Nokea
A nurse is providing teaching to a client about skin cancer. Which of the following should the nurse explain are risk factors for skin cancer? Select all that apply.
- A. Increasing age.
- B. Exposure to chemical pollutants.
- C. Long-term exposure to the sun.
- D. Increased pigmentation.
- E. Genetics.
- F. Immunosuppression.
Correct Answer: A,C,E,F
Rationale: Increasing age, sun exposure, genetics, and immunosuppression increase skin cancer risk. Chemical pollutants are less significant, and increased pigmentation reduces risk.
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Adrenal function is affected by the drug ketoconazole (Nizoral), an antifungal agent used to treat severe fungal infections. How is this effect manifested?
- A. Ketoconazole suppresses adrenal steroid secretion.
- B. Ketoconazole destroys adrenocortical cells, resulting in a 'medical' adrenalectomy.
- C. Ketoconazole increases adrenocorticotropic hormone (ACTH)-induced corticosteroid serum levels.
- D. Ketoconazole decreases duration of adrenal suppression when administered with corticosteroids.
Correct Answer: A
Rationale: Ketoconazole inhibits adrenal steroid synthesis, reducing cortisol production, which can be therapeutic in Cushing's disease.
A 42-year-old female is interested in making dietary changes to reduce her risk of colon cancer. What dietary selections should the nurse suggest?
- A. Croissant, granola and peanut butter squares, whole milk.
- B. Bran muffin, skim milk, stir-fried broccoli.
- C. Granola, bagel with cream cheese, cauliflower salad.
- D. Oatmeal, raisin cookies, baked potato with sour cream, turkey sandwich.
Correct Answer: B
Rationale: A diet high in fiber (bran muffin, broccoli) and low in fat (skim milk) reduces colon cancer risk by promoting healthy digestion and reducing carcinogenic exposure in the colon.
The teaching plan for the client with rheumatoid arthritis includes rest promotion. Which of the following would the nurse expect to instruct the client to avoid during rest periods?
- A. Proper body alignment.
- B. Elevating the part.
- C. Prone lying positions.
- D. Positions of flexion.
Correct Answer: D
Rationale: Positions of flexion can exacerbate joint stiffness and deformity in rheumatoid arthritis. Proper alignment, elevation, and prone positions (if comfortable) support joint health.
The nurse has just admitted a 35-year-old female client who has a serum vitamin B12 concentration of 800 pg/mL. Which of the following laboratory findings should cue the nurse to focus the client history assessment on specific drug or alcohol use?
- A. Total bilirubin, 0.3 mg/dL.
- B. Serum creatinine, 0.5 mg/dL.
- C. Hemoglobin, 16 g/dL.
- D. Folate, 1.5 ng/mL.
Correct Answer: D
Rationale: A serum vitamin B12 level of 800 pg/mL is within the normal range (200–900 pg/mL), but a folate level of 1.5 ng/mL is low (normal: 2.7–17 ng/mL). Low folate levels can be associated with chronic alcohol use, as alcohol impairs folate absorption and metabolism. The nurse should assess the client's history for alcohol use, as this may contribute to the folate deficiency. The other lab values (bilirubin, creatinine, hemoglobin) are normal and do not suggest drug or alcohol use.
The client with diabetes mellitus says, 'If I could just avoid what you call carbohydrates in my diet, I guess I would be okay.' The nurse should base the response to this comment on the knowledge that diabetes affects metabolism of which of the following?
- A. Carbohydrates only.
- B. Fats and carbohydrates only.
- C. Protein and carbohydrates only.
- D. Proteins, fats, and carbohydrates.
Correct Answer: D
Rationale: Diabetes affects the metabolism of carbohydrates, proteins, and fats due to insulin's role in regulating all three macronutrients.