A client has sought care because of a sudden increase in the size of his scrotum after a cough. The nurse's assessment reveals the presence of a large scrotal mass. How can the nurse best assess for a scrotal hernia?

Auscultate the scrotum for bowel sounds

Inspect the femoral hernia while the patient coughs

Ask the client to stand up to see if the mass disappears

Palpate the abdomen for pain

Answer and Explanation

The Correct Answer is A

Choice A reason: Auscultating for bowel sounds in the scrotum detects an inguinal hernia, where intestines protrude after coughing. This confirms the mass’s nature, making it the best method to assess this sudden scrotal enlargement accurately and directly here.
Choice B reason: Inspecting femoral hernia focuses on the thigh, not scrotum. Scrotal masses from coughing suggest inguinal hernia, misaligning this with the primary site, rendering it less effective for this specific assessment entirely and fully here.
Choice C reason: Standing may reduce some hernias, but disappearance isn’t diagnostic. Cough-induced scrotal mass needs auscultation for bowel sounds to confirm hernia, making this less precise than listening for intestinal presence comprehensively here fully.
Choice D reason: Abdominal palpation for pain assesses tenderness, not hernia type. Scrotal mass from coughing points to inguinal hernia, where auscultation directly identifies bowel, making this less specific for the scrotal finding entirely here fully.

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Correct Answer is C

Explanation

Choice A reason: Morphine treats severe pain but isn’t first-line for headaches worsened by coughing, which may signal increased intracranial pressure. Without neurological assessment, this risks masking symptoms of serious conditions like brain tumors, delaying critical diagnosis and intervention.

Choice B reason: Palpating occipital lymph nodes checks for infection or inflammation, but headaches worsened by coughing or sneezing suggest intracranial issues, not lymphatic ones. This action misses the priority of assessing brain function tied to the client’s specific symptom pattern.

Choice C reason: Neurological assessment, like checking reflexes or pupil response, is vital for morning headaches worsening with coughing, hinting at possible intracranial pressure from masses or bleeds. It’s the most direct step to rule out life-threatening causes promptly.

Choice D reason: Explaining migraines assumes a diagnosis without evidence. Morning headaches improving later, worsened by strain, don’t align with typical migraine patterns, risking misdiagnosis of serious conditions like sinus thrombosis, necessitating neurological evaluation over premature reassurance.

A. Acute otitis media B. Serous otitis media C. Scarring from previous infections D. Intact tympanic membrane

Correct Answer is D

Explanation

Choice A reason: Acute otitis media shows a red, bulging tympanic membrane due to bacterial infection and pus. A pearly gray, shiny appearance contrasts this, indicating no acute inflammation or fluid, ruling out this active middle ear condition entirely.

Choice B reason: Serous otitis media presents with amber fluid behind a retracted or neutral tympanic membrane, not pearly gray and shiny. This suggests no sterile effusion, distinguishing it from the normal, healthy membrane observed in this inspection clearly.

Choice C reason: Scarring from past infections appears as white, opaque patches on the tympanic membrane, not uniform pearly gray shininess. This finding lacks the irregular, thickened look of scar tissue, pointing to an unscathed membrane instead here.

Choice D reason: A pearly gray, shiny tympanic membrane is normal, reflecting light off an intact, healthy eardrum. This lacks signs of infection or fluid, aligning with standard anatomy where the membrane’s cone of light confirms its integrity fully.

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A client has sought care because of a sudden increase in the size of his scrotum after a cough. The nurse's assessment reveals the presence of a large scrotal mass. How can the nurse best assess for a scrotal hernia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client comes in with complaints of a headache. The client states, "I always wake up with a headache in the morning, but it gets better in a couple hours. I notice that it always gets worse if I cough or sneeze." What action by the nurse is most appropriate?

Correct Answer is C

Explanation

While inspecting the tympanic membrane the nurse notes a pearly gray and shiny appearance. What would this finding indicate?

Correct Answer is D

Explanation

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