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. 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 assessing a client who has disseminated intravascular coagulation (DIC). Which of the following findings should the nurse expect?
- A. Excessive thrombosis and bleeding
- B. Clotting of the mucous membranes
- C. Increase in platelet count
- D. Excessive red blood cell count
Correct Answer: A
Rationale: The correct answer is A: Excessive thrombosis and bleeding. In DIC, there is a widespread activation of the clotting cascade leading to formation of microthrombi, causing excessive clotting. However, as the clotting factors are depleted, bleeding can occur. This results in a paradoxical situation of both thrombosis and bleeding. B is incorrect as clotting of mucous membranes is not specific to DIC. C is incorrect as platelet count is usually decreased in DIC due to consumption. D is incorrect as excessive red blood cell count is not a characteristic of DIC.
A nurse is providing dietary teaching to a client who has a history of recurring calcium oxalate kidney stones. Which of the following instructions should the nurse include in the teaching?
- A. Increase calcium intake
- B. Avoid foods high in potassium
- C. Drink 3 L of fluid every day
- D. Limit vitamin C intake
Correct Answer: C
Rationale: The correct answer is C: Drink 3 L of fluid every day. Adequate fluid intake helps to dilute urine, reducing the concentration of calcium and oxalate, which are the main components of kidney stones. This instruction can help prevent the formation of new stones. Increasing calcium intake (Choice A) may actually be beneficial as it can bind with oxalate in the intestines, reducing its absorption and subsequent excretion in the urine. Avoiding foods high in potassium (Choice B) is not directly related to preventing calcium oxalate stones. Limiting vitamin C intake (Choice D) is not necessary unless the client is taking excessive amounts of vitamin C supplements, which can increase oxalate levels.
A nurse is assessing a client who reports numbness and pain in his right palm, index finger, and middle finger. The client reports working with a keyboard most of the time while at work. The nurse suspects carpal tunnel syndrome. Which of the following tests should the nurse request that the client perform?
- A. Hold the wrist at a 90-degree flexion.
- B. Perform a straight leg raise test.
- C. Tap the wrist for tenderness.
- D. Hold the arm in an elevated position.
Correct Answer: A
Rationale: The correct answer is A: Hold the wrist at a 90-degree flexion. This test, known as the Phalen's test, is used to assess for carpal tunnel syndrome. By holding the wrist in a flexed position for about 60 seconds, the test can reproduce symptoms of numbness and tingling in the affected fingers. This occurs due to increased pressure on the median nerve, which is characteristic of carpal tunnel syndrome.
Choices B, C, and D are incorrect:
B: Performing a straight leg raise test is used to assess for sciatic nerve irritation in the lower back, not carpal tunnel syndrome.
C: Tapping the wrist for tenderness is not a specific test for carpal tunnel syndrome.
D: Holding the arm in an elevated position is not a recognized test for carpal tunnel syndrome and would not provide relevant information in this context.
A nurse is planning an educational program about basal cell carcinoma. Which of the following information should the nurse plan to include?
- A. Basal cell carcinoma has a low incidence of metastasis.
- B. Basal cell carcinoma often spreads to lymph nodes.
- C. Basal cell carcinoma is most common in young adults.
- D. Basal cell carcinoma is curable with chemotherapy.
Correct Answer: A
Rationale: The correct answer is A: Basal cell carcinoma has a low incidence of metastasis. This should be included in the educational program because basal cell carcinoma rarely metastasizes. Metastasis is the spread of cancer from the original site to other parts of the body, and in the case of basal cell carcinoma, it tends to remain localized. This information is crucial for patients to understand the prognosis and treatment options.
Explanation of why other choices are incorrect:
B: Basal cell carcinoma often spreads to lymph nodes - This statement is incorrect as basal cell carcinoma typically does not spread to lymph nodes.
C: Basal cell carcinoma is most common in young adults - Basal cell carcinoma is more common in older individuals, typically over the age of 50.
D: Basal cell carcinoma is curable with chemotherapy - While chemotherapy may be a treatment option for some cases of basal cell carcinoma, it is not the primary treatment and not always curative.
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.