The nursing assessment finding that represents the most serious indication of a client's deteriorating oxygenation status is:
pursed-lip breathing.
clubbing of the nails.
cyanosis.
poor skin turgor.
The Correct Answer is C
Choice A rationale: Pursed-lip breathing is a compensatory mechanism to improve oxygenation and is not as severe an indication as cyanosis.
Choice B rationale: Clubbing of the nails is a chronic sign of oxygenation issues but may not be an acute and immediate indication of deterioration.
Choice C rationale: Cyanosis, the bluish discoloration of the skin and mucous membranes, is a serious indication of inadequate oxygenation.
Choice D rationale: Poor skin turgor is not a direct indicator of oxygenation status.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale: R/O (rule out) is not appropriate for documenting the client's current presentation.
Choice B rationale: S/P (status post) is not appropriate for describing the client's current respiratory distress.
Choice C rationale: SOB (shortness of breath) is the correct abbreviation to document the client's difficulty in breathing.
Choice D rationale: DOB (date of birth) is not relevant to the client's respiratory distress.
Correct Answer is A
Explanation
Choice A rationale: RLQ (Right Lower Quadrant) is the correct abbreviation for the location of the appendix, which is typically found in the right lower quadrant of the abdomen.
Choice B rationale: RUQ (Right Upper Quadrant) is not the location of the appendix.
Choice C rationale: LUQ (Left Upper Quadrant) is not the location of the appendix.
Choice D rationale: LLQ (Left Lower Quadrant) is not the location of the appendix.
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