Nokea
A 29-year-old woman is concerned about her personal risk factors for malignant melanoma. She is upset because her 49-year-old sister was recently diagnosed with the disease. After gathering information about the client's history of sun exposure, the nurse's best response would be to explain that:
- A. Some melanomas have a familial component and she should seek medical advice.
- B. Her personal risk is low because most melanomas occur at age 60 or later.
- C. Her personal risk is low because melanoma does not have a familial component.
- D. She should not worry because she did not experience severe sunburn as a child.
Correct Answer: A
Rationale: Melanoma can have a familial component, and a family history increases personal risk. Seeking medical advice for screening and risk assessment is appropriate, especially given her sister's diagnosis.
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The nurse is precepting a newly hired nurse administering an intramuscular injection to an adult. Which action by the newly hired nurse requires follow-up?
- A. Prepares to administer the medication in the dorsogluteal.
- B. Prepares to insert the needle at a 90-degree angle.
- C. Uses isopropyl alcohol to clean the area prior to injection.
- D. Washes their hands before and after the procedure.
Correct Answer: A
Rationale: The dorsogluteal site is not recommended due to the risk of sciatic nerve injury.
The client has had hypertension for 20 years. The nurse should assess the client for?
- A. Renal insufficiency and failure.
- B. Valvular heart disease.
- C. Endocarditis.
- D. Peptic ulcer disease.
Correct Answer: A
Rationale: Long-standing hypertension damages kidneys, leading to renal insufficiency or failure, a common complication requiring assessment.
The nurse notes a client's preoperative hemoglobin is 9.8 g/dL. What is the priority nursing action?
- A. Administer iron supplements as ordered.
- B. Notify the surgeon of the result.
- C. Encourage a high-protein diet.
- D. Document the finding and continue preparations.
Correct Answer: B
Rationale: A hemoglobin of 9.8 g/dL indicates anemia, which increases surgical risks. Notifying the surgeon ensures evaluation and possible intervention before proceeding.
When teaching about prevention of infection to a client with a long-term venous catheter, the nurse can document that the client has understood discharge instructions when the client states which of the following?
- A. I will not remove the dressing until I return to the clinic next week.
- B. My husband or I will do the dressing changes three times per week, exactly the way you showed us.
- C. I will monitor my temperature once each weekday.
- D. I know it is very important to wash my hands after irrigating the catheter.
Correct Answer: B
Rationale: Regular dressing changes (three times per week) performed correctly indicate understanding of infection prevention for a long-term venous catheter.
Which of the following expected outcomes would be appropriate for a client with viral hepatitis? The client will:
- A. Demonstrate a decrease in fluid retention related to ascites.
- B. Verbalize the importance of reporting bleeding gums or bloody stools.
- C. Limit use of alcohol to two to three drinks per week.
- D. Restrict activity to within the home to prevent disease transmission.
Correct Answer: B
Rationale: Reporting bleeding (B) indicates awareness of complications like coagulopathy. Ascites (A) is more relevant to cirrhosis. Alcohol (C) should be avoided entirely. Restricting activity to home (D) is unnecessary for hepatitis B or C.