Nokea
The nurse is preparing to discharge a client with an ileal conduit done for treatment of bladder cancer. Which statement by the client indicates the need for further instruction?
- A. I look forward to returning to my local health club to swim.
- B. The local ostomy support group meets on Wednesday morning at 10 a.m.
- C. My stoma should be cleaned daily with soap and water.
- D. During the day I will wear a leg bag to collect my urine.
Correct Answer: A
Rationale: Swimming (A) may pose infection risks or appliance issues with an ileal conduit, requiring further instruction. Support groups (B), stoma care (C), and leg bags (D) are appropriate.
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The nurse is teaching a group of student nurses about radiation therapy. Which would the nurse include in the teaching? Select all that apply.
- A. The dose is always more than the exposure.
- B. Clients receiving brachytherapy are radioactive.
- C. Clients receiving teletherapy are not radioactive.
- D. Beta particles are the most common type of radiation therapy.
- E. Bodily waste from a client receiving brachytherapy does not require special handling.
Correct Answer: B,C
Rationale: Brachytherapy clients are radioactive (B) due to internal sources, while teletherapy clients are not (C). Dose vs. exposure (A) is incorrect, beta particles (D) are less common, and bodily waste (E) requires precautions.
The nurse is assessing a client with Addison's disease. The nurse expects to note which of the following?
- A. craving of salty foods
- B. weight gain
- C. craving of sweet foods
- D. hyperactivity
Correct Answer: A
Rationale: Addison's disease causes sodium loss, leading to salt cravings (A). Weight loss (not gain, B), no sweet cravings (C), and fatigue (not hyperactivity, D) are typical.
The nurse is caring for a client with diabetes whose HgbA1C level is 6.9. The client asks the nurse what this means. Which response by the nurse is appropriate?
- A. Your level is within target range and indicates good glycemic control.
- B. Your level is too high, and you will need to increase your medications.
- C. Your level is too low, and you will need to decrease your medications.
- D. Your health care provider may want to place you on an insulin pump.
Correct Answer: A
Rationale: HgbA1C of 6.9 is within the target range (<7) for diabetes, indicating good glycemic control.
The nurse is caring for a client with hypoparathyroidism. The nurse understands that this client is at risk for which problem?
- A. hypercalcemia
- B. hypermagnesemia
- C. decreased phosphorus levels
- D. low parathyroid hormone levels
Correct Answer: D
Rationale: Hypoparathyroidism is defined by low parathyroid hormone levels (D), leading to hypocalcemia and hyperphosphatemia, not the other options.
A client in the emergency department is complaining of abdominal pain after an episode of nausea and vomiting. Which statement by the client to the nurse necessitates prompt notification of the health care provider?
- A. I started hurting when I got up this morning to go to work.
- B. My grandmother had to have her appendix out many years ago.
- C. I haven't eaten anything because I've been so nauseated and throwing up.
- D. The pain is worse when I cough or move but feels better when I bend my right hip.
Correct Answer: D
Rationale: Pain worsened by movement and relieved by flexing the right hip suggests appendicitis (positive psoas sign), requiring urgent provider notification.