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.
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 B
Explanation
Choice A rationale
Diabetes mellitus can lead to various complications affecting the nails, such as yellowing or thickening due to poor circulation and infections, but it is not typically associated with brittle, concave (spoon-shaped) nails.
Choice B rationale
Iron deficiency anemia is often associated with brittle, spoon-shaped (concave) nails, known as koilonychia. This condition affects the oxygen-carrying capacity of the blood, leading to changes in the nail beds.
Choice C rationale
Coronary heart disease can lead to changes in the nails due to poor circulation, but it is not commonly associated with brittle, concave nails. Other nail changes might include clubbing or cyanosis.
Choice D rationale
Recent candida infection can affect the nails, causing them to become discolored, thickened, or separated from the nail bed, but it does not typically cause the nails to become brittle and concave.
Correct Answer is B
Explanation
Choice A rationale
A translucent, pearly gray, and mobile tympanic membrane is a normal finding and does not align with the symptoms of itching, pain, and discharge.
Choice B rationale
A red, edematous ear canal with no visualization of the tympanic membrane is indicative of otitis externa, commonly known as “swimmer’s ear.”. This condition is characterized by inflammation and infection of the external ear canal, often following swimming.
Choice C rationale
A thickened and bulging tympanic membrane is more indicative of otitis media with effusion or acute otitis media, where fluid or pus collects behind the eardrum.
Choice D rationale
A retracted and non-mobile tympanic membrane is typically associated with eustachian tube dysfunction or negative middle ear pressure, not with the symptoms described.