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The nurse working in a community clinic performs an initial assessment on a client who does not speak English. Which action by the nurse would cause a barrier to communication?
A group of student athletes have come to the clinic for their annual sports physicals. During the assessment, which findings does the nurse determine to be objective data? Select all that apply.
C. Results of a scoliosis screening check on each student
This is an objective finding because it is based on a physical examination and measurable data that can be documented (e.g., curvature of the spine).
E. A student has grown one inch since his last physical
This is objective data because it is a measurable, quantitative change in height, recorded during the assessment.
A nurse and unlicensed assistive personnel (UAP) follow a prescribed standard of care for clients with a hip fracture. The standard of care indicates that the legs should be abducted. How would the nurse instruct the UAP to position the client safely?
The nurse performs a health history interview. What question will the nurse ask to best evaluate the client's values?
The nurse teaches the parent of a child with recurrent ear infections about risk factors for infection and hearing loss. What instructions should the nurse include in the teaching? Select all that apply.
A. Avoid secondhand smoke
Secondhand smoke irritates the eustachian tube, increasing mucus production and inflammation. This makes fluid more likely to accumulate behind the tympanic membrane, placing the child at significantly higher risk for recurrent otitis media. Eliminating smoke exposure is one of the most effective preventive measures for reducing ear infections.
E. Clean only the external ear
Parents should avoid inserting cotton-tipped applicators or any objects into the child’s ear canal. Doing so can push debris inward, introduce bacteria, cause trauma, or perforate the tympanic membrane. Cleaning should be limited to the outer ear with a soft cloth to maintain natural protective mechanisms inside the canal.
F. Stay current with all immunizations
Vaccines—especially pneumococcal and influenza—reduce infections that commonly precede or trigger otitis media. Preventing these illnesses helps decrease the frequency of ear infections and lowers the risk of complications such as hearing loss. Ensuring up-to-date immunizations is a key component of otitis media prevention.
The nurse teaches a health promotion class to a group of middle-aged women. Which should the nurse include in teaching about modifiable risk factors?
Select all that apply.
A. Hormonal birth control
Hormonal contraceptives containing estrogen and/or progesterone are associated with a slightly increased risk of breast cancer. Because a woman can modify or discontinue use based on risk-benefit discussions with her provider, this is considered a modifiable risk factor. Teaching should emphasize individualized decision-making and regular screening for women using hormonal birth control.
C. Alcohol consumption
Alcohol intake increases circulating estrogen levels and promotes inflammation, both of which elevate breast cancer risk. Because alcohol use is fully modifiable, education should stress limiting or avoiding alcohol as an effective breast cancer risk-reduction strategy. Even small daily amounts have been shown to increase risk.
E. Obesity
Obesity—especially after menopause—is a well-established modifiable risk factor. Fat tissue produces estrogen, which can stimulate breast cancer growth. Weight reduction through diet, activity, and lifestyle changes lowers estrogen levels and significantly reduces risk. Obesity is also linked to worse breast cancer outcomes, making prevention efforts essential.
While examining the skin of a client who said, "she slipped at home," the nurse notes bruises of varying stages noted to the superior posterior torso. What would be an appropriate action for the nurse to take?
The nurse palpates tender, warm anterior cervical lymph nodes while assessing a client's neck. What question should the nurse ask to evaluate the finding further?
The nurse is assessing an older adult client newly admitted to the medical–surgical unit. Which assessment findings are expected with this population? Select all that apply.
A. Shallow breaths with diminished breath sounds in bases
Older adults commonly experience decreased chest wall compliance and weaker respiratory muscles. This leads to shallower breaths and decreased airflow reaching the lung bases, causing diminished breath sounds. These changes are expected and reflect normal aging of the respiratory system.
D. Reports of dyspnea on exertion
With aging, lung elasticity decreases and alveolar surface area is reduced, making oxygen exchange less efficient. The cardiovascular system also becomes less responsive. As a result, older adults frequently report dyspnea with activity, which is a normal age-related finding rather than a disease-specific symptom.
E. Crackles on inspiration that clear with coughing
Older adults often have decreased ability to clear secretions due to weaker cough reflexes and limited mobility. Secretions that accumulate in the lower airways may produce crackles, but these typically clear with coughing. This is considered a common and expected age-related assessment finding.
The nurse assesses a 20-year-old male, noting a swelling over the pelvic area while the client is standing that decreases when he lays down. The nurse suspects an indirect inguinal hernia. What other questions should the nurse ask the client for cues to validate this assumption? Select all that apply.
C. Do you have any pain when straining?
Indirect inguinal hernias often worsen with activities that increase intra-abdominal pressure—such as coughing, straining, or bearing down. Pain or discomfort during these actions is a classic associated symptom and helps validate the suspicion of a hernia.
D. Does your scrotum feel heavy when you walk?
A feeling of heaviness or dragging in the scrotum is a common complaint with indirect inguinal hernias because the herniated bowel or tissue may descend into the inguinal canal or scrotum, especially with standing or activity. This symptom supports the assessment cue.
F. Do you notice a bulge in your pelvic area when you lift heavy objects?
Indirect inguinal hernias frequently produce a visible or palpable bulge that becomes more pronounced with lifting, straining, or prolonged standing. Asking about activity-related bulging helps verify herniation behavior and supports the diagnosis.
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