A client recovering from lung cancer is advised to resume lower-intensity activities of daily living. Which of the following activities should the nurse recommend to the client?
- A. Washing dishes
- B. Mowing the lawn
- C. Carrying heavy groceries
- D. Gardening
Correct Answer: A
Rationale: The correct answer is A: Washing dishes. Washing dishes is a lower-intensity activity that is suitable for a client recovering from lung cancer. This activity does not require significant physical exertion and allows the client to engage in a manageable task while still following the provider's instructions for lower-intensity activities. Choices B, C, and D involve more physical effort and may not be appropriate for a client recovering from lung cancer, as they require more energy and physical strain, which could hinder the recovery process.
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A client with diabetes mellitus and a new prescription for insulin is being discharged. Which of the following actions should the nurse plan to complete first?
- A. Provide the client with printed information on insulin self-administration.
- B. Obtain printed information on insulin self-administration.
- C. Make a copy of the medication reconciliation form for the client.
- D. Determine whether the client can afford the insulin administration supplies.
Correct Answer: B
Rationale: Obtaining printed information on insulin self-administration should be the nurse's first priority. This action ensures that the client has the necessary knowledge to safely self-administer insulin at home. Providing the client with printed information (Choice A) is essential to empower the client with the required knowledge before considering additional resources. Making a copy of the medication reconciliation form for the client (Choice C) is important for documentation purposes but not as urgent as ensuring the client's understanding of insulin administration. Determining the client's ability to afford insulin administration supplies (Choice D) is crucial but should follow after ensuring the client is equipped with the necessary information for safe self-administration.
When should discharge planning for a patient admitted to the neurological unit with a diagnosis of stroke begin?
- A. At the time of admission
- B. The day before the patient is to be discharged
- C. When outpatient therapy is no longer needed
- D. As soon as the patient's discharge destination is known
Correct Answer: A
Rationale: Discharge planning for a patient admitted to the neurological unit with a stroke diagnosis should begin at the time of admission. Initiating discharge planning early allows for a comprehensive assessment of the patient's needs, enables better coordination of care, and ensures a smooth transition from the hospital to the next level of care. Option B is incorrect because waiting until the day before discharge does not provide enough time for adequate planning. Option C is incorrect because waiting until outpatient therapy is no longer needed delays the planning process. Option D is incorrect because waiting until the discharge destination is known may result in rushed planning and inadequate preparation for the patient's needs.
A nurse is preparing to insert an IV catheter for an adult client. Which of the following actions should the nurse take?
- A. Choose the most distal site on the selected extremity
- B. Apply a cool compress to the selected extremity before insertion of the IV catheter
- C. Stroke the selected extremity before insertion of the IV catheter
- D. Place the tourniquet above the proposed insertion site
Correct Answer: C
Rationale: When preparing to insert an IV catheter, stroking the extremity before insertion helps to visualize veins, making it easier to locate a suitable vein for catheter insertion. Choosing the most distal site on the extremity is correct because veins more distal are preferred for IV catheter insertion. Applying a cool compress to the extremity before insertion is unnecessary and not a standard practice. Placing the tourniquet below the proposed insertion site is incorrect; the tourniquet should be placed above the proposed insertion site to help engorge the veins for easier visualization and access.
When evaluating care of an immobilized patient, which action will the nurse take?
- A. Focus on whether the interdisciplinary team is satisfied with the care.
- B. Compare the patient's actual outcomes with the outcomes in the care plan.
- C. Involve primarily the patient's family and health care team to determine goal achievement.
- D. Use objective data solely in determining whether interventions have been successful.
Correct Answer: B
Rationale: When evaluating the care of an immobilized patient, the nurse should focus on assessing outcomes and response to nursing care. By comparing the patient's actual outcomes with the outcomes identified during planning, the nurse can determine the effectiveness of the interventions implemented. This process allows for a comprehensive evaluation of the care provided. Choice A is incorrect because the satisfaction of the interdisciplinary team does not directly reflect the patient's outcomes and response to care. Choice C is incorrect as it mainly focuses on the involvement of the patient's family and healthcare team, which may not provide a holistic evaluation of the patient's care. Choice D is incorrect as relying solely on objective data may lead to overlooking important subjective aspects of the patient's response and outcomes, which are also crucial in evaluating care effectively.
When assessing a patient's feet, the nurse notices that the toenails are thick and separated from the nail bed. What does the nurse most likely suspect is the cause of this condition?
- A. Fungi
- B. Friction
- C. Nail polish
- D. Nail polish remover
Correct Answer: A
Rationale: The nurse would most likely suspect fungi as the cause of thickened and separated toenails. Fungal infections can lead to changes in the nail structure, causing them to thicken and separate from the nail bed. Friction, nail polish, and nail polish remover are less likely to cause these specific nail changes. Friction typically leads to calluses or blisters, while nail polish and nail polish remover do not commonly result in thickened and separated toenails.
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