While obtaining a client’s health history related to smoking cigarettes, the nurse plans to determine the client’s smoking pack years.

What information should the nurse obtain for this calculation? Select all that apply.

Packs of cigarettes smoked per day.

Number of attempts to quit smoking.

Client’s current age.

Age when the client started smoking.

Number of years the client smoked.

Answer and Explanation

Correct Answer : A,D,E

Choice A rationale
Packs of cigarettes smoked per day is essential information for calculating smoking pack years.
Choice B rationale
The number of attempts to quit smoking is not required for calculating smoking pack years.
Choice C rationale
The client’s current age is not required for calculating smoking pack years.
Choice D rationale
The age when the client started smoking is necessary to determine the total number of years smoked.
Choice E rationale
The number of years the client smoked is essential for calculating smoking pack years.

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Correct Answer is D

Explanation

Choice D rationale
Orthopnea is a condition where individuals have difficulty breathing while lying flat and may need to sleep with multiple pillows or in a more upright position to alleviate symptoms.
Therefore, asking the client about the number of pillows used for sleep can provide valuable information about the presence and severity of orthopnea.
Choice A rationale
While jugular vein distention can indicate fluid overload or heart failure, it is not a direct assessment of orthopnea, which is the difficulty breathing while lying flat.
Choice B rationale
Auscultating breath sounds while the client is supine can provide information about lung function and the presence of abnormal breath sounds, but it does not specifically address orthopnea.
Choice C rationale
Measuring the blood pressure when the client is lying and standing assesses for orthostatic hypotension, which is a drop in blood pressure upon standing. While orthostatic hypotension can contribute to symptoms of dizziness or fainting upon assuming an upright position, it does not directly assess orthopnea.

A. Works in a day care center. B. Adheres to a gluten-free diet. C. Takes an oral anticoagulant. D. Recently had dental surgery.

Correct Answer is C

Explanation

Choice A rationale
Working in a day care center may expose the client to minor injuries or infections, but it is not directly associated with widespread ecchymosis. Ecchymosis is more likely related to systemic issues rather than occupational hazards.
Choice B rationale
Adhering to a gluten-free diet is typically related to managing celiac disease or gluten intolerance, which primarily affects the gastrointestinal tract. Ecchymosis is not a typical manifestation of gluten intolerance.
Choice C rationale
Taking an oral anticoagulant medication increases the risk of bleeding, which can manifest as ecchymosis (bruising) on the skin. Anticoagulants such as warfarin or aspirin can interfere with the blood’s ability to clot, leading to bleeding into the skin and subsequent ecchymosis.
Choice D rationale
Dental surgery may involve procedures that could cause minor trauma to the oral tissues, leading to localized bruising around the mouth or jaw area. However, this localized bruising would typically not explain the presence of ecchymosis observed on the trunk and extremities.

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While obtaining a client’s health history related to smoking cigarettes, the nurse plans to determine the client’s smoking pack years. What information should the nurse obtain for this calculation? Select all that apply.

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Naxlex Comprehensive Predictor Exams

During the admission assessment, a client admitted with chest pain reports having no breathing problems and no trouble sleeping at night. To obtain further data regarding possible orthopnea, which action should the nurse take?

Correct Answer is D

Explanation

When inspecting the client’s skin, the nurse observes several areas of ecchymosis on the trunk and extremities. Which information in the client’s history requires additional follow-up by the nurse?

Correct Answer is C

Explanation

To objectively confirm the presence of fever, before taking the client’s temperature, which action should the nurse take?

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An adult client exhibits an allergic reaction to an insect bite. The nurse should observe the client’s skin for which finding?

While obtaining a client’s health history related to smoking cigarettes, the nurse plans to determine the client’s smoking pack years.

What information should the nurse obtain for this calculation? Select all that apply.