During the physical assessment, the nurse asks an elderly female patient if she experiences constipation. The nurse knows that

It is common for intestinal peristalsis to slow down as a person ages, causing problems with constipation.

Aging patients always have difficulty having a bowel movement while hospitalized

Elderly patients almost always abuse laxatives, which creates problems with constipation.

In elderly patients, the rectal sphincter has lost elasticity, which decreases the sensation of urgency.

Answer and Explanation

The Correct Answer is A

A: Due to age-related reductions in gastrointestinal muscle efficiency, which slows the digestive process and can lead to increased water absorption from stool.
B: Overstates the issue, not all elderly patients experience difficulties, and it does not account for individual variability or other influencing factors like diet and medication.
C: Misrepresents the frequency and reasons for laxative use among the elderly, not all of whom misuse these medications.
D: While changes in rectal sphincter elasticity can affect some elderly individuals, it is less commonly a direct cause of constipation compared to decreased peristalsis.

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Correct Answer is A

Explanation

A: To accurately assess for orthostatic hypotension, the initial blood pressure should be measured while the client is supine. This establishes a baseline for comparing subsequent measurements.
B: Placing the client in a sitting position is a subsequent step in the sequence to monitor changes but is not the first action.
C: Determining the client's blood pressure changes after each position is essential but follows the initial supine measurement.
D: Assisting the client into a standing position is also part of the assessment process for orthostatic hypotension but should occur after recording the supine and sitting blood pressures.

A. Carotid pulse B. Brachial pulse C. Posterior tibialis D. Femoral pulse

Correct Answer is C

Explanation

A: This is not suitable for assessing circulation issues specifically in the lower extremities as it is located on the upper body.

B: This is not suitable for assessing circulation issues specifically in the lower extremities as it is located on the upper body.
C: Palpating the posterior tibialis pulse is a logical next step for checking lower extremity circulation, particularly when dorsalis pedis is not palpable, helping localize the evaluation of blood flow in the foot and ankle.
D: The femoral pulse is useful for broader leg circulation issues. However, it is less targeted than posterior tibialis for checking blood flow in the lower extremities.

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During the physical assessment, the nurse asks an elderly female patient if she experiences constipation. The nurse knows that

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data on a client to check for orthostatic hypotension. Which of the following actions should the nurse take first?

Correct Answer is A

Explanation

A nurse is unable to palpate a client's dorsalis pedis pulse. The nurse will next attempt to palpate the

Correct Answer is C

Explanation

During the physical assessment, the nurse asks an elderly female patient if she experiences constipation. The nurse knows that

A nurse is assisting with teaching a newly licensed nurse about the loss of body heat. The nurse should include that heat loss that occurs when sweat dries on the skin is caused by which of the following mechanisms?

A nurse is assisting with teaching a class about documenting blood pressure. The nurse should include to document which of the following information?

A nurse is performing an admission assessment on a patient. When collecting objective and subjective data, the nurse identifies subjective data as

A nurse performing an assessment would correctly note that an absent pulse in one or more of the extremities indicates

A nurse is collecting data on client who has a heart rate of 56/min. Which of the following findings should the nurse expect?

While performing an admission history on a confused patient, a licensed practical nurse (LPN) assists the registered nurse (RN) by collecting secondary information about the patient. An example of secondary information would be that

At the staff education meeting, the nurse explains that it is important to use four senses (sight, touch, hearing, and smell) to determine whether a patient is exhibiting signs of illness or injury. These signs of illness or injury are