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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.
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A nurse is caring for four hospitalized clients. Which of the following clients should the nurse identify as being at risk for fluid volume deficit?
- A. The client who has a wound infection and is on antibiotics.
- B. The client who has gastroenteritis and is febrile.
- C. The client who is receiving IV fluids and is in pain.
- D. The client who is on a clear liquid diet and has hypokalemia.
Correct Answer: B
Rationale: The correct answer is B. The client with gastroenteritis and fever is at risk for fluid volume deficit due to increased fluid loss from vomiting and diarrhea. Fever also increases fluid loss through perspiration. The other choices do not directly indicate increased fluid loss. A: Antibiotics for wound infection may not directly lead to fluid volume deficit. C: IV fluids would help maintain hydration status, so this client is not at risk for deficit. D: Hypokalemia may be related to electrolyte imbalance, but not necessarily fluid volume deficit.
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. Avoid sexual activity for the first 6 months.
- C. Use a menstrual pad for vaginal bleeding.
- D. Use a diaphragm for contraception.
Correct Answer: A
Rationale: The correct answer is A: Artificial lubrication can be used to treat vaginal itching and dryness. The rationale for this is that after a total abdominal hysterectomy and bilateral salpingo-oophorectomy, there is a decrease in estrogen levels, leading to vaginal dryness and itching. Using artificial lubrication can help alleviate these symptoms and improve comfort.
Choice B is incorrect as there is no need to avoid sexual activity for 6 months unless specifically advised by the healthcare provider. Choice C is incorrect as there should not be vaginal bleeding after a total abdominal hysterectomy. Choice D is incorrect as using a diaphragm for contraception is not recommended after a hysterectomy.
A nurse is providing teaching for a client who has hypertension and a prescription change from metoprolol to metoprolol/hydrochlorothiazide. Which of the following statements by the client indicates an understanding of the teaching?
- A. With the new medication, I should experience fewer side effects.
- B. I can expect an increase in my blood pressure.
- C. I should expect the medication to work immediately.
- D. I will stop taking the medication when I feel better.
Correct Answer: A
Rationale: The correct answer is A. By stating that with the new medication, the client should experience fewer side effects, the client demonstrates understanding that the addition of hydrochlorothiazide may help reduce side effects compared to taking metoprolol alone. This indicates comprehension of the teaching provided by the nurse.
Choice B is incorrect because the client should not expect an increase in blood pressure with the new medication regimen.
Choice C is incorrect as it typically takes time for medications to reach their full effectiveness, so immediate results are not expected.
Choice D is incorrect because stopping medication when feeling better can lead to a worsening of hypertension and other health issues.
Overall, choice A is the best response as it shows an understanding of the medication change and its potential benefits.
A nurse is reviewing the laboratory values of a client who had a myocardial infarction 3 hr ago. The nurse should expect which of the following laboratory values to be elevated?
- A. Serum sodium
- B. Serum glucose
- C. Troponin I
- D. White blood cell count
Correct Answer: C
Rationale: The correct answer is C: Troponin I. Troponin I is a specific marker for myocardial damage. After a myocardial infarction, the damaged heart muscle releases troponin I into the bloodstream, leading to elevated levels. This helps in diagnosing and monitoring the extent of myocardial damage.
A: Serum sodium levels are not typically affected by a myocardial infarction.
B: Serum glucose levels may be elevated due to stress response but are not specific to myocardial infarction.
D: White blood cell count may be elevated in response to inflammation caused by myocardial infarction, but it is not as specific as troponin I.
A nurse is caring for a client who recently had surgery for insertion of a permanent pacemaker. Which of the following prescriptions should the nurse clarify?
- A. Electrocardiogram
- B. Chest X-ray
- C. Echocardiogram
- D. MRI of the chest
Correct Answer: D
Rationale: The correct answer is D. MRI of the chest should be clarified because the magnetic field can interfere with the function of the pacemaker, potentially causing harm to the patient. An electrocardiogram, chest X-ray, and echocardiogram are safe imaging tests that do not interfere with the pacemaker. Therefore, D is the correct answer that should be clarified to ensure patient safety.