The nurse is obtaining a client's fingerstick glucose level. After gently milking the client's finger, the nurse observes that the distal tip of the finger appears reddened and engorged. Which action should the nurse take?

Collect the blood sample.

Select another finger.

Apply pressure to the site.

Assess radial pulse volume.

Answer and Explanation

The Correct Answer is B

A. Collecting the blood sample from a reddened and engorged fingertip may lead to inaccurate glucose readings and can cause discomfort to the client. Selecting another finger is a more appropriate action.

B. Selecting another finger ensures an accurate blood sample and minimizes discomfort to the client. It allows for a fresh puncture site that is not engorged, improving the accuracy of the glucose reading.

C. Applying pressure to the site may temporarily reduce engorgement but may not be sufficient to obtain an accurate blood sample. Selecting another finger is a more appropriate action.

D. Assessing radial pulse volume is not necessary in this situation, as the client's fingertip appearance does not indicate compromise of peripheral circulation.

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Correct Answer is ["A","B","C","F"]

Explanation

A. Client education is also important, focusing on asthma management, the importance of carrying a non-expired inhaler, and avoiding known triggers.

B. Oxygen therapy via nasal cannula should be considered due to the patient's oxygen saturation of 88% on room air, aiming to maintain SpO2 above 94%.

C. Requesting a list of current medications is essential for reviewing potential drug interactions and ensuring comprehensive care.

D. Trendelenburg position is not indicated for this condition and could exacerbate breathing difficulties.

E. While the patient's condition should be closely monitored, the current information does not suggest an immediate need for intubation; however, the healthcare provider should be notified if the patient's condition worsens.

F. Administering medications as ordered is crucial to address the immediate respiratory distress.

A. Husky voice and troubled by hoarseness. B. Central type obesity, with thin extremities. C. Warm, soft, moist, salmon colored skin. D. Visible swelling of the neck, with no pain.

Correct Answer is B

Explanation

A. Husky voice and hoarseness are not typically associated with Cushing's syndrome but may be related to other conditions affecting the throat or vocal cords.

B. Central type obesity, with thin extremities, is a classic manifestation of Cushing's syndrome due to excess cortisol, which promotes fat accumulation in the trunk and face while causing muscle wasting in the extremities.

C. Warm, soft, moist, salmon-colored skin is not typically associated with Cushing's syndrome and may indicate other dermatological conditions.

D. Visible swelling of the neck with no pain is not a characteristic finding of Cushing's syndrome and may indicate other underlying issues such as goiter or lymphadenopathy.

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The nurse is obtaining a client's fingerstick glucose level. After gently milking the client's finger, the nurse observes that the distal tip of the finger appears reddened and engorged. Which action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Patient Data Exhibits The nurse has identified the priority problem for the client and now must determine proper care interventions. Based on the client history and the assessment data, what action(s) should the nurse anticipate? Select all that apply.

Correct Answer is ["A","B","C","F"]

Explanation

Which findings during the admission assessment should the nurse document that are related to a client diagnosed with Cushing's syndrome?

Correct Answer is B

Explanation

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