Nokea
A gastroenterologist should be consulted for clients suffering from:
- A. digestive system diseases
- B. urinary system diseases
- C. female reproductive system diseases
- D. nervous system diseases
Correct Answer: A
Rationale: A gastroenterologist specializes in treating diseases and disorders of the digestive system, including the stomach, intestines, liver, and pancreas. Therefore, clients with digestive system diseases should consult a gastroenterologist. Choices B, C, and D are incorrect because urinary system diseases are managed by urologists, female reproductive system diseases by gynecologists, and nervous system diseases by neurologists.
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During surgery, it is found that a client with adenocarcinoma of the rectum has positive peritoneal lymph nodes. What is the next most likely site of metastasis?
- A. brain
- B. bone
- C. liver
- D. mediastinum
Correct Answer: C
Rationale: In cases of adenocarcinoma of the rectum with positive peritoneal lymph nodes, the most likely site of metastasis is the liver. Colon tumors commonly spread through the lymphatics and portal vein to the liver. While metastasis to the brain, bone, or mediastinum is possible, the liver is typically the first to be affected due to the anatomical pathways involved in colorectal cancer metastasis. Therefore, the correct answer is the liver. Metastasis to the brain, bone, or mediastinum would be less likely at this stage of colorectal cancer progression.
The ICU nurse caring for a client who has just been declared brain dead can expect to find evidence of the client's wishes regarding organ donation:
- A. on the client's driver's license.
- B. in the client's safety deposit box.
- C. in the client's last will and testament.
- D. on the client's insurance card.
Correct Answer: A
Rationale: In most states, indication of organ donor status is found on the client's driver's license, making it easily accessible for decision-making in critical situations like declaring brain death. Evidence in a last will and testament or a safety deposit box may not be promptly available. Information about organ donation is typically not included on insurance cards. The primary care physician's health record documentation could also be a relevant source for the ICU nurse. Therefore, the correct answer is finding evidence of the client's wishes regarding organ donation on the client's driver's license.
The laws enacted by states to provide immunity from liability to persons who provide emergency care at an accident scene are called:
- A. Good Samaritan laws.
- B. HIPAA.
- C. Patient Self-Determination Act (PSDA).
- D. OBRA.
Correct Answer: A
Rationale: The correct answer is Good Samaritan laws. These laws protect individuals who provide voluntary emergency care from being held liable for any unintended injury or harm that may occur during the care. Good Samaritan laws encourage individuals to assist in emergencies without fear of legal repercussions. HIPAA, on the other hand, focuses on safeguarding patient information and privacy, ensuring confidentiality. The Patient Self-Determination Act (PSDA) pertains to a patient's rights to make decisions about their medical treatment and advance directives. OBRA, enacted in the late 1980s, aims to improve the quality of care in nursing homes and enhance residents' quality of life, focusing on nursing home reform and standards, which is not directly related to immunity for emergency care providers.
When planning play activities for a hospitalized school-age child, a nurse uses Erikson's theory of psychosocial development to select an appropriate activity. The nurse selects an activity that will assist the child in developing which developmental goal?
- A. A sense of industry
- B. Autonomy
- C. A sense of trust
- D. Initiative
Correct Answer: C
Rationale: The correct answer is 'A sense of industry.' According to Erikson, the central task of the school-age years is the development of a sense of industry. During this stage, children engage in activities like schoolwork, crafts, chores, hobbies, and sports to develop a sense of competence and productivity. The development of trust is the primary task of infancy, autonomy is the task of toddlerhood, and initiative is the task of the preschool years. Therefore, in this scenario, focusing on fostering a sense of industry aligns with the developmental goals of a school-age child.
If a visitor accidentally knocks over a plastic pleural drainage system connected to a client, causing it to crack, what should the nurse do first?
- A. Observe the client's response.
- B. Notify the physician.
- C. Change the drainage system.
- D. Observe for leaks.
Correct Answer: C
Rationale: When a pleural drainage system is cracked, the nurse's initial action should be to change the drainage system. This is essential to prevent potential complications like air leaks or infections. While observing the client's response and checking for leaks are important steps, they are secondary to addressing the immediate issue of the cracked system. Notifying the physician, though necessary, can be carried out once the primary concern of the damaged system is resolved.