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A home health nurse assesses an older adult with vision loss due to glaucoma. What is a safety hazard?
- A. Bright overhead lighting
- B. Presence of scatter rugs in the kitchen
- C. Using contrasting colors in home decor
- D. Wearing slip-resistant shoes
Correct Answer: B
Rationale: The correct answer is B: Presence of scatter rugs in the kitchen. Scatter rugs pose a tripping hazard for individuals with vision loss, especially in areas like the kitchen where spills and slippery surfaces are common. The other choices are incorrect because: A - Bright overhead lighting can actually be beneficial for those with vision loss by improving visibility; C - Using contrasting colors can aid in distinguishing objects and pathways; D - Wearing slip-resistant shoes can help prevent falls.
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A nurse is providing discharge teaching to a client who has asthma and a new prescription for fluticasone/salmeterol. For which of the following adverse effects should the nurse instruct the client to report to the provider?
- A. White coating in the mouth
- B. Increased heart rate
- C. Insomnia
- D. Shortness of breath
Correct Answer: A
Rationale: The correct answer is A: White coating in the mouth. This adverse effect can indicate oral thrush, a fungal infection common with inhaled corticosteroids like fluticasone. The nurse should instruct the client to report this to the provider promptly for appropriate treatment. Increased heart rate (B) and insomnia (C) are common side effects of the medication but not usually serious enough to report immediately. Shortness of breath (D) is a symptom of poorly controlled asthma and should be addressed promptly but not considered an adverse effect of the medication in this context.
A nurse is planning care for a client who is being treated with chemotherapy and radiation for metastatic breast cancer, and who has neutropenia. The nurse should include which of the following restrictions in the client's plan of care?
- A. Fresh flowers and potted plants in the room
- B. Use of public transportation
- C. Group activities
- D. Unrestricted visitors
Correct Answer: A
Rationale: The correct answer is A: Fresh flowers and potted plants in the room. Neutropenic clients are at high risk for infections due to low white blood cell count. Fresh flowers and plants can harbor bacteria and fungi that can potentially cause infections. Therefore, restricting fresh flowers and plants helps minimize the risk of infection. Choices B, C, and D are incorrect because they do not directly relate to the risk of infection in neutropenic clients. Using public transportation, engaging in group activities, or having visitors are generally safe as long as proper infection control measures are followed.
A nurse is providing teaching to a client who has had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for uterine cancer. Which of the following instructions should the nurse include in the teaching?
- A. Artificial lubrication can be used to treat vaginal itching and dryness.
- B. Estrogen therapy will reverse vaginal dryness.
- C. Do not use tampons for 6 months.
- D. Avoid sexual activity for 1 year.
Correct Answer: A
Rationale: Correct Answer: A. Artificial lubrication can be used to treat vaginal itching and dryness.
Rationale: After a total abdominal hysterectomy and bilateral salpingo-oophorectomy, the client will experience menopausal symptoms due to the removal of the ovaries. Vaginal dryness and itching are common symptoms that can be managed with artificial lubrication. Estrogen therapy is contraindicated in this client due to the history of uterine cancer. Using tampons can increase the risk of infection post-surgery. Avoiding sexual activity for 1 year is not necessary unless advised by the healthcare provider.
A female middle adult client tells a nurse that she tested positive for a mutant BRCA1 gene. The nurse should recognize that the client is at an increased risk for which of the following situations?
- A. Developing breast cancer
- B. Developing ovarian cancer
- C. Developing uterine cancer
- D. Developing cervical cancer
Correct Answer: A
Rationale: The correct answer is A: Developing breast cancer. The BRCA1 gene mutation is associated with an increased risk of breast cancer in women. The mutation affects the body's ability to repair damaged DNA, leading to a higher likelihood of developing breast cancer. This risk is significantly higher in women with the mutant BRCA1 gene compared to those without it. Choices B, C, and D are incorrect because the BRCA1 gene mutation is not specifically linked to an increased risk of ovarian, uterine, or cervical cancer. Therefore, the client should be counseled and monitored closely for early detection and prevention of breast cancer.
A nurse is providing teaching about a heart healthy diet to a group of clients with hypertension. Which of the following statements by one of the clients indicates a need for further teaching?
- A. I may eat 10 ounces of lean protein each day
- B. I will limit my sodium intake.
- C. I will increase my intake of fruits and vegetables.
- D. I will avoid fried foods and processed meats.
Correct Answer: A
Rationale: The correct answer is A: "I may eat 10 ounces of lean protein each day." This statement indicates a need for further teaching because consuming 10 ounces of lean protein daily may lead to excessive protein intake, which can strain the kidneys and potentially worsen hypertension. Clients with hypertension should limit protein intake and focus on lean sources in moderation. Choices B, C, and D are correct as they align with a heart-healthy diet by limiting sodium intake, increasing fruits and vegetables, and avoiding fried foods and processed meats, respectively.