Nokea
A 45-year-old single mother of three teenaged boys has metastatic breast cancer. Her parents live 750 miles away and have only been able to visit twice since her initial diagnosis 14 months ago. The progression of her disease has forced the client to consider high-dose chemotherapy. She is concerned about the children's welfare during the treatment. When assessing the client's present support systems, the nurse will be most concerned about the potential problems with:
- A. Denial as a primary coping mechanism.
- B. Support systems and coping strategies.
- C. Decision-making abilities.
- D. Transportation and money for the boys.
Correct Answer: B
Rationale: Limited support systems and coping strategies are a major concern, as the client's isolation and responsibility for her children may hinder her ability to manage treatment and emotional stress.
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A client who has had a lumbar laminectomy with a spinal fusion is sitting in a chair. In which position are his feet if he is complying with his postoperative instructions?
- A. On the floor with the feet flat.
- B. On a low footstool.
- C. In any comfortable position with legs uncrossed.
- D. On a high footstool so the feet are level with the chair seat.
Correct Answer: A
Rationale: Feet flat on the floor maintain neutral spine alignment, reducing strain on the surgical site.
A client has undergone a laparoscopic cholecystectomy. Which of the following instructions should the nurse include in the discharge teaching?
- A. Empty the bile bag daily.
- B. Report any bile-colored drainage from the incision.
- C. Resume normal activities immediately.
- D. Avoid pain medications.
Correct Answer: B
Rationale: Laparoscopic cholecystectomy does not involve a bile bag, so option A is incorrect. Patients should monitor for signs of complications, such as bile-colored drainage, which could indicate a bile leak, making option B correct. Resuming normal activities immediately (C) is unsafe due to recovery needs, and avoiding pain medications (D) is unnecessary as pain management is often required.
The nurse is assessing a client with macular degeneration. Identify the illustration that best depicts what clients with this disorder typically see
- A. degeneration-1.png
- B. degeneration-2.png
- C. degeneration-3.png
- D. degeneration-4.png
Correct Answer: C
Rationale: In macular degeneration the center vision is blackened out and only the outer visual fields are clear.
The emergency department (ED) nurse is caring for a client with acetaminophen toxicity. The nurse anticipates a prescription for which medication?
- A. acetylcysteine
- B. deferoxamine mesylate
- C. succimer
- D. flumazenil
Correct Answer: A
Rationale: Acetylcysteine is the antidote for acetaminophen toxicity, protecting the liver by restoring glutathione levels.
A client with colon cancer is having a barium enema. The nurse should instruct the client to take which of the following after the procedure is completed?
- A. Laxative.
- B. Anticholinergic.
- C. Antacid.
- D. Demulcent.
Correct Answer: A
Rationale: After a barium enema, a laxative is ordinarily prescribed. This is done to promote elimination of the barium. Retained barium predisposes the client to constipation and fecal impaction. Anticholinergic drugs decrease gastrointestinal motility. Antacids decrease gastric acid secretion. Demulcents soothe mucous membranes of the gastrointestinal tract and are used to treat diarrhea. CN: Reduction of risk potential; CL: Synthesize