Nokea
A client with a history of breast cancer is admitted with complaints of lymphedema. The nurse should give priority to:
- A. Providing compression therapy
- B. Administering pain medication
- C. Monitoring blood pressure
- D. Administering chemotherapy
Correct Answer: A
Rationale: Compression therapy reduces swelling in lymphedema post-breast cancer, improving comfort and function.
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Which guidelines would hamper staff learning and compliance?
- A. Provide scientific information regarding nosocomial infections.
- B. Clarify information with staff during each session.
- C. Acknowledge resistance of staff to changes in policies.
- D. Utilize diagrams to provide information.
- E. Provide all information needed to the staff on the first session.
- F. Tell the staff that changes were mandated by hospital policy.
- G. Send a memo regarding errors in IV site care procedure.
Correct Answer: E, F, G
Rationale: Providing all information in one session (E) can overwhelm staff, reducing retention. Stating changes are mandated (F) may foster resentment, decreasing compliance. Sending a memo about errors (G) may seem punitive, discouraging engagement. In contrast, scientific information (A), clarification (B), acknowledging resistance (C), and diagrams (D) promote understanding and acceptance.
An alcoholic client who is completing the inpatient segment of a substance abuse program was placed on disulfiram (Antabuse) drug therapy. What should the nurse include in the discharge instructions?
- A. If disulfiram is taken and alcohol ingested, the client experiences nausea, vomiting and elevated blood pressure.
- B. Disulfiram is most effective when prescribed as late as possible in a recovery program.
- C. Disulfiram works on the desensitization principle.
- D. The effects of disulfiram can be triggered by alcohol 5 days to 2 weeks after the drug is discontinued.
Correct Answer: D
Rationale: When alcohol is ingested with disulfiram therapy, the client experiences nausea, vomiting, and a potentially serious drop in blood pressure. Disulfiram is most successful when used early in the recovery process while the individual makes major lifestyle changes necessary for long-term recovery. Disulfiram works on the classical conditioning principle. The effects of disulfiram can be felt when alcohol is ingested 1-2 weeks after disulfiram is discontinued.
The nurse is evaluating the client's pulmonary artery pressure (PAP). The nurse is aware that PAP evaluates:
- A. Pressure in the left ventricle
- B. Systolic, diastolic, and mean pressure in the pulmonary artery
- C. Pressure in the pulmonary veins
- D. Pressure in the right ventricle
Correct Answer: B
Rationale: Pulmonary artery pressure (PAP), measured via a pulmonary artery catheter, reflects systolic, diastolic, and mean pressures in the pulmonary artery, indicating right ventricular function and pulmonary circulation status.
A client has received digoxin 0.25 mg po daily for 2 weeks. Which of the following digoxin levels indicates toxicity?
- A. 0.5 ng/mL
- B. 1.0 ng/mL
- C. 2.0 ng/mL
- D. 3.0 ng/mL
Correct Answer: D
Rationale: Digoxin's therapeutic level is 0.8-2.0 ng/mL. Digoxin's toxic level is >2.0 ng/mL.
A client is admitted for suspected bladder cancer. Which one of the following factors is most significant in the client's diagnosis?
- A. Smoking a pack of cigarettes a day for 30 years
- B. Use of nonsteroidal anti-inflammatories
- C. Eating foods with preservatives
- D. Past employment involving asbestos
Correct Answer: A
Rationale: Smoking is the most significant risk factor for bladder cancer, as tobacco toxins are excreted in urine, directly irritating the bladder lining.