The nurse is assessing the client's sensory input. Which assessments should be included? Select all that apply

A) Sensitivity to touch
B) Sensitivity of sharp to dull stimulation
C) Ability to maintain balance
D) Pupil sensitivity to light changes
E) Ability to recall information


Ans: A, B, C
Feedback:
Examination of sensory function allows the nurse to verify the accuracy and quality of sensory input. Testing should include ability to balance, sensitivity to sharp versus dull stimulation, and sensitivity to light touch of the extremities.

Nursing

You might also like to view...

The charge nurse is beginning rounds after attending morning report. Which clients should the nurse be concerned for developing a never event? (Select all that apply.)

1. Client with hemophilia receiving Factor replacement transfusions 2. Client recovering from a stroke with foul-smelling urine in a catheter drainage bag 3. Client recovering from total knee replacement surgery complaining of right calf pain 4. Client with heart failure being fitted for a C-pap mask for use at home for sleep apnea 5. Client with renal failure with a newly diagnosed stage III pressure ulcer on the left heel

Nursing

The nurse who is taking a sexual history from a client should do which of the following?

1. Ask questions that the client can answer with "yes" or "no." 2. Ask mostly open-ended questions. 3. Have the client fill out a comprehensive questionnaire and review it after the client leaves. 4. Try not to make much direct eye contact.

Nursing

The nurse takes into consideration that according to Kohlberg's theory, the preschool child (3 to 6 years of age) has a moral need for:

a. Rules b. Tolerating frustration c. Focusing on gender differences d. Recognizing that mother is separate from self

Nursing

Which statement provides the strongest support for the hypothesis that psychological dependence is related to activity in the brain?

A. research suggests that amphetamines, heroin, and alcohol are very different pharmacologically, but similar in the way people and animals react to them B. research suggests that dopamine related processes in the nucleus accumbens underlie the reinforcing effects of many drugs C. research suggests that some individuals are more susceptible than others to drug taking behavior D. research suggests that cravings often lead drug dependent individuals to relapse

Nursing