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A nurse is teaching a client with a history of calcium oxalate kidney stones. What advice should be given?
- A. Limit fluid intake to 1 L per day.
- B. Drink 3 L of fluid every day.
- C. Increase calcium intake.
- D. Avoid all citrus juices.
Correct Answer: B
Rationale: The correct answer is B: Drink 3 L of fluid every day. Increasing fluid intake helps prevent the formation of kidney stones by diluting the urine and reducing the concentration of minerals like calcium oxalate. Adequate hydration promotes frequent urination, which helps flush out these minerals. Limiting fluid intake (choice A) can lead to concentrated urine and increase the risk of stone formation. Increasing calcium intake (choice C) can actually help prevent calcium oxalate stones, as calcium binds with oxalate in the intestines, reducing its absorption. Avoiding all citrus juices (choice D) is unnecessary, as they do not directly contribute to the formation of calcium oxalate stones.
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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 client is receiving treatment for stage IV ovarian cancer and asks the nurse to discuss her prognosis. The client plans to have aggressive surgical, radiation, and chemotherapy treatments. Which of the following prognoses should the nurse discuss with the client?
- A. Good
- B. Excellent
- C. Fair
- D. Poor
Correct Answer: D
Rationale: The correct answer is D: Poor. In stage IV ovarian cancer, the cancer has spread beyond the ovaries to distant organs. Prognosis is generally poor due to the advanced stage of the disease. Aggressive treatments can help manage symptoms and improve quality of life but are unlikely to cure the cancer. Discussing a poor prognosis with the client allows for realistic expectations and informed decision-making. Choices A, B, and C are incorrect as they suggest a better prognosis which is not typical for stage IV ovarian cancer.
A nurse teaches a client with vulvodynia about self-care. What statement indicates understanding?
- A. I should use scented soaps.
- B. I should avoid the use of any lubricants.
- C. I should wear tight synthetic underwear.
- D. I should use hot baths frequently.
Correct Answer: B
Rationale: The correct answer is B. Clients with vulvodynia should avoid the use of any lubricants to prevent irritation and exacerbation of symptoms. Lubricants can contain chemicals or fragrances that can further irritate the sensitive skin in the vulvar area. Choosing products specifically designed for sensitive skin or recommended by a healthcare provider is crucial. Using lubricants can worsen symptoms and discomfort.
Avoiding scented soaps (choice A) is important as well because fragrances can also irritate the vulvar area. Wearing tight synthetic underwear (choice C) can trap moisture and heat, leading to increased irritation. Using hot baths frequently (choice D) can also worsen symptoms by further irritating the sensitive skin.
A nurse is preparing a client for a radiation treatment who is postoperative following a mastectomy. The nurse should inform the client to expect which of the following adverse effects from the treatment?
- A. Hair loss
- B. Nausea and vomiting
- C. Fatigue
- D. Skin irritation
Correct Answer: C
Rationale: The correct answer is C: Fatigue. Radiation treatment can cause fatigue as it affects healthy cells in addition to cancer cells, leading to increased tiredness. Hair loss (A) is more commonly associated with chemotherapy, while nausea and vomiting (B) are typical side effects of chemotherapy or certain medications. Skin irritation (D) is a common side effect of radiation treatment, but fatigue is the primary adverse effect in this scenario due to its impact on overall energy levels.
A nurse is planning care for a client who is being treated with chemotherapy and radiation for metastatic breast cancer, and who has neutropenia. The nurse should include which of the following restrictions in the client's plan of care?
- A. Fresh flowers and potted plants in the room
- B. Use of public transportation
- C. Group activities
- D. Unrestricted visitors
Correct Answer: A
Rationale: The correct answer is A: Fresh flowers and potted plants in the room. Neutropenic clients are at high risk for infections due to low white blood cell count. Fresh flowers and plants can harbor bacteria and fungi that can potentially cause infections. Therefore, restricting fresh flowers and plants helps minimize the risk of infection. Choices B, C, and D are incorrect because they do not directly relate to the risk of infection in neutropenic clients. Using public transportation, engaging in group activities, or having visitors are generally safe as long as proper infection control measures are followed.