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
An audible thud without pain is a normal finding when percussing the costovertebral angle (CVA) in a healthy individual. This indicates that there is no inflammation or infection in the kidneys or surrounding tissues.
Choice B rationale
Sharp, severe pain upon percussion of the CVA is a classic sign of pyelonephritis. This pain is due to the inflammation and infection of the kidney, which causes tenderness in the area.
Choice C rationale
Rebound tenderness is typically associated with peritoneal irritation, such as in cases of appendicitis or peritonitis. It is not a common finding in pyelonephritis.
Choice D rationale
Rigidity and firmness are more indicative of muscle spasms or guarding, which can occur in conditions like peritonitis or severe abdominal pain, but not specifically in pyelonephritis.
Correct Answer is A
Explanation
Choice A rationale: Administering oxygen via nasal cannula is the first priority in this scenario. The client’s oxygen saturation is 88% on room air, which indicates hypoxemia. Providing supplemental oxygen will help improve the client’s oxygenation and alleviate symptoms of shortness of breath. Ensuring adequate oxygenation is crucial to prevent further respiratory distress and potential complications.
Choice B rationale: Obtaining a sputum culture is important to identify the causative organism of the client’s respiratory infection and guide appropriate antibiotic therapy. However, this action is not the immediate priority. Addressing the client’s hypoxemia by administering oxygen takes precedence to stabilize the client’s condition.
Choice C rationale: Administering an antipyretic medication can help reduce the client’s fever and improve comfort. However, this is not the immediate priority. The client’s hypoxemia and respiratory distress need to be addressed first by administering oxygen.
Choice D rationale: Encouraging the client to increase fluid intake is important for maintaining hydration and helping to thin respiratory secretions. However, this action is not the immediate priority. The client’s hypoxemia and respiratory distress need to be addressed first by administering oxygen