Nokea
After surgery for gastric cancer, a client is scheduled to undergo radiation therapy. It will be most important for the nurse to include information about which of the following in the client's teaching plan?
- A. Nutritional intake.
- B. Management of alopecia.
- C. Exercise and activity levels.
- D. Access to community resources.
Correct Answer: A
Rationale: Radiation therapy can affect appetite and digestion, making nutritional intake a priority in the teaching plan to maintain the client's strength and recovery. The other options are less critical.
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A client uses a metered-dose inhaler (MDI) to aid in management of his asthma. Which action by the client indicates to the nurse that he needs further instruction regarding its use? Select all that apply.
- A. Activation of the MDI is not coordinated with inspiration.
- B. The client inspires rapidly when using the MDI.
- C. The client holds his breath for 3 seconds after inhaling with the MDI.
- D. The client shakes the MDI after use.
- E. The client performs puffs in rapid succession.
Correct Answer: A,B,C,E
Rationale: Incorrect MDI use includes not coordinating activation with inspiration (A), rapid inspiration (B), holding breath for only 3 seconds (C; should be 10 seconds), and rapid successive puffs (E; wait 1 minute between puffs). Shaking after use (D) is incorrect but less critical.
The nurse is teaching a client with a total knee replacement about incision care. Which statement by the client indicates a need for further teaching?
- A. I'll keep the incision clean and dry.'
- B. I'll report redness or drainage.'
- C. I'll change the dressing weekly.'
- D. I'll avoid soaking the incision.'
Correct Answer: C
Rationale: Changing the dressing weekly is too infrequent; daily or as-needed changes are required to monitor for infection.
A client with acute renal failure has a potassium level of 6.5 mEq/L. The nurse should prepare for:
- A. IV insulin and glucose.
- B. Oral potassium supplements.
- C. Fluid restriction.
- D. Diuretic administration.
Correct Answer: A
Rationale: Insulin and glucose shift potassium into cells, treating hyperkalemia.
A client in hospice care is experiencing noisy, gurgling respirations. The nurse should:
- A. Suction the airway.
- B. Administer oxygen at 6 L/min.
- C. Reposition the client to a lateral position.
- D. Increase I.V. fluids.
Correct Answer: C
Rationale: Noisy, gurgling respirations (death rattle) are best managed by repositioning to a lateral position to allow secretions to drain, improving comfort without invasive measures.
A 32-year-old female meets with the nurse on her first office visit since undergoing a left mastectomy. When asked how she is doing, the woman says her appetite is still not good, she is not getting much sleep because she doesn't go to bed until her husband is asleep, and she is really anxious to get back to work. Which of the following nursing interventions should the nurse explore to support the client's current needs?
- A. Call the physician to discuss allowing the client to return to work earlier.
- B. Suggest that the client learn relaxation techniques for help with her insomnia.
- C. Perform a nutritional assessment to assess for anorexia.
- D. Ask open-ended questions about sexuality issues related to her mastectomy.
Correct Answer: B
Rationale: Insomnia is a primary concern, and relaxation techniques can help improve sleep, addressing the client's emotional and physical recovery needs post-mastectomy.