Which query is best suited for determining the patient's chief complaint?
"Have you ever experienced this problem before?"
"What brings you to the hospital today?"
"Did your doctor tell you to come to the hospital?"
"How long have you been having chest pain?"
The Correct Answer is B
Choice A rationale
Asking "Have you ever experienced this problem before?" elicits historical information about the symptom, which is valuable for understanding the pattern and potential causes of the current complaint. However, it does not directly prompt the patient to articulate their primary reason for seeking medical attention in the present moment.
Choice B rationale
"What brings you to the hospital today?" is an open-ended question that encourages the patient to describe, in their own words, their primary concern or reason for seeking medical care. This allows the healthcare provider to identify the chief complaint directly and without leading the patient toward specific symptoms.
Choice C rationale
"Did your doctor tell you to come to the hospital?" focuses on the referral source rather than the patient's subjective experience of their symptoms. While knowing the referral context can be helpful, it does not directly address the patient's current health concerns or the specific problem they are experiencing.
Choice D rationale
"How long have you been having chest pain?" is a closed-ended question that assumes the presence of chest pain and focuses on its duration. While important for characterizing a specific symptom, it does not allow for the identification of the patient's overall chief complaint, which might be broader than just chest pain.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Having the patient lie flat before administering medications through a tube increases the risk of aspiration, as gastric contents can reflux into the esophagus and potentially enter the airway. Proper patient positioning is crucial to promote safe medication delivery and prevent pulmonary complications.
Choice B rationale
Administering medications when gastric residual volume is 200 mL or more is generally not recommended. A high residual volume indicates delayed gastric emptying, increasing the risk of aspiration and potentially affecting medication absorption. Typically, residuals of 200-250 mL or more warrant holding the feeding and reassessing.
Choice C rationale
Mixing all medications together before administration is often inappropriate and can lead to several problems. Drug incompatibilities can occur, altering medication effectiveness, causing precipitation, or leading to tube occlusion. Each medication should generally be administered separately, flushed with water between doses.
Choice D rationale
Elevating the head of the patient's bed to at least 30 degrees before administering medications through a tube significantly reduces the risk of aspiration. This semi-Fowler's position utilizes gravity to keep gastric contents in the stomach, promoting safe passage of medications and minimizing reflux into the esophagus and lungs.
Correct Answer is ["A","B","C","D"]
Explanation
The aortic valve is best auscultated at the second intercostal space (ICS) along the right sternal border. This anatomical landmark corresponds to the superficial projection of the aorta and is where the sounds of aortic valve closure and blood flow through the aorta are most clearly transmitted to the chest wall. Optimal sound transmission is achieved by minimizing intervening tissue. Pulmonic rationale:
The pulmonic valve is best auscultated at the third intercostal space (ICS) along the left sternal border, also known as Erb's point. While the pulmonic area is typically at the second ICS left sternal border, Erb's point provides a broader area for detecting murmurs related to both the pulmonic and aortic valves. This location provides good sound transmission for the pulmonary artery. Tricuspid rationale:
The tricuspid valve is best auscultated at the fourth intercostal space (ICS) along the left sternal border. This location overlies the right ventricle and the tricuspid valve, allowing for clear detection of its closure sounds and any associated murmurs. The proximity of the valve to the chest wall at this point facilitates optimal auscultation. Mitral rationale:
The mitral valve is best auscultated at the fifth intercostal space (ICS) at the midclavicular line (MCL). This location is also known as the apex of the heart, where the left ventricle's impulse is strongest. Sounds produced by the mitral valve, particularly during its closure, are best heard here due to the direct anatomical projection and maximal cardiac impulse. .
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