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A nurse is implementing interventions for a group of patient’s. Which actions are nursing interventions? (Select all that apply.)

During assessment of a client’s right knee, the nurse notes crepitation. What might this assessment finding indicate?

The patient asked the nurse, “My primary care provider informed me that I have Benign Prostatic Hypertrophy.  What does that mean?”  What is the nurse’s best response? 

The nurse notes the client has 3+ pitting edema that extends 8” above his ankles.  His skin has brown pigmentation noted over his shins.  Identify the suspected cause of these findings.

What is the first assessment technique that should be performed during a complete physical exam?

A 26-year-old female client in the emergency room presents with complaints of tenderness and pain over the left lower abdominal quadrant. Identify a probable cause for the pain.

Before going in for the morning head- to-toe assessment, the nurse viewed the client’s admission history. What additional data should the nurse look up to provide quality safe care?

How should the nurse document dry oral mucous membranes and dry tongue?

The client is not alert and does not respond to his name or vigorous shaking of his shoulder. What would the nurse do next to provoke a response?

The nurse uses a cotton swab to lightly touch the client’s forehead, cheeks, and chin. What component of the nervous system is the nurse assessing?