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A 56-year-old cancer survivor feels guilty at the 'I Can Cope' meetings. The nurse can help him manage his feelings of guilt by pointing out that:
- A. He is really angry at the terminally ill clients in the group.
- B. He is experiencing very volatile emotions.
- C. This is a spiritual response to his illness.
- D. This is a normal reaction when surviving a life-threatening experience.
Correct Answer: D
Rationale: Survivor guilt is a normal reaction for cancer survivors, especially in support groups, and acknowledging this helps the client process their emotions.
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A client who has been diagnosed with bladder cancer is scheduled for an ileal conduit. Preoperatively, the nurse reinforces the client's understanding of the surgical procedure by explaining that an ileal conduit:
- A. Is a temporary procedure that can be reversed later.
- B. Diverts urine into the sigmoid colon, where it is expelled through the rectum.
- C. Conveys urine from the ureters to a stoma opening on the abdomen.
- D. Creates an opening in the bladder that allows urine to drain into an external pouch.
Correct Answer: C
Rationale: An ileal conduit diverts urine from the ureters to an abdominal stoma, where it is collected in an external pouch, a permanent procedure for bladder cancer management.
The nurse is applying a prescribed 5% lidocaine patch to a client's lumbar back region. The nurse plans to remove this patch after how many hours following the application?
- A. 24 hours
- B. 72 hours
- C. 8 hours
- D. 12 hours
Correct Answer: D
Rationale: Lidocaine patches (5%) are typically applied for 12 hours and then removed for 12 hours to prevent skin irritation and systemic absorption, per standard guidelines.
The nurse's best explanation for why the severely neutropenic client is placed in reverse isolation is that reverse isolation helps prevent the spread of organisms:
- A. To the client from sources outside the client's environment.
- B. From the client to health care personnel, visitors, and other clients.
- C. By using special techniques to dispose of contaminated materials.
- D. By using special techniques to handle the client's linens and personal items.
Correct Answer: A
Rationale: Reverse isolation protects severely neutropenic clients by preventing the introduction of pathogens from external sources, such as staff, visitors, or equipment. It is not about preventing spread from the client or specific disposal/handling techniques.
The nurse is reviewing laboratory reports for a client who is taking allopurinol (Zyloprim). Which of the following indicate that the drug has had a therapeutic effect?
- A. Decreased urine alkaline phosphatase level.
- B. Increased urine calcium excretion.
- C. Increased serum calcium level.
- D. Decreased serum uric acid level.
Correct Answer: D
Rationale: Allopurinol reduces serum uric acid levels, indicating therapeutic effectiveness in preventing uric acid stone formation.
What is the nurse's priority when a client experiences a seizure?
- A. Restrain the client.
- B. Protect the airway.
- C. Administer oxygen.
- D. Record the duration.
Correct Answer: B
Rationale: Protecting the airway is the priority to ensure oxygenation during a seizure.