Nokea
A female client diagnosed with lung cancer is to have a left lower lobectomy. Which of the following increase the client's risk of developing postoperative pulmonary complications?
- A. Height is 5 feet, 7 inches and weight is 110 lb.
- B. The client tends to keep her real feelings to herself.
- C. 8.88 stimulates and can climb one flight of stairs without dyspnea.
- D. The client is 58 years of age.
Correct Answer: A
Rationale: Low body weight (5'7€, 110 lb) indicates malnutrition, increasing the risk of postoperative pulmonary complications due to weakened respiratory muscles. Emotional suppression, good exercise tolerance, and age 58 are less directly related.
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The nurse should teach the client with diverticulitis to integrate which of the following into a daily routine at home?
- A. Using enemas to relieve constipation.
- B. Decreasing fluid intake to increase the formed consistency of the stool.
- C. Eating a high-fiber diet when symptomatic with diverticulitis.
- D. Refraining from straining and lifting activities.
Correct Answer: D
Rationale: Refraining from straining and lifting activities prevents increased intra-abdominal pressure, reducing the risk of diverticulitis complications. Enemas, decreased fluid, or high-fiber diets during acute symptoms can worsen the condition. CN: Physiological adaptation; CL: Synthesize
The nurse should caution sexually active female clients taking isoniazid (INH) that the drug has which of the following effects?
- A. Increases the risk of vaginal infection.
- B. Has mutagenic effects on ova.
- C. Decreases the effectiveness of hormonal contraceptives.
- D. Inhibits ovulation.
Correct Answer: C
Rationale: Isoniazid induces liver enzymes, potentially reducing the effectiveness of hormonal contraceptives. It does not increase vaginal infection risk, affect ova, or inhibit ovulation.
A client who had an exploratory laparotomy 3 days ago has a white blood cell (WBC) differential with a shift to the left. The nurse instructs unlicensed personnel to report which clinical manifestation?
- A. Swelling around the incision.
- B. Redness around the incision.
- C. Elevated temperature.
- D. Purulent wound drainage.
Correct Answer: C
Rationale: A left shift in the WBC differential indicates an increase in immature neutrophils, often due to infection. An elevated temperature is a key sign of infection and should be reported promptly. Swelling, redness, and purulent drainage are also concerning but may develop later.
The nurse is planning care for a client with a femoral fracture who is in balanced suspension traction. Which of the following would the nurse be least likely to include in the plan of care?
- A. Use of a fracture bedpan.
- B. Checks for redness over the ischial tuberosity.
- C. Elevation of the head of bed no more than 25 degrees.
- D. Personal hygiene with a complete bed bath.
Correct Answer: C
Rationale: Elevating the head of the bed beyond 25 degrees can disrupt traction alignment, making it least appropriate.
A client has undergone an amputation of several toes and a femoral-popliteal bypass. The nurse should teach the client that after surgery which of the following leg positions is contraindicated for her while sitting in a chair?
- A. Crossing the legs
- B. Elevating the legs
- C. Flexing the ankles
- D. Extending the knees
Correct Answer: A
Rationale: Crossing the legs is contraindicated post-femoral-popliteal bypass and toe amputation, as it compresses blood vessels, impairing circulation and increasing the risk of graft occlusion or ischemia. Elevating legs, flexing ankles, and extending knees are generally acceptable unless otherwise specified.