Author Question: The student nurse is preparing to auscultate the client's lungs during the initial assessment. Which ... (Read 119 times)

charchew · **on:** Jun 25, 2018

The student nurse is preparing to auscultate the client's lungs during the initial assessment. Which student nurse statement to the nurse preceptor indicates the need for further education prior to conducting the assessment?

1. I should think about how loud the auscultated sound is, the tone of the sound, and how long it lasts.
2. I should leave the client's television on during the assessment to make the client feel relaxed and comfortable during the assessment.
3. I have to remember to keep the client warm during this part of the assessment.
4. I cannot listen through the client's gown.

Question 2

The hospitalized client has an indwelling urinary catheter. The nurse notes that the client had 230 milliliters (mL) of urine output during the previous 8-hour shift.

How many mL of urine is the client producing on average each hour?
_______ mL/hour.
Round to the nearest whole number.

tashiedavis420 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Correct Answer: 2
Auscultating body sounds requires a quiet environment in which the nurse can listen not just for the presence or absence of sounds, but also for the characteristics of each sound. External distractions such as radios, televisions, and loud equipment should be eliminated whenever possible. The student nurse should note the intensity, pitch, and duration of the auscultated sound. The student nurse should ensure that the client remains warm during this part of the assessment because shivering can impair the nurse's ability to hear the sound well. The nurse cannot listen through gowns or drapes. The student nurse should place the stethoscope firmly over the area to be auscultated.

Answer to Question 2

Correct Answer: 29 milliliters per hour
The client has produced 230 milliliters of urine over the last 8 hours. 230 divided by 8 is 28.75. When rounded to the nearest whole number, it is 29 milliliters per hour.