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A nurse is caring for a client who is experiencing menopausal symptoms and asks the nurse about menopausal hormone therapy (HT). The nurse should inform the client that HT is not recommended due to which of the following findings in the client's medical history?
- A. History of breast cancer
- B. History of hypertension
- C. History of diabetes
- D. History of osteoarthritis
Correct Answer: A
Rationale: The correct answer is A: History of breast cancer. Menopausal hormone therapy (HT) is contraindicated in women with a history of breast cancer due to the potential risk of hormone-dependent cancer recurrence. Hormones can stimulate the growth of estrogen-sensitive breast cancer cells, increasing the risk of cancer recurrence. Therefore, it is crucial for the nurse to inform the client with a history of breast cancer that HT is not recommended. Choices B, C, and D are not directly contraindications for HT in menopausal clients, as long as these conditions are well-controlled and monitored.
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A nurse explains to a client why two chest tubes are in place after a lobectomy. What is the lower chest tube for?
- A. Draining air from the pleural space
- B. Draining blood and fluid from the pleural space
- C. Providing oxygen directly to the lungs
- D. Preventing lung collapse
Correct Answer: B
Rationale: The lower chest tube after a lobectomy is to drain blood and fluid from the pleural space. This is crucial to prevent complications such as fluid accumulation, which can lead to infection or impaired lung expansion. The other choices are incorrect because: A) Draining air is usually done by the upper chest tube, C) Providing oxygen does not require a chest tube, and D) Preventing lung collapse is more related to the function of the upper chest tube in maintaining negative pressure in the pleural space.
A nurse is preparing a client who has AIDS for discharge. Which of the following statements should the nurse include in the discharge instructions?
- A. Prevent the spread of infection with good household cleaning practices.
- B. Limit handwashing to once a day to avoid skin damage.
- C. Avoid sharing towels with other people in the household.
- D. Do not disinfect surfaces in the home with bleach.
Correct Answer: A
Rationale: The correct answer is A: Prevent the spread of infection with good household cleaning practices. The nurse should include this statement in the discharge instructions because individuals with AIDS have weakened immune systems, making them more susceptible to infections. Good household cleaning practices can help prevent the spread of infections to the client and others.
Incorrect choices:
B: Limit handwashing to once a day to avoid skin damage - This is incorrect as frequent handwashing is crucial to prevent the spread of infections.
C: Avoid sharing towels with other people in the household - This is incorrect as sharing towels can lead to the transmission of infections.
D: Do not disinfect surfaces in the home with bleach - This is incorrect as disinfecting surfaces with bleach is important to kill harmful pathogens.
A nurse cares for a client on ethambutol therapy for tuberculosis. What should be monitored?
- A. Hearing loss
- B. Visual acuity
- C. Liver function
- D. Blood glucose
Correct Answer: B
Rationale: The correct answer is B: Visual acuity. Ethambutol can cause optic neuritis, leading to visual disturbances. Monitoring visual acuity is crucial to detect any changes early.
Incorrect choices:
A: Hearing loss is associated with other medications for TB, not ethambutol.
C: Liver function is not typically affected by ethambutol.
D: Blood glucose is not directly impacted by ethambutol therapy.
In summary, monitoring visual acuity is essential due to the potential optic nerve toxicity of ethambutol, making it the most relevant parameter to monitor in this case.
A nurse is instructing a client how to decrease the nausea associated with chemotherapy and radiation. Which of the following statements indicates an understanding of the teaching?
- A. I will eat food that are served at room temperature.
- B. I will avoid drinking liquids with meals.
- C. I will eat spicy foods to improve appetite.
- D. I will drink hot liquids to settle my stomach.
Correct Answer: A
Rationale: The correct answer is A: "I will eat food that are served at room temperature." This is correct because consuming foods at room temperature helps reduce nausea associated with chemotherapy and radiation. Cold foods can worsen nausea, while hot foods can trigger vomiting. Avoiding extreme temperatures can help alleviate nausea.
Choice B is incorrect because avoiding liquids with meals can lead to dehydration and worsen nausea. Choice C is incorrect because spicy foods can exacerbate nausea rather than improve appetite. Choice D is incorrect because drinking hot liquids can aggravate nausea.
A nurse is preparing a client for a radiation treatment who is postoperative following a mastectomy. The nurse should inform the client to expect which of the following adverse effects from the treatment?
- A. Hair loss
- B. Nausea and vomiting
- C. Fatigue
- D. Skin irritation
Correct Answer: C
Rationale: The correct answer is C: Fatigue. Radiation treatment can cause fatigue as it affects healthy cells in addition to cancer cells, leading to increased tiredness. Hair loss (A) is more commonly associated with chemotherapy, while nausea and vomiting (B) are typical side effects of chemotherapy or certain medications. Skin irritation (D) is a common side effect of radiation treatment, but fatigue is the primary adverse effect in this scenario due to its impact on overall energy levels.