The school nurse is interviewing a 13-year-old girl who wants to go home from school because of "back pain." Which question should the nurse ask the adolescent first?

"What were you doing when you first noticed the problem?"

"Have you taken any medications to relieve the pain?"

"Does changing your position make the pain worse?"

"Do you remember ever having this type of pain in the past?"

Answer and Explanation

The Correct Answer is A

A.   Understanding the onset and activities related to the back pain can help the nurse determine if it is musculoskeletal, posture-related, or indicative of a more serious underlying issue.
B.   Asking about medication is secondary until more information is gathered about the pain's onset and nature.
C.   Changing positions may be relevant later, but initially, it is important to identify any possible triggers for the pain.
D.   Asking about previous pain episodes may be helpful, but understanding the current episode’s cause is more pressing.

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Correct Answer is D

Explanation

A. Absent deep tendon reflexes are not typically associated with nailbed clubbing. While reflexes may be diminished in some conditions, they are not commonly related to the pathophysiology behind clubbing.
B. A capillary refill time of less than 3 seconds is a normal finding and does not align with clubbing, which often indicates chronic hypoxia or systemic conditions such as heart or lung disease.
C. Peripheral dependent edema refers to swelling in the lower extremities, which can be associated with circulatory problems, but it is not directly linked to nailbed clubbing. Edema is more common in conditions like heart failure or kidney disease.
D. A low oxygen saturation of 85% is consistent with conditions that cause chronic hypoxia, such as chronic lung disease or congenital heart disease. Chronic low oxygen levels can lead to nailbed clubbing as a compensatory response to inadequate oxygenation.

A. "It doesn't take much activity before I'm out of breath." B. "I sleep on three pillows at night." C. "I cough a lot at night and it keeps me up half the night." D. "I have multiple attacks of wheezing almost daily."

Correct Answer is B

Explanation

A. This statement could indicate exercise intolerance or shortness of breath with exertion, but it doesn't specifically relate to orthopnea. Orthopnea refers to difficulty breathing when lying flat, not with activity.
B. This statement is indicative of orthopnea. People with orthopnea often need to sleep with multiple pillows or sit up to relieve the shortness of breath they experience when lying flat, often due to heart failure or other respiratory conditions.
C. Nighttime coughing can be a symptom of various conditions, such as asthma or postnasal drip, but it is not specific to orthopnea. Orthopnea is more about difficulty breathing while lying down.
D. Wheezing is a sign of asthma or other respiratory conditions but does not directly correlate with orthopnea. Orthopnea is specifically about the inability to breathe comfortably when lying down, not about wheezing.

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The school nurse is interviewing a 13-year-old girl who wants to go home from school because of "back pain." Which question should the nurse ask the adolescent first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse assesses that a client has nailbed clubbing. Which additional information is consistent with this finding?

Correct Answer is D

Explanation

Which subjective assessment data supports the nurse's conclusion that a client is experiencing orthopnea?

Correct Answer is B

Explanation

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The nurse plans to assess a client's ability to think abstractly. Which question or statement is likely to provide the best information about the client's abstract thinking?

The school nurse is interviewing a 13-year-old girl who wants to go home from school because of "back pain." Which question should the nurse ask the adolescent first?

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