You have received a report and are providing skin care for the following patients. Which patient do you want to assess first?

A 58-year-old patient with uncontrolled diabetes mellitus type two and intact skin.

A 48-year-old patient with poor nutrition, warmth and edema to the coccyx.

An 82-year-old patient with a surgical incision and approximated wound edges.

A 69 year old patient with a colostomy and blanchable erythema to the sacrum.

Answer and Explanation

The Correct Answer is B

A. 58-year-old patient with uncontrolled diabetes mellitus type 2 and intact skin: While diabetes increases the risk of delayed wound healing and infection, intact skin is not an immediate concern.

B. 48-year-old patient with poor nutrition, warmth, and edema to the coccyx: Warmth and edema at a pressure site may indicate the beginning of a pressure injury or infection (e.g., cellulitis). Poor nutrition further increases the risk of skin breakdown and impaired healing, making this patient the priority for assessment.

C. 82-year-old patient with a surgical incision and approximated wound edges: A well-approximated surgical incision suggests healing is progressing normally, making this patient lower priority.

D. 69-year-old patient with a colostomy and blanchable erythema to the sacrum: Blanchable erythema is an early sign of pressure injury, but it is less concerning than warmth and edema, which suggest possible infection or worsening tissue damage.

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Correct Answer is C

Explanation

A. Security and Privacy: While security and privacy are critical in electronic health records (EHR), they do not directly relate to improving documentation efficiency. Security measures protect client data from unauthorized access but do not necessarily enhance the speed of documentation.

B. Gamification: Gamification involves using game-like elements (e.g., rewards, challenges) to engage users. While it may be useful in staff training, it does not directly facilitate documentation of critical changes in client conditions.

C. Data Analytics: Data analytics helps in tracking trends, identifying high-risk patients, and improving documentation efficiency. By setting up real-time alerts and decision-support tools, the system can assist nurses in capturing critical changes efficiently.

D. Copy and Paste: While copy-and-paste functionality can save time, it is often discouraged in healthcare documentation due to the risk of carrying forward outdated or inaccurate information.

A. "Patient with complaints of urinary incontinence." B. "Patient reports urinary retention." C. "Patient reports urinary frequency." D. "Patient has an enlarged prostate."

Correct Answer is B

Explanation

A. "Patient with complaints of urinary incontinence." The patient did not report involuntary leakage of urine, which defines incontinence.
B. "Patient reports urinary retention." Urinary retention refers to the inability to completely empty the bladder, which matches the patient's description.
C. "Patient reports urinary frequency." Urinary frequency means voiding frequently (e.g., every 1-2 hours), but the patient described difficulty emptying.
D. "Patient has an enlarged prostate." While an enlarged prostate (BPH) could cause retention, the nurse should not diagnose—only report symptoms.

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You have received a report and are providing skin care for the following patients. Which patient do you want to assess first?

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

During a health history interview, a client tells the nurse that they do not feel that they completely empty the bladder when they void. How would the nurse report this findings to the provider?

Correct Answer is B

Explanation

A client is having difficulty having a bowel movement laying on the bedpan. What is the physiologic reason for this problem?

The nurse is assessing the patient's output for the shift. What finding is most concerning?

The nurse is providing indwelling catheter care for a patient who is uncircumcised. What intervention will help prevent a catheter associated urinary tract infection?

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