Nokea
A client has just had an inguinal herniorrhaphy. Which of the following instructions would be most appropriate to include in his discharge plan?
- A. Turning, coughing, and deep breathing every 2 hours.
- B. Applying an ice bag to the scrotum.
- C. Raising the scrotum with a support.
- D. Remaining in a high Fowler's position while resting.
Correct Answer: B
Rationale: Applying an ice bag to the scrotum reduces swelling and discomfort post-inguinal herniorrhaphy. Turning and breathing are general postoperative care, scrotal support is not specified, and high Fowler's position is not necessary. CN: Physiological adaptation; CL: Synthesize
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A client returned from surgery with a debrided open tibial fracture and has a three-way drainage system. The nurse should first:
- A. Review the results of culture and sensitivity testing of the wound.
- B. Look for the presence of a pressure dressing over the wound.
- C. Determine if the client has increased pain from exposed nerve endings.
- D. Check the client's blood pressure for hypotension resulting from additional vessel bleeding.
Correct Answer: D
Rationale: Checking blood pressure for hypotension is the priority, as bleeding from an open fracture can be life-threatening.
Which of the following findings should the nurse report to the client's physician for a client with unstable type 1 diabetes mellitus? Select all that apply.
- A. Systolic blood pressure, 145 mm Hg.
- B. Diastolic blood pressure, 87 mm Hg.
- C. High-density lipoprotein (HDL), 30 mg/dL.
- D. Glycosylated hemoglobin (HbA1c), 10.2%.
- E. Triglycerides, 425 mg/dL.
- F. Urine ketones, negative.
Correct Answer: A,C,D,E
Rationale: Systolic hypertension (145 mm Hg), low HDL (30 mg/dL), high HbA1c (10.2%), and elevated triglycerides (425 mg/dL) indicate poor control and cardiovascular risk, requiring reporting. Normal diastolic pressure and negative ketones are not concerning.
The nurse is caring for a client reporting an abrupt onset of severe pain associated with metastatic cancer. Which prescription should the nurse plan to administer?
- A. fentanyl via transdermal patch
- B. pregabalin
- C. ketorolac
- D. hydromorphone
Correct Answer: D
Rationale: Hydromorphone is appropriate for rapid relief of severe, acute cancer pain due to its fast-acting opioid properties.
A 68-year-old client with colon cancer experiences an increase in his feelings of anxiety and depression and has suicidal ideation. He appears to be in great distress. The nurse realizes that he is at which stage in his disease?
- A. Initiation of definitive treatment.
- B. End of his first course of treatment.
- C. End stage of his disease.
- D. Recurrence of the disease.
Correct Answer: C
Rationale: Increased anxiety, depression, and suicidal ideation suggest the client is in the end stage of colon cancer, facing mortality and existential distress.
Which of the following is the most common initial manifestation of acute renal failure?
- A. Dysuria.
- B. Anuria.
- C. Hematuria.
- D. Oliguria.
Correct Answer: D
Rationale: Oliguria, reduced urine output, is the most common initial sign of acute renal failure due to impaired kidney filtration.