The nurse in the clinic is preparing to perform a physical assessment on a client who arrived for a routine check-up. Before beginning the assessment, which four activities should the nurse carry out? (Select all that apply.)
Wash hands
Provide patient privacy
Obtain a provider healthcare order
Position the client comfortably on the sturdy examination table
Explain the procedure to the client
Correct Answer : A,B,D,E
A. Washing hands is a crucial step to prevent infection and maintain hygiene before any physical assessment.
B. Providing patient privacy is essential to ensure the client's comfort and confidentiality during the assessment.
C. While it’s important to follow the provider’s orders, a routine check-up typically does not require a new healthcare order, as the nurse can perform the assessment as part of standard care.
D. Positioning the client comfortably on the examination table is necessary to facilitate the assessment and ensure the client's comfort during the procedure.
E. Explaining the procedure to the client helps to alleviate anxiety, improve understanding, and foster cooperation during the assessment.
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Correct Answer is D
Explanation
A. Sensitivity to cold is more commonly associated with hypothyroidism, not hyperthyroidism.
B. Constipation is also more commonly associated with hypothyroidism; hyperthyroidism often causes increased bowel movements.
C. Weight gain is typically not seen in hyperthyroidism; clients often experience weight loss despite an increased appetite.
D. Irritability and nervousness are common manifestations of hyperthyroidism due to increased metabolism and sympathetic nervous system activity.
Correct Answer is D
Explanation
A. Providing a safe and comfortable environment and applying critical thinking involves both objective and subjective data collection, not just one type.
B. While family members can contribute to patient care, the professional responsibilities of providing a safe environment and critical thinking in assessments fall to trained healthcare providers.
C. This process encompasses both subjective and objective data, as critical thinking requires integrating multiple types of information.
D. The actions described are essential professional responsibilities of trained healthcare providers, who must ensure a safe environment, apply critical thinking, and identify patient cues effectively.