Nokea
A client is undergoing a diagnostic work-up for suspected testicular cancer. When obtaining the client’s history, the nurse checks for known risk factors for this type of cancer. Testicular cancer has been linked to:
- A. Testosterone therapy during childhood
- B. Sexually transmitted disease
- C. Early onset of puberty
- D. Cryptorchidism
Correct Answer: D
Rationale: The correct answer is D: Cryptorchidism. Cryptorchidism, or undescended testicle, is a known risk factor for testicular cancer as the undescended testicle is more prone to developing cancerous changes. This condition increases the risk of testicular cancer even if the testicle is surgically corrected later in life. Other choices like A (Testosterone therapy during childhood) and B (Sexually transmitted disease) are not linked to testicular cancer. Choice C (Early onset of puberty) is not a direct risk factor for testicular cancer.
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A nurse is collecting information from a client with dementia. The client’s daughter accompanies the client. Which of the following statements by the nurse would recognize the client’s value as an individual?
- A. “Can you tell me how long your father has been this way?”
- B. “Sarah, I have to go and read your father’s old charts before we talk.”
- C. “Mr. Koeppe, tell me what you do to take care of yourself.”
- D. “Mr. Koeppe, I know you can’t answer my questions, but it’s okay.”
Correct Answer: C
Rationale: The correct answer is C because it acknowledges the client's value as an individual by directly addressing them and asking about their own self-care practices, which respects their autonomy and personhood. Choice A focuses on the client's father rather than the client themselves. Choice B addresses the daughter, not the client, and implies a lack of prioritization of the client's needs. Choice D is dismissive and does not recognize the client's capacity to communicate, undermining their dignity.
Bacterial meningitis alters intracranial physiology, causing:
- A. Cerebral edema
- B. Raised intracranial pressure
- C. Increased permeability of the blood-barrier
- D. All of the above changes
Correct Answer: D
Rationale: The correct answer is D. Bacterial meningitis alters intracranial physiology by causing cerebral edema, raised intracranial pressure, and increased permeability of the blood-brain barrier. Cerebral edema is the accumulation of fluid in the brain tissue, leading to increased pressure. Raised intracranial pressure occurs due to the inflammation and swelling caused by the infection. Increased permeability of the blood-brain barrier allows substances to pass through that would normally be blocked, contributing to the inflammatory response. Therefore, all of these changes are interconnected and commonly observed in bacterial meningitis cases. Choices A, B, and C individually describe specific alterations seen in bacterial meningitis but do not encompass the full spectrum of changes that occur, making them incorrect options.
What is the causative agent in HIV/AIDS?
- A. trichomonas vaginalis
- B. Treponema pallidum
- C. Human, T-cell lymphotrophio virus
- D. Chlamydia tranchomatis
Correct Answer: C
Rationale: The correct answer is C: Human, T-cell lymphotrophic virus, as it is the causative agent for HIV/AIDS. This virus specifically targets and infects the body's T-cells, weakening the immune system. Trichomonas vaginalis, Treponema pallidum, and Chlamydia trachomatis are all different pathogens that do not cause HIV/AIDS. Trichomonas vaginalis is a protozoan parasite that causes trichomoniasis, Treponema pallidum causes syphilis, and Chlamydia trachomatis causes chlamydia. Therefore, the correct answer is C based on the specific viral agent responsible for HIV/AIDS.
The nurse is conducting a nursing history of a client with a respiratory rate of 30, audible wheezing, and nasal flaring. During the interview, the client denies problems with breathing. What action should the nurse take next?
- A. Clarify discrepancies of assessment data with the client.
- B. Validate client data with members of the health care team.
- C. Document all data collected in the nursing history and physical examination.
- D. Seek input from family members regarding the client’s breathing at home.
Correct Answer: A
Rationale: Step-by-step rationale:
1. The nurse should clarify discrepancies of assessment data with the client to ensure accurate information.
2. The client's denial of breathing problems conflicts with physical signs, indicating a potential lack of awareness or reluctance to disclose symptoms.
3. By clarifying with the client, the nurse can address any misunderstandings or encourage honest communication.
4. This approach promotes client-centered care and ensures a comprehensive understanding of the client's health status.
Summary:
- Choice A is correct as it addresses the need to clarify discrepancies with the client for accurate assessment.
- Choice B is incorrect as validation with the healthcare team may not provide insight into the client's perception.
- Choice C is incorrect as it does not address the need to resolve conflicting assessment data.
- Choice D is incorrect as family input may not provide accurate information if the client denies symptoms.
A client has squamous cell cancer of the right lung that has metastasized to the brain. In addition to chemotherapy for lung cancer, the physician prescribes lomustine (CeeNU), 100 mg/m2 as a single dose, to treat the brain metastasis. What are the major administration and excretion routes of lomustine?
- A. Oral administration and urinary
- B. I.V. administration and urinary excretion
- C. I.V administration and fecal excretion
- D. Oral administration and fecal excretion
Correct Answer: B
Rationale: The correct answer is B: I.V. administration and urinary excretion. Lomustine is typically administered intravenously, allowing for rapid systemic distribution. The drug is metabolized in the liver and excreted primarily through the kidneys, thus the urinary route. This choice is correct as lomustine's pharmacokinetics align with this pattern.
A: Oral administration and urinary - While some drugs are administered orally, lomustine is not typically given orally due to poor bioavailability.
C: I.V. administration and fecal excretion - Lomustine is not primarily excreted via the feces, making this choice incorrect.
D: Oral administration and fecal excretion - Lomustine is not primarily excreted via the feces, making this choice incorrect.