven pigmentation rather than uniform color. Uniform color is more characteristic of benign moles. Melanomas can show a mix of colors, including shades of brown, black, and sometimes red or white.
D) Borders well demarcated: Malignant melanoma often has irregular, not well-defined borders. The edges of a melanoma are usually uneven or not clearly defined, unlike benign moles, which typically have smooth, well-demarcated borders.

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The nurse reads in the patient chart the doctor's day round note. The doctor writes AOX3, the nurse knows this means the patient is oriented to: Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During an abdominal examination, the nurse palpates a bulging area in the Right Lower Quadrant of a female patient. The nurse suspects that this mass could be associated with which of the following organs? (Select all that apply.)

Correct Answer is ["B","C","D"]

Explanation

A client asks a nurse to look at a raised lesion on the skin that has been present for about 5 years. Which is an "ABCD" characteristic of malignant melanoma?

Correct Answer is A

Explanation

A nurse is preparing to administer insulin to a client who has type 1 diabetes mellitus. Which of the following types of prevention is the nurse demonstrating?

A nurse is admitting a client with suspected appendicitis. Identify where the nurse will palpate to assess for pain at McBurney's point. (Selectable areas, or "Hot Spots," are outlined in the artwork below. Select only the outlined area that corresponds to your answer.)

A patient is diagnosed with a Pneumothorax on the right lung. During the assessment, when percussing this area the nurse expects to find the percussion note as:

A patient is diagnosed with Receptive Aphasia. The nurse understands this patient can:

While at a woman's health clinic a healthy 56-year-old female client tells the nurse that she thinks she is starting the menopausal phase of her life. The nurse should instruct the client that she may experience

During an assessment of the cranial nerves, a client reports spontaneously losing balance. The nurse should focus additional assessment on which cranial nerve?

Which of the following would the nurse expect to be done to assess the size of the prostate?