A Drug Rehabilitation nurse is conducting the health history. When would be the most natural time to ask the client about alcohol use?

After discussing reactions to allergens.

After asking about cigarette smoking.

After reviewing current medications.

After asking about previous surgeries.

Answer and Explanation

The Correct Answer is B

Choice A reason:
Discussing reactions to allergens typically focuses on environmental or food triggers that may cause allergic reactions. While it's important to understand a client's allergies, this topic is not closely related to alcohol use, which has different implications for health and lifestyle choices.
Choice B reason:
Asking about alcohol use naturally follows the discussion about cigarette smoking because both involve substance use and have potential health risks. It allows the nurse to transition smoothly from one lifestyle factor to another, which can impact the client's overall health. This approach also helps in creating a comprehensive picture of the client's habits that may contribute to or affect their current health status.
Choice C reason:
Reviewing current medications is an essential part of the health history, as it can reveal potential interactions with alcohol. However, it might be more appropriate to ask about alcohol use after discussing other lifestyle habits such as smoking, as they are more directly related. Once the client's substance use habits are established, the nurse can then discuss how these might interact with prescribed medications.
Choice D reason:
Asking about previous surgeries is important for understanding a client's medical history, but it is not directly related to the client's current lifestyle habits like alcohol use. Therefore, it would be more natural to ask about alcohol use in the context of other substance use discussions rather than after surgical history.

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Correct Answer is C

Explanation

Choice A reason:
Tachycardia, or an abnormally rapid heart rate, is not a typical finding in myxedema. Myxedema is associated with hypothyroidism, which usually presents with bradycardia, or a slower than normal heart rate, due to the decreased metabolic demands on the body.
Choice B reason:
Diarrhea is not commonly associated with myxedema. Instead, patients with hypothyroidism and myxedema often experience constipation due to slowed gastrointestinal motility.
Choice C reason:
Facial edema, particularly around the eyes, is a classic sign of myxedema. Myxedema is a severe form of hypothyroidism that can cause mucopolysaccharide deposition in the skin, leading to non-pitting edema. This can be particularly noticeable in the face and periorbital area.
Choice D reason:
Heat intolerance is more commonly associated with hyperthyroidism, not hypothyroidism. Patients with myxedema typically have cold intolerance due to a decrease in basal metabolic rate and reduced heat production.

A. Review of Systems B. Chief Complaint C. History of Present Illness D. Past Medical History

Correct Answer is C

Explanation

Choice A Reason:
The Review of Systems (ROS) is a systematic approach for collecting the patient's self-reported data on all body systems. It is not typically where the narrative of symptoms is documented. Instead, the ROS is used to uncover symptoms the patient may not have mentioned during the initial recounting of their history.

Choice B Reason:
The Chief Complaint (CC) is a concise statement describing the symptom, problem, condition, diagnosis, or other factors that are the reason for the encounter, usually stated in the patient's words¹. While it does include the symptom prompting the visit, it is not the section where a detailed narrative or description of symptoms is provided.

Choice C Reason:
The History of Present Illness (HPI) is indeed where the detailed narrative of the patient's symptoms is documented. It includes the onset of the problem, the setting in which it developed, its manifestations, and any treatments to date. The HPI tells the story of the patient's chief complaint and provides context for the clinical reasoning process.

Choice D Reason:
The Past Medical History (PMH) includes information about the patient's past experiences with illnesses, operations, injuries, and treatments. It does not contain the current symptoms' narrative but rather the patient's health status before the present illness or concern.

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A Drug Rehabilitation nurse is conducting the health history. When would be the most natural time to ask the client about alcohol use?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has myxedema. Which of the following findings should the nurse expect?

Correct Answer is C

Explanation

During a health history assessment, where is the symptoms description/narrative typically documented?

Correct Answer is C

Explanation

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