Nokea
A client with rheumatoid arthritis is prescribed a nonsteroidal anti-inflammatory drug (NSAID). Which client statement indicates a need for further teaching?
- A. I'll take the medication with food.'
- B. I should report any stomach pain.'
- C. I can take ibuprofen with this drug.'
- D. I'll monitor for bruising or bleeding.'
Correct Answer: C
Rationale: Taking ibuprofen with another NSAID increases the risk of gastrointestinal bleeding, indicating a knowledge deficit.
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The incidence and risk of cancer increase when smoking is combined with:
- A. Asbestos exposure and alcohol consumption.
- B. Ultraviolet radiation exposure and alcohol consumption.
- C. Asbestos exposure and ultraviolet radiation exposure.
- D. Alcohol consumption and human papillomavirus (HPV) infection.
Correct Answer: A
Rationale: Smoking combined with asbestos exposure and alcohol consumption significantly increases cancer risk, particularly for lung and head/neck cancers, due to synergistic carcinogenic effects.
Which of the following is an appropriate expected outcome for a client recovering from a total laryngectomy? The client will:
- A. Regain the ability to taste and smell food.
- B. Demonstrate appropriate care of the gastrostomy tube.
- C. Communicate feelings about body image changes.
- D. Demonstrate sterile suctioning technique for stoma care.
Correct Answer: C
Rationale: Communicating feelings about body image changes is an appropriate psychosocial outcome post-laryngectomy, addressing adaptation to altered appearance. Taste and smell may be impaired long-term. Gastrostomy tubes are not always required. Sterile suctioning is a nursing task, not a client outcome.
Following a thoracotomy, the client has severe pain. Which of the following strategies for pain management will be most effective for this client?
- A. Repositioning the client immediately after administering pain medication.
- B. Reassessing the client 30 minutes after administering pain medication.
- C. Verbally reassuring the client after administering pain medication.
- D. Readjusting the pain medication dosage as needed according to the client's condition.
Correct Answer: D
Rationale: Readjusting pain medication dosage based on the client's condition ensures adequate pain control, critical for recovery. Repositioning, reassessing, and reassurance are supportive but less effective alone.
The nurse is planning care for an 80-year-old client with a pressure ulcer (see figure). The nurse should do which of the following? Select all that apply.
- A. Elevate the head of the bed to 50 degrees.
- B. Obtain daily cultures.
- C. Cover with protective dressing.
- D. Reposition the client every 2 hours.
- E. Request an alternating-pressure mattress.
Correct Answer: C,D,E
Rationale: Protective dressings, frequent repositioning, and pressure-relieving mattresses promote healing and prevent worsening of pressure ulcers. High head elevation increases shear, and daily cultures are unnecessary unless infection is suspected.
Which of the following increases the risk of having a large abdominal aortic aneurysm rupture?
- A. Anemia
- B. Dehydration
- C. High blood pressure
- D. Hyperglycemia
Correct Answer: C
Rationale: High blood pressure increases wall stress in a large abdominal aortic aneurysm, elevating the risk of rupture per Laplace's law (wall tension ˆ pressure × radius). Anemia, dehydration, and hyperglycemia do not directly increase rupture risk.