During the assessment of an older adult client's skin, the nurse notes small areas of hyperpigmentation on the dorsal aspect of the client's hands
The client states, "I've been getting more of these big freckles as I get older." Which term will the nurse use when documenting this finding in the medical record?
1. Senile lentigines.
2. Cherry angiomas.
3. Cutaneous tags.
4. Cutaneous horns.
Correct Answer: 1
The nurse is describing "liver spots" or areas of hyperpigmentation over the backs of the client's hands. Cherry angiomas are small, bright red spots common in older adults. Cutaneous tags may appear on the neck and upper chest. Cutaneous horns may occur on any part of the face.
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During assessment of a patient who is new to the critical care unit, the nurse observes perianal ecchymosis. The nurse suspects the patient has a
a. pelvic fracture. c. rectal laceration. b. bladder trauma. d. spleen laceration.
An infant has been diagnosed with failure to thrive (FTT) classified according to the pathophysiology of inadequate caloric intake. The nurse understands that the reason for the FTT is most likely related to what?
a. Cow's milk allergy b. Congenital heart disease c. Metabolic storage disease d. Incorrect formula preparation
A student nurse is working with a preceptor who appears abrupt and disinterested in precepting students. What action by the student is most appropriate?
a. Notify the instructor. b. Talk with the nurse to see what is wrong. c. Identify this as lateral violence. d. Nothing, he was having a bad day.
Which type of nutrition should the nurse include when planning care for a newborn who is diagnosed with galactosemia?
1. Goat's milk formula 2. Breast milk 3. Cow's milk–based formula 4. Lactose-free formula