The school nurse is interviewing an adolescent who wants to go home from school because of "back pain." Which question should the nurse ask first?

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

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

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

"Does changing your position make the pain worse?

Answer and Explanation

The Correct Answer is A

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

This question helps to identify any specific activities or events that may have triggered the onset of back pain. Understanding the circumstances surrounding the pain can provide valuable information about its potential cause.

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

While it's important to assess if the adolescent has taken any medications, such as over-the-counter pain relievers, to manage the pain, this question may not be the most immediate priority. It's essential to first gather information about the nature and onset of the pain to guide further assessment and management.

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

This question helps to determine if the adolescent has a history of similar back pain episodes. Past episodes of back pain can provide insight into potential underlying conditions or recurrent issues that may be contributing to the current complaint.

D. "Does changing your position make the pain worse?"

This question is crucial in assessing the characteristics of the pain and its response to movement or positional changes. It can help differentiate between musculoskeletal causes of back pain, which may worsen with movement, and other potential causes.

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Correct Answer is C

Explanation

A. Trapped subcutaneous air causing crepitus will be absorbed, so the finding is not significant. While trapped air can be absorbed, crepitus can indicate underlying issues such as a pneumothorax or other trauma, so it should not be dismissed as insignificant.

B. Since this client has only a small area of crepitus, it probably is not a significant finding. The size of the area does not necessarily correlate with the severity of the underlying condition. Even a small area of crepitus should be investigated.

C. Crepitus is always abnormal and should be followed-up with a more detailed assessment. This is the most accurate interpretation. Crepitus indicates the presence of air in the subcutaneous tissues, which is always abnormal and warrants further investigation.

D. Since a fractured rib often creates crepitus, a chest x-ray should be scheduled immediately. While a chest x-ray can be part of the assessment, stating that a fractured rib "often" creates crepitus might be misleading. Crepitus can arise from other conditions, and a thorough assessment is needed before determining the exact cause.

A. Detailed questions about a symptom. B. Open ended questioning. C. Leading questions. D. Closed ended questions.

Correct Answer is B

Explanation

A. Detailed questions about a symptom: This technique is beneficial for gathering specific information about a symptom. However, asking detailed questions right from the start may not allow the client to provide a broad overview of their symptoms and could limit the information shared.

B. Open-ended questioning: Open-ended questions encourage the client to describe their symptoms in their own words, providing a comprehensive and detailed account. This approach is particularly useful in understanding the quality, color, and consistency of the sputum, which are important details in the assessment of pneumonia. This technique allows for a thorough and unbiased description of the sputum, which is crucial for a complete health assessment in the context of bilateral pneumonia.

C. Leading questions: Leading questions suggest a particular answer and can bias the client's response. For example, asking "Is your sputum thick and green?" may lead the client to agree even if their sputum is different, thus providing inaccurate information.

D. Closed-ended questions: Closed-ended questions elicit short, often one-word answers, such as "yes" or "no." While these can be useful for clarifying specific details, they do not provide the comprehensive description needed to assess the sputum thoroughly in the context of pneumonia.

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The school nurse is interviewing an adolescent who wants to go home from school because of "back pain." Which question should the nurse ask first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During a routine physical examination of a client, chest palpation is determined to be normal except for a 2 inch (5.1 cm) diameter area of crepitus over the upper right anterior chest. Which interpretation is the most accurate for this finding?

Correct Answer is C

Explanation

While completing a health assessment for a client being admitted with bilateral pneumonia, the nurse asks the client to describe the sputum. Which communication technique should the nurse use to obtain this information?

Correct Answer is B

Explanation

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