Nokea
A family member asks the nurse why their loved one with end-stage liver cancer is so restless. The nurse's best response is:
- A. Restlessness is a side effect of pain medications.
- B. It may be due to decreased oxygen to the brain.
- C. It's a normal part of the dying process.
- D. It's caused by dehydration.
Correct Answer: C
Rationale: Restlessness is a common symptom in the dying process, often due to metabolic changes or psychological factors, and explaining this normalizes the family's experience.
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A client with peripheral vascular disease has chronic, severe pretibial and ankle edema bilaterally. Because the client is on complete bed rest and circulation is compromised, one goal is to maintain tissue integrity. Which of the following interventions will help achieve this outcome?
- A. Administering pain medication
- B. Encouraging fluids
- C. Turning the client every 1 to 2 hours
- D. Maintaining hygiene
Correct Answer: C
Rationale: Turning the client every 1 to 2 hours prevents pressure ulcers by relieving pressure on dependent areas, promoting circulation, and maintaining skin integrity in a client with PVD and edema on bed rest. Pain medication, fluids, and hygiene are important but do not directly address tissue integrity.
The nurse cares for a client receiving fentanyl via patient-controlled analgesia (PCA). After the client reports increased pain, the nurse obtains a provider's order to adjust the PCA settings. While making the prescribed changes on the PCA device, the nurse should prioritize
- A. verifying the settings with a second nurse.
- B. educating the client about the medication's side effects.
- C. repositioning the client for nonpharmacological pain relief.
- D. reassessing the client's current pain level.
Correct Answer: A
Rationale: Verifying PCA settings with a second nurse ensures accuracy and safety.
A 58-year-old male is going to have chemotherapy for lung cancer. He asks the nurse how the chemotherapeutic drugs will work. The most accurate explanation the nurse can give is which of the following?
- A. Immunotherapy affects all rapidly dividing cells.
- B. The molecular structure of the DNA is altered.
- C. Cancer cells are susceptible to drug toxins.
- D. Chemotherapy encourages cancer cells to divide.
Correct Answer: B
Rationale: Chemotherapy often works by altering the DNA structure of cancer cells, inhibiting their ability to replicate and leading to cell death.
The nurse is preparing a client for a paracentesis. The nurse should:
- A. Have the client void immediately before the procedure.
- B. Place the client in a side-lying position.
- C. Initiate an I.V. line to administer sedatives.
- D. Place the client on nothing-by-mouth (NPO) status 6 hours before the procedure.
Correct Answer: A
Rationale: Voiding before paracentesis (A) prevents bladder injury during the procedure. Side-lying (B) is incorrect; upright is preferred. IV sedatives (C) are not routine, and NPO status (D) is unnecessary.
Which of the following interventions is most appropriate for a client who has stomatitis?
- A. Drinking hot tea at frequent intervals.
- B. Gargling with antiseptic mouthwash.
- C. Using an electric toothbrush.
- D. Eating a soft, bland diet.
Correct Answer: D
Rationale: Stomatitis involves inflammation of the oral mucosa, often causing pain and sensitivity. A soft, bland diet is most appropriate as it minimizes irritation and discomfort during eating. Hot tea, antiseptic mouthwash, and electric toothbrushes can exacerbate irritation or pain in the inflamed oral tissues.