Nokea
After completing her first chemotherapy treatment, what behavior indicates that a female client with breast cancer understands her discharge care needs?
- A. She refuses to take anti-nausea medication.
- B. She rents movies and borrows books to pass time at home.
- C. She plans to resume strenuous physical activity immediately.
- D. She reports severe fatigue and inability to perform daily activities.
Correct Answer: B
Rationale: Renting movies and borrowing books for use during recovery indicates the client is planning restful activities at home, which aligns with appropriate post-chemotherapy care. Choices A, C, and D are incorrect because refusing anti-nausea medication can lead to complications, resuming strenuous physical activity immediately can be harmful, and reporting severe fatigue and inability to perform daily activities may indicate a need for medical attention rather than understanding discharge care needs.
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The nurse is evaluating the laboratory reports of a client with hypothyroidism. The nurse would expect which of the following laboratory values?
- A. Increased TSH
- B. Increased thyroxine (T4)
- C. Decreased TSH
- D. Decreased T3
Correct Answer: A
Rationale: The correct answer is A: Increased TSH. In hypothyroidism, the thyroid gland is underactive, leading to low levels of thyroid hormones. As a compensatory mechanism, the pituitary gland releases more thyroid-stimulating hormone (TSH) to try to stimulate the thyroid gland to produce more hormones. Therefore, increased TSH levels are expected in hypothyroidism. Choice B is incorrect because in hypothyroidism, thyroxine (T4) levels are usually decreased, not increased. Choice C is incorrect as hypothyroidism is characterized by increased TSH levels, not decreased. Choice D is also incorrect because in hypothyroidism, T3 levels may be decreased, but TSH is a more sensitive indicator for diagnosis.
A client with cirrhosis is at risk for bleeding due to impaired liver function. Which laboratory result is the most important to monitor?
- A. Blood urea nitrogen (BUN)
- B. Prothrombin time (PT)
- C. Aspartate aminotransferase (AST)
- D. Serum albumin
Correct Answer: B
Rationale: Prothrombin time (PT) measures the time it takes for blood to clot and is a critical indicator of bleeding risk in clients with liver dysfunction. Impaired liver function reduces clotting factor production, leading to an increased PT, which requires close monitoring. Monitoring BUN (Choice A) is more indicative of kidney function, not clotting ability. Aspartate aminotransferase (AST) (Choice C) and serum albumin (Choice D) are important indicators of liver function, but they do not directly assess the client's bleeding risk.
A client presents to the clinic with a large abscess on the right thigh. The healthcare provider incises and drains the abscess. Which instruction should the nurse provide to the client upon discharge?
- A. Avoid showering until the wound is completely closed
- B. Perform daily wound care and dressing changes
- C. Apply heat to the wound for 15 minutes twice a day
- D. Take the prescribed antibiotic until the wound is fully healed
Correct Answer: B
Rationale: After incision and drainage of an abscess, it is crucial to perform daily wound care and dressing changes to prevent infection and promote healing. Avoiding showering until the wound is completely closed (choice A) may not be practical or necessary. Applying heat to the wound (choice C) can increase the risk of infection and delay healing. While taking the prescribed antibiotic (choice D) is important, wound care and dressing changes are more directly related to promoting healing and preventing complications.
A client with Type 2 diabetes is admitted with frequent hyperglycemic episodes and glycosylated hemoglobin (A1C) of 10%. What actions should the nurse include in the client's plan of care?
- A. Mixing glargine with aspart insulin to manage glucose levels.
- B. Teaching foot care to prevent injuries.
- C. Coordinating carbohydrate-controlled meals and subcutaneous injections.
- D. Reviewing site rotation for insulin injections.
Correct Answer: C
Rationale: In managing a client with Type 2 diabetes experiencing frequent hyperglycemic episodes and with a high A1C level, it is crucial to coordinate carbohydrate-controlled meals and subcutaneous injections. This approach helps regulate blood glucose levels effectively. Mixing glargine with aspart insulin (Choice A) is not a recommended practice as these insulins have different onset and peak times. Teaching foot care (Choice B) is important in diabetes management but is not the priority in this scenario. Reviewing site rotation for insulin injections (Choice D) is important to prevent lipodystrophy but is not the immediate action needed to address the client's hyperglycemia and high A1C level.
A client presents with three positive responses to the CAGE questionnaire. What interpretation should the nurse provide?
- A. CAGE is a tool for general substance abuse screening.
- B. Two positive responses suggest alcohol dependence.
- C. One positive response does not indicate alcohol addiction.
- D. All four responses must be positive to suggest alcohol dependence.
Correct Answer: B
Rationale: Two positive responses on the CAGE questionnaire strongly suggest alcohol dependence. Choice A is incorrect as the CAGE questionnaire specifically targets alcohol abuse. Choice C is incorrect because one positive response is not enough to indicate alcohol addiction. Choice D is incorrect because alcohol dependence can be suggested with two positive responses, not all four.