Which of the following should the nurse do before conducting a physical examination of a client? (Select all that apply)

Obtain and check needed equipment.

Turn on relaxing music of the client's choice.

Identify ways to ensure client privacy.

Wash hands.

Dim the lighting to promote comfort.

Answer and Explanation

Correct Answer : A,C,D

Choice a reason:
Obtaining and checking the needed equipment is essential before conducting a physical examination. This ensures that all necessary tools are functional and readily available, which facilitates a smooth and efficient assessment process. It also minimizes interruptions that could cause discomfort or anxiety for the client.
Choice b reason:
While turning on relaxing music of the client's choice may create a calming environment, it is not a standard procedure before a physical examination. Music preferences are subjective, and what is relaxing for one person may be distracting for another. Additionally, music could interfere with the ability to hear heart, lung, or bowel sounds during auscultation.
Choice c reason:
Identifying ways to ensure client privacy is a fundamental nursing responsibility. It respects the client's dignity and promotes a sense of safety and comfort. Privacy can be ensured by closing curtains, securing the area, and making sure the examination is conducted in a private setting.
Choice d reason:
Washing hands is a critical step before any physical examination. It is a primary measure for infection control, protecting both the nurse and the client from potential transmission of microorganisms.
Choice e reason:
Dimming the lighting to promote comfort is not typically recommended before a physical examination. Adequate lighting is crucial for the inspection phase of the examination, allowing the nurse to observe the client's general appearance, skin color, and other physical characteristics accurately.

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Correct Answer is C

Explanation

Choice A reason:
Acute pain is typically sudden in onset and is usually the result of a specific injury or illness. It is characterized by its sharp quality and tends to last for a short duration, generally not longer than six months. Since the patient's knee pain has persisted for eleven months, it does not fall under the category of acute pain.
Choice B reason:
Intermittent pain is pain that comes and goes at intervals. Although the patient's pain could be intermittent, the classification based on duration would not be described as intermittent. This term refers more to the pattern of the pain rather than its chronicity or cause.
Choice C reason:
Chronic pain is defined as pain that persists for longer than six months, often continuing even after the injury or illness that caused it has healed. The patient's bilateral knee pain has been present for eleven months, which exceeds the six-month threshold, thus categorizing it as chronic pain.
Choice D reason:
Idiopathic pain refers to pain that arises without a clear cause. It is not categorized based on the duration of the pain but rather on the absence of an identifiable underlying reason. Since the patient's pain has a specific duration, it is not appropriate to classify it as idiopathic without further information regarding its cause.

A. The eye cannot look to the outside. B. Myopia. C. Ptosis will be evident and no pupillary constriction. D. Normal eye movement.

Correct Answer is C

Explanation

Choice a reason:
The inability of the eye to look outward, known as lateral rectus palsy, is associated with cranial nerve VI, the abducens nerve, not the oculomotor nerve. The oculomotor nerve does not control the lateral rectus muscle which governs this movement.

Choice b reason:
Myopia, or nearsightedness, is a refractive error of the eye where distant objects appear blurry while close objects can be seen clearly. It is not related to oculomotor nerve paralysis, which affects eye movements and pupil response, not the shape of the eyeball or the refractive properties of the lens.

Choice c reason:
Ptosis, or drooping of the upper eyelid, and an absence of pupillary constriction are classic signs of oculomotor nerve paralysis. The oculomotor nerve controls most of the eye's movements, including lifting the eyelid via the levator palpebrae superioris muscle and constricting the pupil through the circular muscles of the iris.

Choice d reason:
Normal eye movement would not be expected in a patient with oculomotor nerve paralysis. This nerve controls the majority of the eye's movements, so paralysis would lead to abnormal eye movement, such as the inability to move the eye upward, downward, or inward.

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Which of the following should the nurse do before conducting a physical examination of a client? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

The nurse read the patient's health history and noted cranial nerve III oculomotor paralysis. Which of the following would the nurse expect?

Correct Answer is C

Explanation

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