Nokea
A client is scheduled for an ileostomy. Which of the following interventions would be most helpful in preparing the client psychologically for the surgery?
- A. Include family members in preoperative teaching sessions.
- B. Encourage the client to ask questions about managing an ileostomy.
- C. Provide a brief, thorough explanation of all preoperative and postoperative procedures.
- D. Invite a member of the ostomy association to visit the client.
Correct Answer: B
Rationale: Encouraging the client to ask questions about managing an ileostomy promotes active engagement, addresses specific concerns, and supports psychological preparation. Including family, providing explanations, or arranging visits are helpful but less directly empower the client's coping process. CN: Psychosocial adaptation; CL: Synthesize
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The client with Hodgkin's disease develops B symptoms. These manifestations indicate which of the following?
- A. The client has a low-grade fever (temperature lower than 100°F [37.8°C]).
- B. The client has a weight loss of 5% or less of body weight.
- C. The client has night sweats.
- D. The client probably has not progressed to an advanced stage.
Correct Answer: C
Rationale: B symptoms in Hodgkin's disease include fever (>38°C), night sweats, and weight loss (>10% of body weight). Night sweats are a hallmark symptom indicating possible disease progression.
The nurse provides discharge instructions to a client diagnosed with bacterial conjunctivitis. Which of the following statements by the client would indicate effective understanding? Select all that apply.
- A. It is okay for me to wear my contact lenses during this infection.'
- B. Swimming during this infection is allowed.'
- C. I should not share my towels with family members.'
- D. To prevent injury, I should not rub my eye.'
- E. I should wash my hands frequently.'
Correct Answer: C,D,E
Rationale: Bacterial conjunctivitis requires avoiding contact lenses and swimming to prevent worsening or spreading infection, not sharing towels, avoiding eye rubbing to prevent corneal damage, and frequent hand washing to reduce transmission.
The nurse is planning to teach incisional care to a client before discharge. Which of the following instructions should be included?
- A. Do not touch your incision before your next appointment.
- B. Clean your incision three times a day with hydrogen peroxide and water.
- C. Do not be concerned about uneven lumps under the suture lines.
- D. If the staples don't come out by themselves before your next appointment, the surgeon will remove them.
Correct Answer: C
Rationale: Uneven lumps under suture lines are normal due to tissue healing and swelling. This reassurance prevents unnecessary worry. Hydrogen peroxide is not routinely recommended, and staples are typically removed by the surgeon.
A postmenopausal client is scheduled for a bone-density scan. To plan for the client's test, what should the nurse communicate to the client?
- A. Request that the client remove all metal objects on the day of the scan.
- B. Instruct the client to consume foods and beverages with a high content of calcium for 2 days before the test.
- C. Inform the client that she will need to ingest 600 mg of calcium gluconate by mouth for 2 weeks before the test.
- D. Tell the client that she should report any significant pain to her physician at least 2 days before the test.
Correct Answer: A
Rationale: Metal objects can interfere with the bone-density scan, so they must be removed. Calcium intake or pain reporting is not required for the test.
A client with acute respiratory distress syndrome (ARDS) has fine crackles at lung bases and the respirations are shallow at a rate of 28 breaths/minute. The client is restless and anxious. In addition to monitoring the arterial blood gas results, the nurse should do which of the following? Select all that apply.
- A. Monitor serum creatinine and blood urea nitrogen levels.
- B. Administer a sedative.
- C. A. Administer humidified oxygen.
- D. Auscultate the lungs.
Correct Answer: C,D
Rationale: Administering humidified oxygen (C) improves oxygenation in ARDS. Auscultating lungs (D) monitors crackles and ventilation. Creatinine/BUN monitoring is unrelated to acute respiratory status. Sedatives may depress respiration.