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A nurse is caring for a client diagnosed with polycythemia vera. Which of the following should the nurse include in the client and family education?
- A. Resume normal activity
- B. Wear support hose while awake
- C. Decrease fluid intake to no more than 1 liter per day
- D. Diet high in vitamin K intake
Correct Answer: B
Rationale: Polycythemia vera thickens blood, slowing venous return support hose boost circulation, cutting clot risk, a practical teaching point for clients and families. Normal activity's fine but misses prevention. Less fluid thickens blood further, dangerous here; high vitamin K aids clotting, counterproductive. Nurses push hose use, easing symptoms like swelling, a key strategy in managing this hyperviscous state.
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A patient receiving head and neck radiation for larynx cancer has ulcerations over the oral mucosa and tongue and thick, ropey saliva. Which instructions should the nurse give to this patient?
- A. Remove food debris from the teeth and oral mucosa with a stiff toothbrush.
- B. Use cotton-tipped applicators dipped in hydrogen peroxide to clean the teeth.
- C. Gargle and rinse the mouth several times a day with an antiseptic mouthwash.
- D. Rinse the mouth before and after each meal and at bedtime with a saline solution.
Correct Answer: D
Rationale: Head and neck radiation trashes the mouth ulcers and ropey saliva need saline rinses to clean gently, easing pain without wrecking tissue. Stiff brushes shred mucosa; peroxide burns it; antiseptic washes sting and dry. Nurses in oncology teach this saline's soothing, safe, and fights infection risk in a radiated, vulnerable mouth.
A client is receiving interleukins along with chemotherapy. What assessment by the nurse takes priority?
- A. Blood pressure
- B. Lung assessment
- C. Oral mucous membranes
- D. Skin integrity
Correct Answer: A
Rationale: Interleukins, a type of biologic response modifier used with chemotherapy, can cause capillary leak syndrome, where fluid shifts from blood vessels into tissues, leading to hypotension and edema. This makes blood pressure the priority assessment, as a drop could indicate intravascular depletion, risking shock or organ failure if undetected. Lung assessment is relevant for potential pulmonary edema, but hypotension precedes respiratory distress in this context. Oral mucous membranes and skin integrity matter for chemotherapy's broader effects (e.g., mucositis, rashes), but these are less urgent than hemodynamic stability. Monitoring blood pressure first ensures early detection of a life-threatening complication, aligning with nursing's focus on airway, breathing, and circulation principles, critical in managing interleukin therapy's systemic impact.
Which of the following is FALSE regarding patient education for insulin therapy?
- A. It improves the patients experience and adherence to insulin therapy
- B. It requires time and preparation
- C. It can only be done by diabetes nurse educators
- D. Different topics and focus can be covered at different stages of insulin therapy
Correct Answer: C
Rationale: Insulin education boosts adherence and takes prep varied topics hit stages, and checking understanding's key. But pinning it to diabetes nurse educators alone flops; GPs, pharmacists, even peers can teach, widening reach. Team effort trumps solo specialty, ensuring chronic care's flexible, not bottlenecked, a practical truth in diabetes' long haul.
The public health nurse is presenting a health-promotion class to a group at a local community center. Which intervention most directly addresses the leading cause of cancer deaths in North America?
- A. Monthly self-breast exams
- B. Smoking cessation
- C. Annual colonoscopies
- D. Monthly testicular exams
Correct Answer: B
Rationale: Lung cancer tops the list of cancer deaths in North America for both men and women, as noted in the feedback, with over 570,000 deaths projected in 2011 alone. Smoking is the primary risk factor for lung cancer, making cessation the most direct intervention to tackle this killer. Self-breast and testicular exams target breast and testicular cancers, respectively, which rank lower in mortality (breast is second for women, prostate second for men). Colonoscopies address colorectal cancer, third in frequency, but lung cancer's dominance ties directly to smoking's prevalence. By pushing cessation, nurses hit the root cause head-on, reducing exposure to carcinogens like tar and nicotine that drive malignant transformation in lung tissue. This aligns with primary prevention, cutting incidence before it starts, unlike screening which catches disease later.
The genetic profile determines the prevalence of diabetic nephropathy in a population group. Question: Which population group has the LOWEST risk to develop endstage renal disease as a consequence of diabetes?
- A. Afro-Americans
- B. Iberians (Spanish origin)
- C. Caucasians
- D. Native Americans
Correct Answer: C
Rationale: Caucasians dodge worst kidney doom Afro-Americans, Native Americans soar high, Iberians mid-tier. Genes and diabetes hit lighter here, a chronic renal risk low nurses screen this gradient.