While performing a health history the nurse asks the client, "You don't use recreational drugs, do you?" This approach is most likely to elicit which response from the client?

"No, of course not."

"I smoked marijuana before, but only once."

"What would you classify as recreational?"

"I've been known to on occasion."

Answer and Explanation

The Correct Answer is A

A.   This response is a straightforward denial. It reflects a direct and possibly automatic answer that the client does not use recreational drugs. However, this type of response might be influenced by the phrasing of the question, which could lead the client to respond in a way that aligns with what they perceive as socially acceptable or expected.
B.   This response indicates that the client acknowledges past use of a recreational drug (marijuana) but minimizes its frequency and significance. The response suggests that the phrasing of the question might have led the client to clarify their past behavior, showing an attempt to be honest while downplaying the extent of use.

C.   This response suggests that the client is seeking clarification on what the term "recreational drugs" includes. The question might have been vague or broad, prompting the client to ask for a definition or to specify which substances are considered recreational drugs. This response indicates that the client might be unsure about whether their drug use falls into the category of recreational drugs.
D.   This response implies that the client does use recreational drugs but does so infrequently or sporadically. It suggests a level of acknowledgment of occasional use without providing specifics. This type of answer might reflect that the client is uncomfortable with a direct yes/no response and opts for a more ambiguous acknowledgment.

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Correct Answer is D

Explanation

A. This may involve using a stethoscope to auscultate the apical pulse, as it might be more easily heard than felt, especially in individuals with significant muscle mass or other anatomical variations. This approach ensures that a thorough cardiac assessment is conducted.
B. Dimming the lights would not impact the ability to palpate or auscultate the apical pulse. Lighting adjustments are generally more relevant for visual examinations rather than for palpation or auscultation of heart sounds. This action would not address the issue of locating the apical pulse.
C. While steroid use can affect cardiovascular health, such as potentially causing changes in heart size or function, questioning the client about steroid use is not the immediate priority if the apical pulse cannot be palpated. The priority should be to ensure a correct assessment and use proper techniques to locate the pulse.
D. Positioning the client in high Fowler's position (sitting up at a 60-90 degree angle) can help in various cardiac assessments and might make it easier to detect the apical pulse, especially if the client has a high muscle mass. This position can improve access to the chest and potentially facilitate better auscultation of heart sounds.

A. Diminished short term memory over the past year. B. Reduced fine motor skills. C. A negative Babinski reflex. D. A change in awareness of surroundings.

Correct Answer is D

Explanation

A. Diminished short-term memory in older adults can be a sign of normal aging or early cognitive decline, such as mild cognitive impairment or early-stage dementia. While this is concerning, it is not typically an immediate indicator requiring urgent medical follow-up. It is important to monitor and assess memory changes over time, but it might not necessitate immediate action unless accompanied by other significant symptoms.
B. Reduced fine motor skills can occur due to aging, arthritis, or neurological conditions such as Parkinson's disease. While this finding is important for evaluating the client's functional status and quality of life, it does not usually require immediate medical follow-up unless it is sudden, severe, or accompanied by other alarming symptoms.

C. The Babinski reflex is a neurological test where stroking the sole of the foot causes the big toe to extend. In adults, a negative Babinski reflex (where the big toe does not extend) is normal and indicates that the corticospinal tract is functioning properly. A positive Babinski reflex is abnormal in adults and may indicate neurological damage.
D. A change in awareness of surroundings is a more urgent concern. It could indicate acute cognitive changes, delirium, or severe neurological issues that require prompt evaluation. Such changes can be related to various serious conditions, including infections, metabolic imbalances, or acute brain disorders.

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While performing a health history the nurse asks the client, "You don't use recreational drugs, do you?" This approach is most likely to elicit which response from the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When assessing a 24-year-old body-builder, the nurse is unable to palpate an apical pulse. Which action should the nurse implement?

Correct Answer is D

Explanation

The nurse is assessing older clients in a community health clinic. Which assessment finding is an indicator for immediate medical follow-up?

Correct Answer is D

Explanation

Patient Data Exhibits

While assessing a client, the nurse notes an audible expiratory wheeze and a respiratory rate of 30 breaths/minute. Which action should the nurse implement?

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The nurse is assessing a client with type 2 diabetes mellitus and observes an abnormal response when using a monofilament. Which finding should the nurse document that is consistent with an abnormal finding?