A nurse is collecting data from a client who has hepatitis A. Which of the following findings should the nurse expect?
Splenomegaly
Abdominal pain
Irregular heart rate
Tarry stools
The Correct Answer is B
A nurse collecting data from a client who has hepatitis A should expect to find that the client may have abdominal pain. Hepatitis A is a liver infection that can cause inflammation and discomfort in the abdomen.
The other options are not typical symptoms of hepatitis
a) Splenomegaly is an enlargement of the spleen and is not a typical symptom of hepatitis A.
c) An irregular heart rate is not a typical symptom of hepatitis A.
d) Tarry stools may indicate bleeding in the digestive tract and is not a typical symptom of hepatitis A.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The most concerning finding in the assessment of a client's right leg after a femoropopliteal bypass graft would be if the client's pedal pulse in the right foot is not palpable. This could indicate a problem with blood flow to the limb.
The other options are also concerning and should be reported to the healthcare provider.
a) A cooler footmay indicate decreased blood flow to the limb.
c) A capillary refill time of 5 secondsmay also indicate decreased blood flow.
d) A pain level of 8 on a scale from 0 to 10should also be reported and addressed.
Correct Answer is D
Explanation
d. Apply the dressing loosely over the incision.
Explanation:
The correct answer is d. Apply the dressing loosely over the incision.
When caring for an older adult client, it is important for the nurse to be sensitive to age-related changes and promote their comfort and well-being. Applying the dressing loosely over the incision allows for beter circulation and ventilation, which can help prevent complications such as skin breakdown and infection.
Option a is not the correct answer. Asking the client to help with the dressing change may not be appropriate, as postoperative clients, especially older adults, may have limited mobility or dexterity. It is the nurse's responsibility to provide the necessary care and support during the dressing change.
Option b is not the correct answer. Waiting for the client to approach the nurse for assistance may lead to delays in care and could potentially compromise the client's healing process. The nurse should proactively assess the client's needs and provide appropriate care.
Option c is not the correct answer. Using paper tape for securing the new dressing does not specifically address sensitivity to age-related changes. While paper tape may be gentle on the skin, it is not the primary consideration in this situation.
By applying the dressing loosely over the incision, the nurse demonstrates sensitivity to age-related changes and promotes the client's comfort and optimal healing. This approach takes into account the potential for decreased skin elasticity and fragility in older adults, allowing for proper circulation and reducing the risk of complications.
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