Nokea
A client with malignant melanoma asks the nurse about the prognosis. The nurse should base a response that informs the client that the prognosis depends on:
- A. The amount of ulceration of the lesion.
- B. The age of the client.
- C. The location of the lesion on the body.
- D. The thickness of the lesion.
Correct Answer: D
Rationale: Melanoma prognosis primarily depends on lesion thickness (Breslow depth), as thicker lesions indicate deeper invasion and worse outcomes.
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Which goal is the most realistic and appropriate for a client diagnosed with Parkinson's disease?
- A. To cure the disease.
- B. To stop progression of the disease.
- C. To begin preparations for terminal care.
- D. To maintain optimal body function.
Correct Answer: D
Rationale: Maintaining optimal body function is realistic, focusing on symptom management and quality of life. Parkinson's is incurable, progression cannot be stopped, and terminal care is premature for most clients.
Which of the following techniques for administering the Mantoux test is correct?
- A. Hold the needle and syringe almost parallel to the client's skin.
- B. Pinch the skin when inserting the needle.
- C. Aspirate before injecting the medication.
- D. Massage the site after injecting the medication.
Correct Answer: A
Rationale: The Mantoux test requires intradermal injection, with the needle held almost parallel to the skin to form a wheal. Pinching, aspirating, or massaging disrupts the test's accuracy.
After surgery for an ileal conduit, the nurse should closely assess the client for the occurrence of which of the following complications related to pelvic surgery?
- A. Peritonitis.
- B. Thrombophlebitis.
- C. Ingestes.
- D. Inguinal hernia.
Correct Answer: A,B
Rationale: Peritonitis and thrombophlebitis are significant complications of pelvic surgery like an ileal conduit, due to potential infection or vascular issues. 'Ingestes' appears to be a typo and is not a recognized complication.
Which of the following would indicate that a client with asthma is experiencing status asthmaticus?
- A. Wheezing on expiration only.
- B. Use of accessory muscles for breathing.
- C. Diminished breath sounds bilaterally.
- D. Productive cough with thick mucus.
Correct Answer: C
Rationale: Status asthmaticus, a life-threatening asthma exacerbation, is indicated by diminished breath sounds bilaterally due to severe airway obstruction. Wheezing, accessory muscle use, and productive cough are present in asthma but not specific to status asthmaticus.
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.