Author Question: The nurse assesses the superior ventral and dorsal left lateral aspect of the body, and correctly ... (Read 64 times)

HudsonKB16 · **on:** Jul 22, 2018

The nurse assesses the superior ventral and dorsal left lateral aspect of the body, and correctly documents which of the following?

1. Active bowel sounds in all four quadrants
2. Client complains of headache located near the forehead.
3. Breath sounds diminished in the left with rales noted.
4. Lower abdomen tender to the touch and slightly distended

Question 2

The nurse working a college health center receives a call from an 18-year-old freshman who says she feels like she is getting sick, and noticed petechiae on her feet an hour ago, and now it has spread to her mid-thigh.

The nurse instructs the student to: 1. Go to the Emergency Department immediately.
2. Take two acetaminophens and drink plenty of fluids.
3. Elevate the legs and apply ice.
4. Call her family physician and make an appointment for this week.

sarah_brady415 · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

3
Rationale: The superior aspect would be above the waist. Ventral and dorsal surfaces include the front and back of the body. Superior left lateral would be the left chest, or breath sounds. The stomach is on the superior plane, but is generally not assessed by the nurse dorsally. The headache is in the cranial cavity. Abdominal problems would be described as inferior, ventral, and either right or left upper or lower quadrants.

Answer to Question 2

1
Rationale: The symptoms reported by this client are highly suspicious of meningococcal meningitis, which is a disease that begins with a feeling of generally not feeling well and a petechial rash on the most distal extremities (hands and feet), and spreads rapidly. This condition is often fatal, and early intervention is essential to survival, so the client should be told to go to the Emergency Department immediately, and the Emergency Department should be notified the client is on her way in, and of her symptoms, so they can isolate her to prevent contamination of others.