While obtaining a client’s health history related to smoking cigarettes, the nurse plans to determine the client’s smoking pack years.

What information should the nurse obtain for this calculation? Select all that apply.

Packs of cigarettes smoked per day.

Number of attempts to quit smoking.

Client’s current age.

Age when the client started smoking.

Number of years the client smoked.

Answer and Explanation

Correct Answer : A,D,E

Choice A rationale
Packs of cigarettes smoked per day is essential information for calculating smoking pack years.
Choice B rationale
The number of attempts to quit smoking is not required for calculating smoking pack years.
Choice C rationale
The client’s current age is not required for calculating smoking pack years.
Choice D rationale
The age when the client started smoking is necessary to determine the total number of years smoked.
Choice E rationale
The number of years the client smoked is essential for calculating smoking pack years.

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Correct Answer is D

Explanation

Choice A rationale
Paresthesia refers to abnormal sensations such as tingling or numbness, which is not indicated by the client’s ability to sense two points at specific distances.
Choice B rationale
A marginal decline in sensory function would be indicated by a significant increase in the distance required to sense two points, which is not the case here.
Choice C rationale
A rebound reaction to the needle points is not a recognized interpretation of the two-point discrimination test.
Choice D rationale
The client’s ability to sense two points at a distance of 3 mm on the fingertips and 10 mm on the palms is within the normal range for two-point discrimination.

A. A 75-year-old with a pneumothorax and a chest tube. B. A 54-year-old who is 5 feet (152.4 cm) tall and weighs 300 pounds (136.1 kg). C. A 2-year-old who is demonstrating diaphragmatic breathing. D. A 45-year-old long distance runner with a body mass index (BMI) of 18 kg/m².

Correct Answer is B

Explanation

Choice A rationale
A 75-year-old with a pneumothorax and a chest tube may have a displaced PMI due to the pneumothorax, but it is not necessarily difficult to locate. The chest tube may also cause some displacement, but it is not the primary factor affecting PMI location.
Choice B rationale
A 54-year-old who is 5 feet (152.4 cm) tall and weighs 300 pounds (136.1 kg) is likely to have difficulty locating the PMI due to the increased adipose tissue. Obesity can make it challenging to palpate the PMI as the excess tissue can obscure the heart’s apex.
Choice C rationale
A 2-year-old who is demonstrating diaphragmatic breathing may have a PMI that is slightly higher and more medial than in adults, but it is generally not difficult to locate.
Choice D rationale
A 45-year-old long-distance runner with a body mass index (BMI) of 18 kg/m² is likely to have a more prominent PMI due to a leaner body composition and a potentially enlarged heart from athletic conditioning.

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While obtaining a client’s health history related to smoking cigarettes, the nurse plans to determine the client’s smoking pack years. What information should the nurse obtain for this calculation? Select all that apply.

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Correct Answer is D

Explanation

The nurse should anticipate difficulty locating the point of maximal impulse (PMI) in which client?

Correct Answer is B

Explanation

While interviewing a newly admitted older female client, the nurse observes that the client ignores Questions asked by the nurse, and speaks loudly to her son who brought her to the hospital. Which action should the nurse implement first?

An adult client exhibits an allergic reaction to an insect bite. The nurse should observe the client’s skin for which finding?

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A client reports experiencing stomach pain and it is localized in the middle section of the abdomen below the xiphoid process. The nurse should describe the pain as occurring in which region of the abdomen?

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When evaluating a client’s rectal bleeding, which findings should the nurse document?

While obtaining a client’s health history related to smoking cigarettes, the nurse plans to determine the client’s smoking pack years.

What information should the nurse obtain for this calculation? Select all that apply.