A client describes a 3-week history of hoarseness. The client also reports feeling fatigue and noticeable weight gain over the past month. Which cause should the nurse consider as most likely?
Hypothyroidism
Gingivitis
Aphthous ulcers
Dysphagia
The Correct Answer is A
Choice a reason:
Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones. This can lead to a variety of symptoms, including hoarseness, fatigue, and weight gain. The hoarseness can be due to the effect of hormone deficiency on the vocal cords, while fatigue and weight gain are common due to the slowed metabolism associated with hypothyroidism.
Choice b reason:
Gingivitis is inflammation of the gums and does not typically cause hoarseness, fatigue, or weight gain. It is more commonly associated with symptoms like red, swollen gums and bleeding during brushing or flossing.
Choice c reason:
Aphthous ulcers, also known as canker sores, are small, shallow lesions that develop on the soft tissues in the mouth or at the base of the gums. While they can be painful and cause difficulty with eating and speaking, they do not cause systemic symptoms such as hoarseness, fatigue, or weight gain.
Choice d reason:
Dysphagia, or difficulty swallowing, can lead to hoarseness if there is an associated throat disorder. However, it is not typically associated with systemic symptoms like fatigue and weight gain unless it is part of a broader condition that affects the body's metabolism or energy levels.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
An ophthalmoscope is primarily used for examining the interior structures of the eye, such as the retina, and is not typically used for assessing near vision. It provides a view of the fundus of the eye, which is essential for diagnosing various eye conditions but does not directly assess a patient's reading or close-up vision.
Choice B Reason:
The Snellen Chart is traditionally used to measure distance visual acuity and would not be the first choice for assessing near vision. However, there are versions of the Snellen Chart or similar charts designed for near vision assessment, typically held at a reading distance of about 14 inches from the patient. These charts have rows of letters or symbols that decrease in size and are used to determine the smallest print size a person can read.
Choice C Reason:
A magazine can be a practical tool for assessing near vision informally, as it contains various sizes of print and is a good representation of everyday reading material. The nurse can ask the patient to read a specific paragraph to observe their ability to see and comprehend text at a close distance.
Choice D Reason:
A penlight is not used for assessing near vision. It is typically used to assess the pupillary light reflex or to illuminate specific areas of the eye during an examination. The penlight helps to evaluate the response of the pupils to light but does not measure the patient's ability to read or see objects up close.
Correct Answer is C
Explanation
Choice A Reason:
Family History is used to document health events in the patient's family, including diseases that may be hereditary or place the patient at risk. The statement about feeling like an elephant is sitting on the chest is not related to family health but is a description of the patient's current symptoms.
Choice B Reason:
Past Medical History includes information about the patient's past health issues, surgeries, hospitalizations, allergies, and treatments. It does not include current symptoms or the reasons for the current hospital visit.
Choice C Reason:
The Chief Complaint is the section where the nurse documents the primary reason for the patient's visit in their own words. The phrase "feels like an elephant is sitting on his chest" is a classic description of chest pain or discomfort, often associated with cardiac issues, and would be documented here as it represents the patient's main concern.
Choice D Reason:
Present Illness or History of Present Illness would include a detailed account of the development of the patient's illness or health concern. While it is closely related to the Chief Complaint, it is more detailed and includes the onset, duration, and character of the symptoms, among other aspects. The initial statement would be part of the Chief Complaint, which leads into the more detailed History of Present Illness.
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