Nokea
A client with metastatic cancer of the liver is concerned about his progress. Which of the following nursing interventions is most appropriate?
- A. Provide information for the client to consider a liver transplantation.
- B. Assure the client that the prescribed medications will shrink all tumor sites.
- C. Explain the effects of chemotherapy.
- D. Place emphasis on providing symptomatic and comfort measures.
Correct Answer: D
Rationale: For metastatic liver cancer, palliative care focusing on symptom relief and comfort is most appropriate, as transplantation or tumor shrinkage may not be feasible.
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A client has polycystic kidney disease. The client asks the nurse, 'How did I get these fluid-filled bubbles on my kidneys? I have not had any X-ray type tests.' How should the nurse respond to help the client understand risk factors for this disease process?
- A. Second-hand smoke puts you at greater risk for developing cysts.'
- B. Exposure to dyes used to color fruits and vegetables increases the risk of polycystic kidney disease.'
- C. There is a higher incidence of polycystic kidney disease among blood relatives.'
- D. Drinking alcohol daily allows the kidneys to develop cysts.'
Correct Answer: C
Rationale: Polycystic kidney disease is primarily genetic, with a higher incidence among blood relatives due to autosomal dominant or recessive inheritance patterns.
A client has a prescription to begin short-term therapy with enoxaparin. The nurse explains to the client that this medication is being prescribed for which action?
- A. Dissolve urinary calculi
- B. Relieve migraine headaches
- C. Stop progression of multiple sclerosis
- D. Reduce the risk of deep vein thrombosis
Correct Answer: D
Rationale: Enoxaparin is an anticoagulant that is administered to prevent deep vein thrombosis and thromboembolism in selected clients at risk. It is not used to treat urinary calculi, migraine headaches, or multiple sclerosis.
A 6-month-old has had a pyloromyotomy to correct a pyloric stenosis. Three days after surgery, the parents have placed their infant in his own infant seat (see fi gure). The nurse should do which of the following?
- A. Reposition the infant to the left side.
- B. Ask the parents to put the infant back in his crib
- C. Remind the parents that the infant cannot use a pacifier now.
- D. Tell the parents they have positioned their infant correctly
Correct Answer: D
Rationale: Following pyloromyotomy the infant should be positioned with the head elevated and slightly on the right side to promote gastric emptying; the parents have positioned their infant correctly. The infant should be positioned on the right side, not the left side. When the child is in a crib, the head can be elevated and the infant can be propped on the right side. The infant can use a pacifi er if needed.
A client is very dependent on the staff but is able to make simple decisions. The client asks, 'Would you do my laundry? I don't know how the machine works.' Which of the following responses would be best?
- A. Sure, I have time; I can do it for you.'
- B. You'll have to wait; I don't have time now.'
- C. Can your family do it for you?'
- D. Get your laundry; I'll show you how the machine works.'
Correct Answer: D
Rationale: Teaching the client to use the machine promotes independence while addressing their request.
The nurse is caring for a client post-thyroidectomy. Which finding indicates a potential complication?
- A. Hoarseness
- B. Incisional pain
- C. Mild swelling at the site
- D. Thirst
Correct Answer: A
Rationale: Hoarseness post-thyroidectomy may indicate recurrent laryngeal nerve damage, a serious complication requiring immediate reporting.