Nokea
An appropriate nursing intervention for a client with fatigue related to cancer treatment includes teaching the client to:
- A. Increase fluid intake.
- B. Minimize naps or periods of rest during day.
- C. Conserve energy by limiting activities.
- D. Limit dietary intake of high-fiber foods.
Correct Answer: C
Rationale: Conserving energy by limiting activities helps manage fatigue, a common side effect of cancer treatment, by balancing rest and activity.
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A nurse is caring for a client who is prescribed a medication with a narrow therapeutic index (NTI). Which action should the nurse take when administering this medication?
- A. Administer the medication as prescribed, ensuring strict adherence to the dosing schedule.
- B. Administer the medication concurrently with herbal supplements to augment its efficacy.
- C. Combine the medication with other medications to enhance its therapeutic effects.
- D. Administer the medication at a higher dose than prescribed to achieve faster results.
Correct Answer: A
Rationale: NTI medications require strict adherence to dosing to maintain therapeutic levels and avoid toxicity.
The nurse should plan to begin rehabilitation efforts for the burn client:
- A. Immediately after the burn has occurred.
- B. After the client's circulatory status has been stabilized.
- C. After the client's pain has been eliminated.
- D. After the client's pain has been eliminated.
Correct Answer: B
Rationale: Rehabilitation begins after stabilizing the client's circulatory status (emergent phase), as this ensures survival and allows focus on recovery. Immediate rehab is unsafe, and complete pain elimination is unrealistic.
A client at risk for lung cancer asks why he is scheduled for a computed tomography (CT) scan as part of his initial workup. The nurse's best response is which of the following?
- A. CT is far superior to magnetic resonance imaging for evaluating lymph node metastasis.
- B. CT is noninvasive and readily available.
- C. CT is useful for distinguishing small differences in tissue density and detecting nodal involvement.
- D. CT can distinguish a malignant from a nonmalignant adenopathy.
Correct Answer: C
Rationale: CT scans are valuable in lung cancer workups because they can detect small differences in tissue density and identify nodal involvement, aiding in staging and diagnosis.
The nurse observes that an older female has small to moderate, distended and tortuous veins running along the inner aspect of her lower legs. The nurse should:
- A. Apply a half-leg pneumatic compression device
- B. Suggest the client contact her physician
- C. Assess the client for foot ulcers
- D. Encourage the client to avoid standing in one position for long periods of time
Correct Answer: D
Rationale: Distended, tortuous veins suggest varic varicose veins. Avoiding prolonged standing reduces venous pooling and symptom progression. Applying compression devices requires a prescription, contacting a physician is premature, and foot ulcers are not indicated by the description.
An 80-year-old client had spinal anesthesia for a transurethral resection of the prostate and received 4,000 mL of room temperature isotonic bladder irrigation. He now has continuous irrigation through a three-way indwelling urinary catheter. Which postoperative nursing intervention is most important to include in his plan of care?
- A. Empty the catheter drainage bag.
- B. Cover the client with warm blankets.
- C. Hang new bags of irrigation.
- D. Turn the client.
Correct Answer: B
Rationale: Room-temperature irrigation can cause hypothermia, especially in an elderly client. Covering with warm blankets is the most important intervention to maintain normothermia.