During an assessment of the patient's integument, the nurse notes a flat, nonpalpable change in skin colour that is smaller than 1 cm. How is this finding documented by the nurse?
a. Macule
b. Papule
c. Vesicle
d. Nodule
A
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A The finding is consistent with the definition of a macule.
B A papule is a palpable, circumscribed, solid elevation in skin, smaller than 1 cm.
C A vesicle is a circumscribed elevation of skin filled with serous fluid, smaller than 1 cm.
D A nodule is an elevated solid mass, deeper and firmer than a papule, 1 to 2 cm in diameter.
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The nurse is obtaining data on an older adult client. What finding may indicate to the nurse the early symptom of heart failure?
A) Decreased urinary output B) Dyspnea on exertion C) Hypotension D) Tachycardia
The nurse is aware that the purpose of debriefing as outlined in the disaster plan for the health professionals who were involved in caring for the victims of a disaster a month ago is to:
a. analyze the effectiveness of the disaster plan. b. assess the efficiency of the service pro-vided by various agencies. c. modify the disaster plan. d. help allay post-traumatic stress disorders.
When preparing to care for a client with a family history of Paget's disease, it is most important for the nurse to include education in which area?
a. Avoidance of infections b. Exercise program c. Nutrition high in vitamin C d. Need for genetic testing
Which client is at greatest risk for the development of hyperkalemia?
A. 60-year-old man with heart failure using a salt substitute B. 60-year-old woman taking a thiazide diuretic for hypertension C. 40-year-old woman taking NSAIDs daily for rheumatoid arthritis D. 40-year-old man with type 2 diabetes taking an oral antidiabetic agent