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A nurse is providing education to a patient with polycythemia vera about self-care strategies. What advice should the nurse include?
- A. Avoid hot showers
- B. Drink plenty of fluids
- C. Avoid tight and restrictive clothing
- D. Avoid prolonged sitting
Correct Answer: B
Rationale: The correct advice for a patient with polycythemia vera is to drink plenty of fluids. This helps in reducing the risk of thrombosis by keeping the blood less viscous. Avoiding hot showers (Choice A) is not directly related to managing polycythemia vera. While avoiding tight and restrictive clothing (Choice C) can help improve circulation, it is not the most crucial advice for these patients. Avoiding prolonged sitting (Choice D) is important to prevent blood clots but is not as critical as staying well-hydrated.
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The nurse is teaching a client about the risk factors associated with colorectal cancer. The nurse determines that further teaching is necessary related to colorectal cancer if the client identifies which item as an associated risk factor?
- A. Age younger than 50 years
- B. History of colorectal polyps
- C. Family history of colorectal cancer
- D. Chronic inflammatory bowel disease
Correct Answer: A
Rationale: The correct answer is A: Age younger than 50 years. Colorectal cancer is more commonly diagnosed in individuals over the age of 50, so being younger than 50 is not typically considered a significant risk factor. Choice B, history of colorectal polyps, is a known risk factor as polyps can develop into cancer over time. Choice C, family history of colorectal cancer, is a well-established risk factor due to genetic predisposition. Choice D, chronic inflammatory bowel disease, such as Crohn's disease or ulcerative colitis, increases the risk of developing colorectal cancer. Therefore, the incorrect choice is A as age younger than 50 years is not a common risk factor for colorectal cancer.
When working with clients experiencing alopecia, what is the best method for a nurse to help them manage the psychosocial impact of this issue?
- A. Assisting the client in pre-planning for this event.
- B. Reassuring the client that alopecia is temporary.
- C. Teaching the client ways to protect the scalp.
- D. Telling the client that there are worse side effects.
Correct Answer: A
Rationale: Assisting the client in pre-planning for alopecia is the best method to help them manage the psychosocial impact of the issue. By helping clients anticipate and prepare for the challenges associated with alopecia, they can cope better with the psychological impact. Reassuring the client that alopecia is temporary (choice B) may provide false hope as some types of alopecia are permanent. Teaching ways to protect the scalp (choice C) is important but not the most effective method for managing the psychosocial impact. Telling the client that there are worse side effects (choice D) is dismissive of the client's feelings and not helpful in addressing the psychosocial impact of alopecia.
The home health care nurse is caring for a client with cancer who is complaining of acute pain. The most appropriate determination of the client's pain should include which assessment?
- A. The client's pain rating
- B. Nonverbal cues from the client
- C. The nurse's impression of the client's pain
- D. Pain relief after appropriate nursing intervention
Correct Answer: A
Rationale: The correct answer is A: The client's pain rating. Pain assessment should primarily rely on the client's self-report for the most accurate determination of pain intensity. Nonverbal cues from the client (choice B) can provide additional information but should not replace the client's self-report. The nurse's impression of the client's pain (choice C) may be subjective and less reliable than the client's self-assessment. Pain relief after appropriate nursing intervention (choice D) is an important outcome but does not replace the initial assessment of the client's pain.
A 54-year-old has a diagnosis of breast cancer and is tearfully discussing her diagnosis with the nurse. The patient states, 'They tell me my cancer is malignant, while my coworker's breast tumor was benign. I just don't understand at all.' When preparing a response to this patient, the nurse should be cognizant of what characteristic that distinguishes malignant cells from benign cells of the same tissue type?
- A. Slow rate of mitosis of cancer cells
- B. Different proteins in the cell membrane
- C. Differing size of the cells
- D. Different molecular structure in the cells
Correct Answer: B
Rationale: The correct answer is B. Malignant cells have different proteins in their membranes, such as tumor-specific antigens, which distinguish them from benign cells. Choice A is incorrect as cancer cells typically have a rapid and uncontrolled rate of mitosis. Choice C is incorrect as the size of cells alone does not distinguish between malignant and benign cells. Choice D is incorrect as the molecular structure is not the primary characteristic that distinguishes between malignant and benign cells.
A client with neutropenia is admitted to the hospital. What precaution is most important for the nurse to implement?
- A. Strict hand hygiene.
- B. Limit visitor contact with the client.
- C. Administer prophylactic antibiotics as ordered.
- D. Administer blood products as ordered.
Correct Answer: A
Rationale: The correct answer is A: Strict hand hygiene. Neutropenic clients have a low level of neutrophils, which are important in fighting infections. Therefore, maintaining strict hand hygiene is crucial in preventing the introduction of pathogens that could lead to infections. Limiting visitor contact (choice B) is important but not as critical as preventing the introduction of pathogens through proper hand hygiene. Administering prophylactic antibiotics (choice C) and blood products (choice D) are treatment measures and do not address the preventive aspect that hand hygiene provides.