A nurse is collecting data from an older adult client who has had some bone density loss. The nurse observes excessive forward curvature of the thoracic spine. The nurse should document this finding using which of the following terminology?

Kyphosis

Scoliosis

Lordosis

Ankylosis

Answer and Explanation

The Correct Answer is A

A. Kyphosis: Excessive forward curvature of the thoracic spine, commonly due to osteoporosis-related bone loss in older adults.

B. Scoliosis refers to a lateral curvature of the spine.

C. Lordosis: exaggerated inward curvature of the lumbar spine, often seen in pregnancy or obesity.

D. Ankylosis: abnormal stiffening or fusion of joints, unrelated to spinal curvature.

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Correct Answer is D

Explanation

A. Prior to inspecting the abdomen. The correct order of abdominal assessment is inspection → auscultation → percussion → palpation to avoid altering bowel sounds.

B. After checking for kidney tenderness. Assessing kidney tenderness is done through percussion, which should be performed after auscultation.

C. After palpating the abdomen. Palpation can stimulate bowel activity, potentially leading to false findings during auscultation.

D. Prior to palpating the abdomen. Auscultation should be done before palpation to prevent artificially altering bowel sounds.

A. Nausea B. Dysphagia C. Warm, dry skin D. Cyanosis E. Cyanosis

Correct Answer is D

Explanation

A. Nausea – Not a primary manifestation of hypoxia. Hypoxia primarily affects oxygen delivery to tissues, leading to respiratory and neurological changes.

B. Dysphagia – Difficulty swallowing is not a common sign of hypoxia. It is more often associated with neurological conditions or structural abnormalities.

C. Warm, dry skin – Hypoxia typically causes cool, clammy skin due to vasoconstriction and poor oxygenation, not warm, dry skin.

D. Cyanosis – Correct. Cyanosis (bluish discoloration of the skin, lips, or nail beds) occurs due to inadequate oxygenation of the blood, making it a key sign of hypoxia.

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A nurse is collecting data from an older adult client who has had some bone density loss. The nurse observes excessive forward curvature of the thoracic spine. The nurse should document this finding using which of the following terminology?

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A nurse is collecting data from an older adult client who has had some bone density loss. The nurse observes excessive forward curvature of the thoracic spine. The nurse should document this finding using which of the following terminology?