What is an example of a pertinent negative finding during a physical examination?
- A. Chest pain that does not radiate to the arm
- B. Elevated blood pressure in a patient with hypertension
- C. Pupils that are equal and react to light and accommodation
- D. Clear and full lung sounds in a patient with chronic bronchitis
Correct Answer: A
Rationale: The correct answer is 'Chest pain that does not radiate to the arm.' Pertinent negatives highlight clinically significant absences of expected findings, helping rule out certain conditions like cardiac ischemia.
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Derek has recently converted his outdoor garage to a gym. He has been exercising frequently in his new gym due to the convenience, even in the extreme heat. He has started taking salt tablets. The physician thinks his current symptoms may be owing to hypernatremia. His physician recognizes these as:
- A. Cardiac arrhythmias,palpitations and sinus arrest.
- B. Weakness,dizziness,abdominal distention, nausea ,vomiting, and diarrhea.
- C. Weight gain,irritability,muscle twitching and decreased myocardial contractility.
- D. Muscle cramps,malaise,constipation,rhabdomyolysis and pupillary constriction.
Correct Answer: B
Rationale: The correct answer is Weakness, dizziness, abdominal distention, nausea, vomiting, and diarrhea (B). Hypernatremia occurs when there is an excess of sodium in the body, often due to dehydration or excessive salt intake. Symptoms include gastrointestinal disturbances, neurological symptoms like confusion and dizziness, and muscle weakness.
Which factor may promote anxiety for a client undergoing a surgical procedure?
- A. Decreased mobility
- B. Unfamiliar environment
- C. Unclear expectations
- D. Decreased alertness
Correct Answer: C
Rationale: The correct answer is C because unclear expectations can increase anxiety in clients facing surgery.
The health care provider has ordered IV morphine q2-4hr PRN for a patient following major abdominal surgery. When should the nurse plan to administer the morphine?
- A. Before all planned painful activities
- B. Every 2 to 4 hours during the first 48 hours
- C. Every 4 hours as the patient requests the medication
- D. After assessing the nature and intensity of the patient's pain
Correct Answer: D
Rationale: Pain assessment guides the timing and dosage of analgesics, ensuring effective pain management.
Build-up of bile salts may cause the systemic symptom of
- A. Hypotension.
- B. Pruritis (itching).
- C. Ecchymosis (bruising).
- D. Urticaria (hives).
Correct Answer: B
Rationale: Bile salt accumulation can lead to itching.
Which measures or drugs may be effective in controlling pain in the physiologic pain process stage of transduction (select all that apply)?
- A. Distraction
- B. Corticosteroids
- C. Epidural opioids
- D. Local anesthetics
Correct Answer: D
Rationale: The correct answers are D, Local anesthetics, distraction, and NSAIDs target the transduction stage.