Author Question: In preparing to conduct a physical examination on a client, the nurse plans to: 1. Perform ... (Read 34 times)

newyorker26 · **on:** Jul 23, 2018

In preparing to conduct a physical examination on a client, the nurse plans to:

1. Perform painful procedures at the end of the exam
2. Take long, detailed notes of all the findings during the exam
3. Keep the TV or radio on to distract the client throughout the exam
4. Assess the dominant side of the client's body only in the examination

Question 2

The client has an enlarged thyroid gland and is currently admitted to a medical nursing unit. Which of the following is accurate regarding the procedure for a thyroid assessment for this cli-ent?

1. Deep palpation should be used anterior and posterior.
2. Swallowing sips of water causes the isthmus of the thyroid gland to rise.
3. The posterior approach is used when the fingers are placed over the trachea.
4. The diaphragm of the stethoscope is best used for the auscultation of bruits.

sylvia · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: 1
In organizing a physical examination, the nurse should perform painful procedures near the end of the examination. The nurse should record quick notes during the examination to avoid keeping the client waiting. Observations can be completed at the end of the examination. The TV or radio should be turned off so as to not distract the client throughout the examination, and to provide an environment conducive to auscultation.
Both sides of the body should be assessed for comparison to determine symmetry. A degree of asymmetry is normal in the dominant versus nondominant arm.

Answer to Question 2

ANS: 2
During assessment of the thyroid gland, the client holds a cup of water and takes a sip to swal-low once instructed by the nurse. As the client swallows, the isthmus of the thyroid gland rises. The nurse should feel if it is enlarged. Normally the thyroid gland is small, smooth, and free of nodules. Light, gentle palpation is needed to feel any abnormalities.
For the posterior approach, both of the nurse's hands are placed around the neck, with two fin-gers of each hand on the sides of the trachea just beneath the cricoid cartilage.
The bell of the stethoscope is best for auscultation of bruits.