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A 56-year-old female with lung cancer is undergoing a thoracentesis. Which of the following outcomes of the procedure are expected? Select all that apply.
- A. Treatment of recurrent malignant effusion.
- B. Diagnosis of underlying disease.
- C. Palliation of symptoms.
- D. Relief of acute respiratory distress.
- E. Removal of the cancer cells.
Correct Answer: B,C,D
Rationale: Thoracentesis diagnoses underlying disease (B), palliates symptoms like dyspnea (C), and relieves acute respiratory distress (D). It does not treat recurrent effusions or remove cancer cells.
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On the fourth day after surgery, a client has a postoperative wound infection. Which of the following should the nurse assess? Select all that apply.
- A. Total white blood count (WBC) 10,000/mm³.
- B. Redness and swelling beyond the incision line.
- C. Temperature of 102°F (38.9°C).
- D. Client reports of pain at the incision site.
- E. Warmth at the incision site.
Correct Answer: B,C,D,E
Rationale: Signs of wound infection include redness/swelling (B), fever (C), pain (D), and warmth (E). A WBC of 10,000/mm³ (A) is normal and not indicative of infection.
A male client underwent a spinal fusion yesterday. Which of the following nursing assessments should alert the nurse to the development of a possible complication?
- A. Lateral rotation of the head and neck.
- B. Clear yellowish fluid on the dressing.
- C. No need to stand in order to void.
- D. Nonproductive cough.
Correct Answer: B
Rationale: Clear yellowish fluid suggests a cerebrospinal fluid leak, a serious complication requiring immediate attention.
A health care provider has just inserted nasal packing for a client with epistaxis. The client is taking ramipril (Altace) for hypertension. What should the nurse instruct the client to do?
- A. Use 81 mg of aspirin daily for relief of discomfort.
- B. Omit the next dose of ramipril (Altace).
- C. Remove the packing if there is difficulty swallowing.
- D. Avoid rigorous aerobic exercise.
Correct Answer: D
Rationale: Avoiding rigorous aerobic exercise prevents increased blood pressure, which could worsen epistaxis. Aspirin increases bleeding risk. Omitting ramipril is not indicated without physician guidance. Removing packing is unsafe and should be done by a healthcare provider.
Following a gastrectomy, the nurse should position the client in which of the following positions?
- A. Prone.
- B. Supine.
- C. Right or left Sims.
- D. Fowler's.
Correct Answer: D
Rationale: Fowler's position (semi-upright) promotes lung expansion, reduces aspiration risk, and aids drainage post-gastrectomy. The other positions are less optimal for postoperative recovery.
A 62-year-old female is taking long-acting morphine 120 mg every 12 hours for pain from metastatic breast cancer. She can have 20 mg of immediate-release morphine every 3 to 4 hours as needed for breakthrough pain. The physician should be notified if the client uses more than how many breakthrough doses of morphine in 24 hours?
- A. Seven.
- B. Four.
- C. Two.
- D. One.
Correct Answer: B
Rationale: More than four breakthrough doses (80 mg additional morphine) in 24 hours indicates inadequate baseline pain control, requiring physician notification to adjust the long-acting morphine dose.