Exam 26: Assessment

When a nurse asks a client to focus on an object in the distance and then move her gaze to a nearby object,what process is the nurse assessing?

A client complains of numbness,tingling,and coldness of the left leg.The nurse observes that the skin appears pale and is cool to touch.What assessment should be obtained next?

During auscultation of all four quadrants of a client's abdomen,the nurse hears 20 or more bowel sounds per minute.How should this finding be documented?

When percussing over the client's liver area,the nurse hears a low-pitched,thudlike sound.What is this normal finding called?

A 95-year-old client has the following vital signs: oral T 98.6 degrees Fahrenheit,P 84 with a regular irregularity,R 18,and BP 140/86.What additional nursing assessment should be done at this time?

When a client has an order for "daily weight," when should the nurse weigh the client?

How should a beginning nursing student perform deep palpation of a client's liver?

The client is admitted in an emergency situation.The nurse is aware that the client's health history should be obtained:

Convert between Fahrenheit and Celsius temperatures. 36.5 degrees Celsius

A client complains of dizziness when moving from a reclining position to a standing position.Which of these assessments will provide the nurse with the MOST pertinent data about the client's symptoms?

The nurse is testing the patency of a client's nostrils.The MOST appropriate steps to take would be:

When assessing a client's breath sounds,the nurse hears low-pitched snoring sounds that are louder on exhalation.These breath sounds are called:

In addition to demographic information and client and family medical history,a client's health history should contain which of these data?

What is the rationale for using the head-to-toe format when performing a physical examination?

A client's pulse pressure should be between how many mmHg?

A nurse observes a client's lips and nail beds are cyanotic,which means that there is:

The client's upper extremity strength is assessed as normal when a handshake reveals which of the following?

While assessing a client's mucous membranes of the lips and mouth,the nurse notes a smell like ammonia.This abnormal breath odor is associated with which of the following disease processes?

After noting that a client has a pulse deficit,what action should the nurse take next?

A client's blood pressure readings have shown great variation since admission.Which of these actions should the nurse take next?