What subjective data should the nurse obtain about a client's respiratory status? Select all that apply.

question the patient about shortness of breath

palpate the chest and back for masses

inspect the skin and nails for integrity and color

Ask the patient about color and quantity of sputum

auscultate for lung sounds anteriorly and posteriorly

Answer and Explanation

Correct Answer : A,D

A. Asking about shortness of breath is critical subjective data that indicates respiratory distress.
B. Palpating for masses is more of a physical assessment and does not yield subjective data.
C. Inspecting skin and nails is also part of the objective assessment rather than subjective data.
D. Inquiring about the color and quantity of sputum provides important subjective data related to respiratory function.
E. Auscultation is an objective assessment technique and does not pertain to subjective data.

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Correct Answer is B

Explanation

A. While posterior to anterior comparisons are used, they do not encompass the entire technique for auscultation.
B. Side-to-side comparison is the correct method as it allows for immediate assessment of differences between lung fields and helps to identify abnormal sounds effectively.
C. Interspace-by-interspace comparison is not a commonly recognized term for this method and can lead to confusion in technique.
D. Proximal to distal comparison is not specific to lung auscultation and does not effectively apply to lung assessment.
E. Top-to-bottom comparison may miss abnormalities in a specific region of the lungs; side-to-side is preferred.

A. Edema B. Shortness of breath C. Increase in appetite D. Extreme weight loss E. Jugular vein distended (enlarged)

Correct Answer is ["A","B","E"]

Explanation

A. Edema is a common finding in heart failure due to fluid retention.
B. Shortness of breath occurs due to fluid accumulation in the lungs, common in heart failure.
C. Increased appetite is not typical in heart failure; decreased appetite is more common.
D. Weight gain due to fluid retention is more common in heart failure, rather than extreme weight loss.
E. Jugular vein distention is a classic sign of right-sided heart failure due to increased central venous pressure.

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What subjective data should the nurse obtain about a client's respiratory status? Select all that apply.

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Naxlex Comprehensive Predictor Exams

The nurse is observing the lung auscultation technique of a student nurse. What is the correct method to use when progressing from one auscultatory site to another?

Correct Answer is B

Explanation

The nurse is assessing a newly admitted client for heart failure. What findings would the nurse expect to find during the assessment? Select all that apply.

Correct Answer is ["A","B","E"]

Explanation

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