Nokea
A 32-year-old woman recently diagnosed with Hodgkin's disease is admitted to the hospital outpatient clinic for staging by undergoing a bone marrow aspiration and biopsy. To obtain more information about the client's nutrition status the nurse should review the results of which of the following tests?
- A. Red blood cell count.
- B. Direct and indirect bilirubin levels.
- C. Reticulocyte count.
- D. Albumin level.
Correct Answer: D
Rationale: Albumin levels reflect nutritional status, as low levels indicate protein malnutrition, common in cancer patients. The other tests assess hematologic or liver function.
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The nurse caring for a child diagnosed with a patent ductus arteriosus should base planning on which fact concerning this disorder?
- A. It involves an opening between the two atria.
- B. It produces abnormalities in the atrial septum.
- C. It involves an opening between the two ventricles.
- D. It involves an artery that connects the aorta and the pulmonary artery.
Correct Answer: D
Rationale: Patent ductus arteriosus is described as an artery that connects the aorta and the pulmonary artery during fetal life. It generally closes spontaneously within a few hours to several days after birth. It allows abnormal blood flow from the high-pressure aorta to the low-pressure pulmonary artery, resulting in a left-to-right shunt. The remaining options are not characteristics of this cardiac defect.
A 9-year-old child is newly diagnosed with type 1 diabetes mellitus. The nurse is planning for home care with the child and the family and determines that which is an age-appropriate activity for health maintenance?
- A. Administering insulin drawn up by an adult
- B. Self-administering insulin with adult supervision
- C. Making independent decisions with regard to sliding-scale coverage of insulin
- D. Having an adult assist in the self-administration of insulin and glucose monitoring
Correct Answer: B
Rationale: School-age children have the cognitive and motor skills to draw up and administer insulin with adult supervision. Developmentally, they do not yet have the maturity to make independent decisions such as about sliding-scale coverage without adult validation. Options requiring adult to manage insulin administration and glucose monitoring suppress the maximum level of independence appropriate to the level of this child.
The nurse is caring for a client with a new colostomy. Which statement by the client indicates a need for further teaching?
- A. I should change the pouch every 5 to 7 days.'
- B. I can eat high-fiber foods to promote regular bowel movements.'
- C. I should avoid gas-forming foods like beans.'
- D. I need to drink 2 to 3 liters of fluid daily.'
Correct Answer: B
Rationale: High-fiber foods may cause blockages in a new colostomy. The client should start with a low-residue diet and gradually introduce fiber, indicating a need for further teaching.
A client with a history of chronic obstructive pulmonary disease (COPD) is prescribed fluticasone (Flovent). The nurse should instruct the client to:
- A. Rinse the mouth after inhalation.
- B. Use the inhaler as needed for shortness of breath.
- C. Take the inhaler with meals.
- D. Stop the inhaler if dizziness occurs.
Correct Answer: A
Rationale: Rinsing the mouth after fluticasone inhalation prevents oral thrush.
The nurse is assessing a client with suspected appendicitis. Which of the following findings supports this diagnosis?
- A. Pain at McBurney's point.
- B. Left lower quadrant pain.
- C. Decreased bowel sounds.
- D. Absence of fever.
Correct Answer: A
Rationale: Pain at McBurney's point (right lower quadrant) is a hallmark sign of appendicitis due to localized peritoneal irritation.