A 25-year-old client is about to undergo a unilateral orchie...

A 25-year-old client is about to undergo a unilateral orchiectomy for treatment of testicular cancer. The client says to the nurse, 'I'm so worried that my future spouse is going to call off our engagement.' What is the best response by the nurse?

A. Are you concerned about how the surgery will affect your sexuality?'
B. If you are concerned about infertility, you could always bank your sperm.'
C. The cancer is at an early stage. You are going to be fine.'
D. What have you and your future spouse discussed about your condition?'

Correct Answer: D

Rationale: Asking about discussions with the spouse (D) encourages the client to share concerns and clarifies the situation. Options A, B, and C assume specific fears or provide reassurance without exploration.

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The nurse reinforces education to the parent of a child who was diagnosed with attention-deficit hyperactivity disorder and received a prescription of methylphenidate. Which statement by the parent best demonstrates that teaching has been effective?

A. An additive-free, low-sugar diet will reduce my child's symptoms.'
B. I can now manage my child's condition on my own.'
C. My child should take the last daily dose of methylphenidate before 6:00 PM.'
D. Once the medication is started, I will not have to monitor my child anymore.'

Correct Answer: C

Rationale: Taking methylphenidate before 6:00 PM (C) prevents sleep disruption, indicating effective teaching. Diet changes (A), self-management (B), and no monitoring (D) are incorrect or incomplete.

Which interventions does the nurse perform to promote normal rest and sleep patterns for a critically ill client? Select all that apply.

A. Dimming the lights at night
B. Leaving the television on for diversion at night
C. Opening the window blinds/shades in the morning
D. Scheduling interventions and activities during the day when possible
E. Turning off equipment alarms in the client's room at night

Correct Answer: A, C, D

Rationale: Dimming lights (A), opening blinds in the morning (C), and scheduling activities during the day (D) promote circadian rhythms and rest. Leaving the TV on (B) may disrupt sleep, and turning off alarms (E) compromises safety.

The clinic nurse is reinforcing teaching to a client about the advance directive form that needs to be completed. Which statement indicates that the client understands the information?

A. I will give a copy of this to my daughter, who is listed as my health care proxy.'
B. I will need to get this approved by my doctor before it goes into effect.'
C. I will put this on my refrigerator so no one will give me cardiopulmonary resuscitation.'
D. You and my daughter can witness this for me.'

Correct Answer: A

Rationale: Giving a copy to the health care proxy (A) ensures the advance directive is communicated. Doctor approval (B), refrigerator posting (C), and nurse witnessing (D) are incorrect or unnecessary.

A nurse is reinforcing teaching to a client that breastfeeds who has been diagnosed with mastitis of the right breast. Which of the following instructions should be included? Select all that apply.

A. Cease breastfeeding from right breast
B. Increase oral fluid intake
C. Reduce frequency of feeds to every 8 hours in right breast
D. Take ibuprofen as needed for pain
E. Use a tight-fitting underwire bra 24 hours per day

Correct Answer: B, D

Rationale: Increased fluids (B) and ibuprofen (D) manage dehydration and pain. Ceasing breastfeeding (A) or reducing feeds (C) can worsen mastitis, and tight bras (E) may increase discomfort.

Laboratory reference ranges
INR (Therapeutic – atrial fibrillation)
2.0-3.0

The nurse has reinforced teaching for a client with atrial fibrillation who is receiving warfarin. Which of the following statements by the client would indicate a correct understanding of the teaching? Select all that apply.

A. Antibiotics can affect my INR value.'
B. I am going to eat more leafy green vegetables.'
C. I will take the medication at the same time every day.'
D. I understand that my INR value should be between 4 and 5.'
E. If I miss a dose of medication, I'll double my dose the next day.'

Correct Answer: A, C

Rationale: Antibiotics affecting INR (A) and consistent timing (C) are correct. More leafy greens (B) can lower INR, INR of 4-5 (D) is too high, and doubling doses (E) is dangerous.