Nokea
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.
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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 is evaluating teaching on a client who has a new prescription for montelukast to treat asthma. Which of the following statements by the client indicates an understanding of the teaching?
- A. I'll take this medication once a day in the evening.
- B. I'll take this medication only when I have an asthma attack.
- C. I'll take this medication in the morning before exercise.
- D. I'll stop the medication if I feel better.
Correct Answer: A
Rationale: Correct Answer: A. "I'll take this medication once a day in the evening."
Rationale:
1. Montelukast is usually taken once daily in the evening to provide optimal control of asthma symptoms.
2. Taking it consistently at the same time every day helps maintain a steady level of the medication in the body.
3. This statement shows the client understands the prescribed dosing schedule and is likely to adhere to it.
Summary of other choices:
B. Incorrect: Waiting to take the medication only during an asthma attack is not the correct way to manage asthma as montelukast is meant for daily maintenance.
C. Incorrect: Taking the medication before exercise is not the recommended timing for montelukast administration.
D. Incorrect: Stopping the medication when feeling better can lead to a worsening of asthma symptoms as montelukast helps prevent asthma attacks.
A nurse is providing discharge teaching to a client who has a new arteriovenous fistula in the right forearm. Which of the following manifestations should the nurse include in the teaching as a possible indication of venous insufficiency?
- A. Cold and numbness distal to the fistula site
- B. Swelling around the fistula
- C. Bleeding from the fistula
- D. Pain at the site of fistula
Correct Answer: A
Rationale: The correct answer is A: Cold and numbness distal to the fistula site. This is indicative of venous insufficiency, which can occur when the arteriovenous fistula is not functioning properly. When there is inadequate blood flow through the fistula, it can result in reduced circulation to the distal part of the arm, leading to coldness and numbness. Swelling around the fistula (choice B) is more commonly associated with infection or inadequate drainage. Bleeding from the fistula (choice C) is a potential complication but not a typical manifestation of venous insufficiency. Pain at the site of the fistula (choice D) may indicate infection or clotting issues rather than venous insufficiency.
A nurse is caring for a middle adult client who has just received the diagnosis of endometrial cancer. In taking a nursing history, which of the following manifestations is likely to be reported by this client?
- A. Postmenopausal bleeding
- B. Weight loss
- C. Increased appetite
- D. Abnormal hair growth
Correct Answer: A
Rationale: The correct answer is A: Postmenopausal bleeding. Endometrial cancer commonly presents with postmenopausal bleeding as a key manifestation due to abnormal growth of the endometrial tissue. This occurs because the cancerous cells disrupt the normal shedding process of the endometrium, leading to bleeding after menopause. Weight loss (B) is often associated with advanced stages of cancer, but it is not a specific early manifestation of endometrial cancer. Increased appetite (C) and abnormal hair growth (D) are not typically associated with endometrial cancer.
A nurse is reviewing discharge instructions with a client following a right cataract extraction. Which of the following instructions should the nurse include?
- A. Avoid lifting anything heavier than 4.5 kg (10 lb) for 1 week.
- B. Take a warm shower every day.
- C. Resume regular activities immediately.
- D. Avoid all physical activity for the next month.
Correct Answer: A
Rationale: The correct answer is A: Avoid lifting anything heavier than 4.5 kg (10 lb) for 1 week. This instruction is crucial after a cataract extraction to prevent any strain on the eye during the initial healing period. Lifting heavy objects can increase intraocular pressure and potentially lead to complications. Choice B (Take a warm shower every day) is not directly related to post-operative care for a cataract extraction. Choice C (Resume regular activities immediately) is incorrect as the client should avoid strenuous activities, including heavy lifting, to allow proper healing. Choice D (Avoid all physical activity for the next month) is overly restrictive and unnecessary. It's important to provide specific, clear, and relevant instructions to support the client's recovery.