Health assessment exam 4 Prepu (PT 2)

The nurse is assessing the neurologic system of an adult client. To test the client's use of memory to learn new information, the nurse should ask the client

Correct response: "Can you repeat brown, chair, textbook, tomato?" Explanation: Remote memory (past dates and historical accounts) may be impaired in cerebral cortex disorders.

A nurse is providing care to a 1-year-old female client. The parents ask the nurse about having female circumcision performed, saying that it is a part of their culture. What is the best response of the nurse?

Correct response: "Female circumcision is against the law in the United States." Explanation: Female circumcision, also known as female genitalia mutilation (FMG/C), is against the law in the United States and other countries; if performed here or parents travel abroad for the procedure they could be arrested and receive a jail sentence of 5 years or more. There is no benefit to FMG/C; however, there are many risks, including death. FMG/C continues to be performed in western, eastern, and northeastern parts of Africa and areas of the Middle East and Asia.

A client asks the nurse when a colonoscopy is recommended. Which advise by the nurse provides the most appropriate advice?

Correct response: "A flexible sigmoidoscopy should be done every five years starting at age 50" Explanation: Beginning at age 50, men and women should have a fecal occult blood test or a flexible sigmoidoscopy every five (5) years. Both of these are preferred over either one separately. All screening should start at age 50, not 60 years of age. Health care providers should adhere to the screening guidelines not make their own decisions.

What instruction should a nurse give a client when having trouble eliciting a response from testing the patellar deep tendon reflex?

Correct response: "Place your hands together, lock your fingers, and squeeze." Explanation: If deep tendon reflexes are diminished or absent, a reinforcement technique may be used to enhance the client's response. When testing the leg reflexes, have the client interlock the hands and squeeze. Closing the eyes and tightening the thigh muscles of the opposite leg will not aid in eliciting a reflex response. Clenching the teeth is a reinforcement technique that is helpful to elicit a response when assessing the arm reflexes.

A 57-year-old woman calls the clinic reporting painful intercourse followed by spotting. She tells the nurse that she hasn't had a period in 2 years. What should the nurse tell her?

Correct response: "These findings are common in postmenopausal women." Explanation: Menopause usually occurs between 48 and 51 years of age, although variability is wide. The ovaries stop producing estrogen and progesterone, causing the uterus to droop and the cervix to shrink. Associated findings include thinning of the genital hair, thinning and loss of elasticity of vaginal mucosa, and diminished vaginal secretions as a result of lower estrogen levels. The fat pads atrophy and the labia and clitoris decrease in size.

A nurse performs a two-point discrimination test on a client who was in an automobile accident to assess for the presence of a lesion of the sensory cortex. The nurse touches the client's body at various sites on his right side with the two points of EKG calipers. Which finding, stated as the distance between the two points at which the client can no longer distinguish the two points as separate, would indicate an abnormal response on the part of the client?

Correct response: 20 mm on the dorsal hand Explanation: Normal two-point discrimination findings on the right side include the following: 6 mm at the fingertips, 15 mm on the dorsal hand, 45 mm on the chest, and 40 mm on the upper arm. Thus, the finding of 20 mm on the dorsal hand is abnormal and may indicate a lesion of the sensory cortex.

Which client would the nurse identify as being at highest risk for the development of testicular cancer?

Correct response: A 25-year-old man with a history of cryptorchidism. Explanation: Testicular cancer is most common in between 15 and 34 years of age and is the leading cause of cancer deaths in men between 25 to 34 years of age. Its incidence is higher in Caucasians and men with a history of cryptorchidism. Other clients at risk are those with a family history of the disease, those who are HIV-positive or have developed AIDS, and those who already have had cancer in one testicle.

An adult female client is about to undergo a physical assessment conducted by a nurse practitioner at the gynecology clinic. The nurse is preparing the room for a complete head-to-toe examination, along with a genitalia and rectal assessment and screening through the Papanicolaou test. What should the nurse do next before proceeding?

Correct response: Ask for the client's permission to perform the assessment Explanation: Following completion of the health history previously described, the nurse explains the process for the physical examination, from head to toe and including auscultation of the heart and lung sounds, auscultation and palpation of the abdomen, and screening for neuromuscular problems. Because some assessments may be uncomfortable (e.g., breast, gynecological), the nurse asks the client for permission to perform them. Once the nurse has the client's permission, the nurse would ask the client if the client prefers to have a third person in the room or, if appropriate, a same-gender nurse. The nurse would take care to preserve modesty; however, this would not be the immediate next step. Alterations to the order of the examination would be unlikely unless the client had an emergency concern.

The nurse instructs the client to lean forward so she can inspect the breasts. What might this position reveal that is not visible in another position?

Correct response: Asymmetry of the breast or nipple Explanation: This position may reveal an asymmetry of the breast or nipple not otherwise visible.

During a prostate examination, the prostate is noted to have a rubbery or boggy glandular consistency. The nurse recognizes that this is what?

Correct response: BPH Explanation: BPH is a common finding in men older than 60 years of age and is exhibited by a rubbery or boggy glandular consistency. Cancer, prostatic calculi and chronic fibrosis are noted to be hard during the prostate exam.

A nurse is preparing to assess a client's cerebellar function. What aspect of neurological function should the nurse address?

Correct response: Balance Explanation: Balance and coordination are functions of the pyramidal and extrapyramidal tracts of the motor and cerebellar systems. Remote memory and mental status exam provide information about the client's cognitive ability. Testing for sensation would address issues with specific cranial nerves or problems involving the parietal lobe.

A 24-year-old travel agent comes to your clinic complaining of pain and swelling in her vulvar area. She states that 2 days before she could feel a small tender spot on the left side of her vagina but now it is larger and extremely tender. Her last period was 1 year ago; she is sexually active. She uses the Depo-Provera shot for contraception. She denies any nausea, vomiting, constipation, diarrhea, pain with urination, or fever.

Correct response: Bartholin's gland infection Explanation: Bartholin's gland infections cause a red-hot tender abscess at the duct opening to the Bartholin's glands. Gonococci, Chlamydia, and other organisms often cause them. Size is variable and if chronic, can present as a nontender cyst.

When assessing a client during the physical examination of the genitalia, the nurse palpates the scrotal contents. Which finding should the nurse recognize as an indication that an infection or cysts are present?

Correct response: Beaded or thickened cord Explanation: A beaded or thickened cord indicates infection or cysts. The presence of palpable and tortuous veins indicates varicocele. A smooth, nontender, and rope-like cord is a normal finding. In most men, one testicle hangs lower than the other; in 65% of males, the left hangs lower than the right.

Which of the following is inconsistent with a digital rectal examination?

Correct response: Can reveal a hydrocele Explanation: The DRE is recommended as part of the regular health checkup for every man older than 40 years of age. It is a screening for cancer of the prostate gland. It enables the examiner to assess the size, shape, and consistency of the prostate gland.

After teaching a group of student about structural abnormalities of the male reproductive system, the instructor determines that the teaching was successful when the students identify which of the following as an example?

Correct response: Cryptorchidism Explanation: Structural abnormalities include cryptorchidism, torsion of the spermatic cord, phimosis, paraphimosis, hydrocele, spermatocele, and varicocele. Erectile dysfunction and priapism are erection disorders. Prostatitis is an infectious disorder.

A client is concerned about his risk for developing testicular cancer. Which of the following should the nurse mention as a risk factor for this type of cancer?

Correct response: Cryptorchidism Explanation: Cryptorchidism increases the risk of testicular cancer. Being uncircumcised increases the risk for cancer of the glans penis, but not testicular cancer. A sedentary lifestyle increases the risk for colorectal cancer, not testicular cancer. Smoking is not associated with an increased risk for testicular cancer.

A 48-year-old woman has presented to her primary care provider concerned about the recent detection of a mass in her left breast. The mass is tender on palpation, and the nurse notes that it is round, well-delineated, and mobile. There is no evidence of nipple retraction on inspection. Which of the following breast masses would the nurse first suspect?

Correct response: Cyst Explanation: Cysts are typically tender, mobile, and well-delineated and usually occur in women age 30-50. Retraction signs are normally absent.

A young adult woman presents at the clinic stating, "I think I have a yeast infection." The nurse notes this is the third time in the past 90 days that this client has been to the clinic for yeast infections. What should the nurse consider as a comorbidity to be discussed with this client?

Correct response: Diabetes Explanation: A client with recurring yeast infections should be evaluated for diabetes and HIV. None of the other options are associated with recurrent yeast infections.

When assessing a client's coordination by asking the client to touch the nose with the finger, what should a nurse keep in mind about a client's movements?

Correct response: Dominant side will be more coordinated than nondominant side Explanation: A nurse should ask a client to touch the tip of the nose with the right index finger, then the left. This should be repeated three times. Movements should be smooth and performed without hesitation. The nurse should keep in mind that the client's dominant side will be more coordinated than the nondominant side. The elderly client may be slower but the movement should still be smooth and accurate. Movements should not become less accurate as the client repeats the maneuver.

Which of the following recommendations would a nurse advocate during infancy and childhood to help reduce potential adult complications such as orchitis?

Correct response: Ensure immunizations against infectious diseases such as mumps. Explanation: Nurses should advocate for infant and childhood immunizations against infectious diseases such as mumps to reduce potential adult complications such as orchitis. Minimizing activities involving heavy lifting or urging limited intake of caffeine have no effect on the potential for adult complications such as orchitis. The nurse should encourage foods that are low in fat and starch; however, this also would have no effect on the potential for orchitis.

A nurse examines the anal area of a client and observes the presence of a varicose vein. How should the nurse document this finding?

Correct response: External hemorrhoid Explanation: Hemorrhoids are usually painless papules caused by varicose veins, either external or internal. If the hemorrhoid becomes thrombosed is can become painful and swollen. A perianal abscess is a cavity of pus caused by infection in the skin around the anal opening. An anal fissure is a split in the tissue of the anal canal caused by trauma. An anorectal fistula is a small, round opening in the skin that surrounds the anal opening. It suggests an inflammatory tract from the anus or rectum out to the skin.

A female client has been diagnosed with menorrhagia. What information should the nurse provide the client concerning menses flow?

Correct response: Flow may include clots. Explanation: Menorrhagia is a term used to describe a heavy menstrual flow. Unlike the normal dark red menstrual discharge, excessive flow tends to be bright red and may include "clots" (not true fibrin clots). Because menorrhagia is a heavy menstrual flow, the nurse should not describe the flow as light. The flow may or may not be accompanied by cramping.

A client presents to the health care clinic with reports of yellow stool. Which condition should the nurse most suspect?

Correct response: Increased fat content Explanation: Yellow stool suggests increased fat content or steatorrhea. Black stools may indicate gastrointestinal bleeding in this client who has not been receiving iron supplements or taking Pepto-Bismol. Clay-colored stool results from the lack of bile pigment. Cancer of the rectum or colon may be indicated by blood detected in the stool.

A teenage male client comes to the ED with severe left testicular pain and vomiting. Elevation of his left testicle does not lessen the pain. What could these symptoms indicate for this client?

Correct response: Left testicular torsion Explanation: Signs of testicular torsion include acute pain that is not relieved by elevating the testicle, nausea, and vomiting. Epididymitis usually presents in adult males. The client presents with unilateral pain to one testis, but fever, dysuria, and possibly urethral discharge. Hydrocele is the accumulation of fluid around a testicle. This condition usually presents as a non-tender and soft testicle. Often testicular cancer presents lump or swelling, which may or may not be painful. The condition could also present with pain in the abdomen or low back.

The client presents at the clinic with a complaint of weakness that is made worse with repeated effort and improves with rest. The client's complaint is consistent with what health problem?

Correct response: Myasthenia gravis Explanation: Weakness made worse with repeated effort and improved with rest suggests myasthenia gravis.

What is the purpose of the rectovaginal examination?

Correct response: Palpate the vaginal wall for evidence of a rectocele Explanation: This examination is used to evaluate any rectocele (bulging of rectum into the vagina) or rectovaginal fistula (opening between the vagina and the rectum allowing feces to enter the vagina). A cystocele is a protrusion of the bladder into the anterior vaginal canal and beyond. Uterine prolapse involves the descent of the uterus into the vagina and beyond. A urethral caruncle develops from ectropion of the posterior urethral wall.

During a comprehensive assessment, the nurse identifies signs of possible dementia. What is the best action of the nurse?

Correct response: Perform the SLUMS examination to assess cognitive function. Explanation: The nurse would further investigate the client's symptom of forgetfulness using COLDSPA and tools such as the SLUMS (St. Louis University Mental Status) examination to identify cognitive deficits. The nurse may ask the family, if they are present during the interview, if there has been a change in mental status to validate what the client is stating, but that is not the best action. After completing the entire assessment, the nurse may recommend laboratory work and a computed tomography of the head to rule out other conditions.

When performing the physical assessment of a client, the nurse notes the presence of a small cyst that contains hair, which is located midline in the sacrococcygeal area and has a palpable sinus tract. How should the nurse document this finding?

Correct response: Pilonidal cyst Explanation: A pilonidal cyst is a congenital disorder characterized by a small dimple or cyst/sinus that contains hair. External hemorrhoids are usually painless papules below the anorectal junction, caused by varicose veins. Anal fissures are splits in the tissue of the anal canal caused by trauma. Perianal abscess is a cavity of pus, caused by infection in the skin around the anal opening.

A 35-year-old woman visits her family doctor and reports mood swings, swelling of her breasts, acne, bloating, and weight gain every month, starting about 2 weeks prior to her period. What disorder is this client describing?

Correct response: Premenstrual syndrome (PMS) Explanation: Premenstrual syndrome is the emotional and physical symptoms that occur at the same time before menses each month.

A client comes to the Emergency Department complaining of sudden sharp testicular pain. Further examination reveals torsion of the spermatic cord. Which of the following would the nurse expect to do next?

Correct response: Prepare the client for surgery. Explanation: For the client with torsion, immediate surgery is necessary to prevent atrophy of the spermatic cord and preserve fertility. Analgesics would be given preoperatively. Postoperatively, a scrotal support is applied and dressings are inspected for drainage. Circumcision is done to relieve phimosis or paraphimosis.

The nurse is reviewing the functions of the ovaries, uterus, clitoris and vagina with a group of nursing students. Based on this information, what would be the best response by a nursing student about the function of the ovaries?

Correct response: Produces female gametes (ova) and secretes female sex hormones. Explanation: The ovaries functions to produce female gametes or ova and secretes female sex hormones. The uterus functions to receive the fertilized ovum and provides housing and nourishment for a fetus. The vagina functions to receive sperm provide an exit for menstrual flow and serve as the birth canal. The clitoris is a small erectile structure that responds to sexual stimulation.

Mr. Jackson, 50 years old, has had discomfort between his scrotum and anus. He also has had some fevers and dysuria. Rectal examination is halted by tenderness anteriorly, but no frank mass is palpable. What is the most likely diagnosis?

Correct response: Prostatitis Explanation: This examination, associated with a history of dysuria, frequency, and incomplete voiding, should lead to a suspicion of acute prostatitis. Prostate cancer, colon cancer, and polyps should not ordinarily cause systemic symptoms such as fever.

When assessing level of consciousness, what should a nurse do if a client does not respond appropriately to a verbal stimulus?

Correct response: Repeat the command louder and in a lower tone of voice Explanation: When assessing the level of consciousness, the nurse should begin with the least noxious stimulus which is verbal, and then proceed to tactile, to painful. The client may just need the command to be given louder or in a lower tone of voice.

An adult male client comes to the clinic complaining of awakening at night to void and voiding more than once in a 2-hour time period. The client has a history of bladder irritation. What would be an appropriate nursing diagnosis for this client?

Correct response: Risk for urge incontinence Explanation: The most appropriate nursing diagnosis is risk for urge incontinence related to irritation of bladder. Risk factors for this diagnosis are voiding more than once every 2 hours and awakening at night. urinary retention would be a concern if the client was unable to urinate, or urinated frequently with only small amounts of urine voided. Frequent urination at night is not a risk for infection. The symptoms noted are not related to ineffective sexuality pattern.

Upon inspection and palpation of the scrotum, the nurse discovers a mass. The nurse asks the client to lie down, and the bulge remains. On auscultation, the nurse finds bowel sounds. The nurse should document this finding as which type of hernia?

Correct response: Scrotal Explanation: The nurse should document this finding as scrotal hernia if the bulge remains when the client lies down and bowel sounds can be auscultated over it. If the mass in the scrotum cannot be pushed into the abdomen, it could be an incarcerated hernia. A hernia is strangulated if the blood supply is cut off. A bulge or mass on the front of the thigh in the femoral canal area is a femoral hernia.

When palpating the internal female genitalia, the nurse separates the client's labia and asks her to strain down to assess which of the following?

Correct response: Support of vaginal walls Explanation: The nurse assesses for any bulging of the vaginal walls by separating the labia and asking the client to bear down. This specific assessment does not help identify lesions, edema, or inflammation.

A 57-year-old woman has come to the OB/GYN clinic for her annual physical. She tells the nurse that it has been 14 months since her last period. What should the nurse further assess?

Correct response: The client is postmenopausal. Explanation: Perimenopause is the period extending from the first signs of menopause, usually hot flashes, vaginal dryness, and irregular menses. Postmenopause is the period beginning from about 1 year after menses cease and beyond. The scenario does not describe a client who has developed cervical cancer, or a client who is premenopausa

An adult male client comes to the clinic for his annual physical examination. During the nursing assessment, the nurse asks, "Do you have any current or chronic illnesses such as diabetes, hypertension, respiratory problems, or cardiovascular disease?" Why does the nurse ask this question?

Correct response: To assess risk for erectile dysfunction Explanation: Men with diabetes, hypertension, neurologic respiratory problems, or cardiovascular disease are at increased risk for erectile dysfunction. The other options are not related to health related issues.

On visualization of the penis he is circumcised; there are no lesions or discharge from the meatus. Scrotal skin is tense and red. Palpation of the left testicle causes severe pain and causes the client to cry. His prostate examination is unremarkable. His cremasteric reflex on the left is absent but normal on the right. Catheterization is necessary to get a urine sample, the analysis of which is unremarkable. The boy is admitted to the emergency department of a nearby hospital for further work

Correct response: Torsion of the spermatic cord Explanation: Torsion is caused by twisting of the testicle on its spermatic cord and blood vessels, leading to severe pain. The scrotum becomes red and tense. Torsion is usually seen in adolescents and is a true surgical emergency. If not quickly surgically repaired, the testicle's function is lost and it has to be removed. Presence of a cremasteric reflex is reassuring, but in this case a thorough evaluation must take place as soon as possible.

A client is clenching the jaw closed to avoid taking a prescribed oral medication. The nurse can use this observation to confirm the client is demonstrating motor function of which cranial nerve?

Correct response: Trigeminal Explanation: The motor function of the trigeminal nerve includes the temporal and masseter muscles, both used with jaw clenching. The motor function of the facial nerve controls facial expression and closing the eyes and the mouth. The motor function of the glossopharyngeal nerve controls the pharynx. The motor function of the vagus nerve controls the palate, pharynx, and larynx.

The nurse observes an orange peel appearance, or peau d'orange, of the areolae of a client's breasts. The nurse should explain to the client that this is most likely due to

Correct response: blocked lymphatic drainage. Explanation: A pigskin-like or orange-peel (peau d'orange) appearance results from edema, which is seen in metastatic breast disease. The edema is caused by blocked lymphatic drainage.

While assessing an adult male client, the nurse detects pimple-like lesions on the client's glans. The nurse explains the need for a referral to the client. The nurse determines that the client has understood the instructions when the client says he may have

Correct response: bowel sounds at the bulge. Explanation: Bowel sounds auscultated over the mass indicate the presence of bowel and thus a scrotal hernia.

The nurse is assessing an adult male client when the nurse observes gynecomastia in the client. The nurse should ask the client if he is taking any medications for

Correct response: depression. (liver disorder) Explanation: Gynecomastia, a smooth, firm, movable disc of glandular tissue, may be seen in one breast in males during puberty, usually temporary. However, it may also be seen in hormonal imbalances, drug abuse, cirrhosis, leukemia, and thyrotoxicosis. Irregularly shaped, hard nodules occur in breast cancer.

The Cowper glands

Correct response: empty into the urethra. Explanation: The Cowper's (or bulbourethral) glands are mucus-producing, pea-sized organs located posterior to the prostate gland. These glands surround and empty into the urethra.

The rectum is lined with folds of mucosa, and each fold contains a network of arteries, veins, and visceral nerves. When these veins undergo chronic pressure, the result may be

Correct response: hemorrhoids. Explanation: The anorectal junction is not palpable, but may be visualized during internal examination. The folds contain a network of arteries, veins, and visceral nerves. If the veins in these folds undergo chronic pressure, they may become engorged with blood, forming hemorrhoids.

A male client has a distinctive bulge in the right inguinal area when standing. What should the nurse suspect is occurring with this client?

Correct response: hernia Explanation: A noticeable bulge in the inguinal area when standing strongly suggests that the male client has a hernia. Hypospadias is a displacement of the urinary meatus. Testicular torsion would be suspected if the scrotum were edematous and painful. An epidermoid cyst is a painless mobile mass in the scrotum. It would not be observed while the client is standing.

The inguinal canal in a male client is located

Correct response: just above and parallel to the inguinal ligament. Explanation: The internal inguinal ring is the internal opening of the inguinal canal. It is located 1 to 2 cm above the midpoint of the inguinal ligament and cannot be palpated.

The prostate gland consists of two lobes separated by the median sulcus. rectovesical pouch. valves of Houston. anorectal junction.

Correct response: median sulcus. Explanation: The prostate gland consists of two lobes separated by a shallow groove called the median sulcus.

A client reports resting and skipping exercise during a holiday from work. Which part of the nervous system is controlling this client's behavior?

Correct response: parasympathetic Explanation: The parasympathetic nervous system conserves energy and resources during times of rest and relaxation. The central nervous system consists of the brain and spinal cord. The sympathetic nervous system mobilizes organs and their functions during times of stress and arousal. The cranial nerves emerge from within the cranial vault through skull foramina and canals to structures in the head and neck.

A client is in the emergency room with what could be a lumbar injury. Which deep tendon reflex would be most appropriate to test?

Correct response: patellar

The client exhibits auditory hallucinations while the nurse is performing a mental health assessment. The nurse should document this as an alteration in which component of the mental health assessment?

Correct response: perception Explanation: Perception is the sensory awareness of objects in the environment and their interrelationships (external stimuli). Perception also refers to internal stimuli, such as dreams or hallucinations. The thought process involves the logic, coherence, and relevance of a client's thought as it leads to selected goals or how people think.

The nurse notes that a client has a small red papule that is clean, smooth, and glistening on the penis. What should the nurse suspect is causing this lesion?

Correct response: primary syphilis Explanation: Manifestations of primary syphilis include a small red papule that is clean, smooth, and glistening. Manifestations of gonorrhea include a penile discharge and not skin changes. Manifestations of genital herpes include small scattered or grouped vesicles on the penis. Manifestations of genital warts include single or multiple papules or plaques of variable shapes.

A nurse observes that the mucosa of the rectum and the rectal wall of a female client protrudes out through the anal opening. It appears as a red, doughnut-like mass with radiating folds. How should the nurse document this condition of the rectum?

Correct response: prolapse Explanation: The nurse should document this condition as rectal prolapse. Soft structures like nodules that may be present in the muscular anal ring are called rectal polyps. They are rather common and occur in varying size and number. If cancer metastasizes to the peritoneal cavity, it may be felt as a nodular, hard, shelf-like structure called rectal shelf that protrudes onto the anterior surface of the rectum in the area of the rectouterine pouch in women. Rectal cancer may feel like a firm nodule, an ulcerated nodule with rolled edges, or, as it grows, a large, irregularly shaped, fixed, hard nodule. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 26: Ass

A male client tells the nurse that he has received a diagnosis of hernia. He visits the clinic because he is nauseated and has extreme tenderness on the left side. The nurse should

Correct response: refer the client to an emergency room. Explanation: A hernia is strangulated when its blood supply is cut off. The client typically complains of extreme tenderness and nausea. If you suspect that the client has a strangulated hernia, refer the client immediately to the physician and prepare him for surgery.

Sensations of temperature, pain, and crude and light touch are carried by way of the

Correct response: spinothalamic tract. Explanation: Sensations of pain, temperature, and crude and light touch travel by way of the spinothalamic tract.

When examining the eye, the nurse notices difficulty with downward motion. The nurse understands that which cranial nerve is involved?

Correct response: trochlear Explanation: The trochlear nerve controls inferomedial eye movement.

The nurse is asked to prepare material on erectile dysfunction to be placed in a urologist's office waiting room. What should the nurse include as reasons for the development of this disorder? Select all that apply. Diabetes Depression Alcohol use Myocardial infarction Antihypertensive medications

Diabetes Depression Alcohol use Antihypertensive medications Erectile dysfunction occurs frequently in adult males and may be attributed to diabetes, depression, alcohol use, and antihypertensive medications. Myocardial infarction is not associated with the development of erectile dysfunction.

During morning report the nurse learns that an assigned client needs assistance with ambulation because of spastic hemiparesis. What should the nurse expect when ambulating with this client?

Half of one side of the body drags and a flex of the arm close to the body (the side that's dragging)

The nurse notes that an older client speaks rapidly and uses words that make no sense or communicate any clear meaning. When documenting this finding, the nurse should use which term to describe this client's speech?

Wernicke's aphasia

After using the SLUMS tool to test a client's mental status, the nurse calculates a score of 12. The nurse should make

mild MCi A referral to the primary health care provider for further evaluation