The patient was admitted with a complaint of abdominal pain. Later the nurse observed the patient demonstrating dyspnea. This change in condition required an assessment called:

systemic

specialized

individualized

Focused

Answer and Explanation

The Correct Answer is D

A. Systemic – A systemic assessment is a head-to-toe examination that evaluates all body systems. The patient’s condition change requires a more targeted approach.

B. Specialized – A specialized assessment refers to an in-depth evaluation of a specific condition, usually performed by a specialist.

C. Individualized – While all assessments should be individualized, this term does not specifically describe the type of assessment needed in response to a sudden change in condition.

D. Focused – A focused assessment is performed when there is a specific change in the patient’s condition, such as new-onset dyspnea. It concentrates on the affected system (e.g., respiratory system) to determine the underlying cause.

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Correct Answer is A

Explanation

A. Diaphoresis – Diaphoresis refers to excessive sweating, which can be caused by fever, infections, hyperthyroidism, or stress.

B. Hypoxia – Hypoxia is a condition where tissues do not receive adequate oxygen, leading to symptoms like confusion and cyanosis.

C. Hemoptysis – Hemoptysis is the coughing up of blood, commonly seen in tuberculosis, lung cancer, or pulmonary embolism.

D. Tachypnea – Tachypnea is rapid breathing, which may occur due to fever, anxiety, or metabolic acidosis but does not involve excessive sweating.

A. 30 seconds to 1 minute B. 10-15 seconds C. 20 seconds D. 2-5 minutes

Correct Answer is D

Explanation

A. 30 seconds to 1 minute. – This time frame is characteristic of 3+ pitting edema, not 4+.

B. 10-15 seconds. – This time frame is associated with 2+ pitting edema, which indicates a moderate level of fluid retention.

C. 20 seconds. – This time frame is associated with 3+ pitting edema.

D. 2-5 minutes. – 4+ pitting edema is the most severe form, where the indentation remains for 2-5 minutes, indicating significant fluid retention and possible cardiac or renal dysfunction.

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The patient was admitted with a complaint of abdominal pain. Later the nurse observed the patient demonstrating dyspnea. This change in condition required an assessment called:

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Naxlex Comprehensive Predictor Exams

The profuse secretion of sweat associated with an elevated body temperature, certain disease conditions, physical exertion, exposure to heat and mental or emotional stress is termed:

Correct Answer is A

Explanation

The patient has been found to have edema of the lower extremities. The nurse is assessing whether or not it is pitting and to what degree. After pressing the skin against a bony prominence for 5 seconds, the nurse identifies 4+ pitting edema because the rebound time is:

Correct Answer is D

Explanation

Auscultation of the heart sounds will result in a lubb-dupp sound when using the bell and the diaphragm of the stethoscope. The lub part of the sound is caused by the:

A nurse is collecting data from a 70-year-old man who has coronary artery disease (CAD) and hypertension (HTN) Which of the following findings will the nurse report as "signs?" (select all that apply)

The term used to describe a disease where there has been a partial or complete disappearance of clinical and subjective characteristics of the disease is:

A nursing assessment is a process of collecting data to establish a database. The information contained in the database is the basis for:

The study of all factors involved in the development of the disease or the cause of the disease is termed:

When performing a physical examination of the patient, the nurse uses a technique that is particularly useful in identifying areas of tenderness. This technique is:

Febrile is an abnormal elevation of:

Short, discrete, interrupted crackling or bubbling adventitious breath sounds heard most commonly on inspiration is termed: