Nokea
Common clinical feature of renal carcinoma is:
- A. Dysuria
- B. Pain less haematuria
- C. Urgency
- D. Erythema
Correct Answer: B
Rationale: Renal carcinoma (e.g., renal cell carcinoma) often presents insidiously. Dysuria (choice A) suggests infection, not cancer. Painless hematuria (choice B) is classic, as tumors bleed into urine without early pain, often the first sign. Urgency (choice C) relates to bladder issues, not renal tumors. Erythema (choice D) is skin redness, unrelated. B is correct, reflecting renal carcinoma's hallmark. Nurses educate on reporting hematuria, monitor for flank pain or mass (later signs), and support diagnostic imaging, aiding early detection.
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A client reports difficulty sleeping at night, which interferes with daily functioning. Which intervention should the nurse suggest to this client?
- A. Avoid beverages containing caffeine
- B. Take a sleep medication regularly at bedtime
- C. Watch television for 30 minutes in bed to relax before falling asleep
- D. Advise the client to take several naps during the day
Correct Answer: A
Rationale: The correct answer is A: Avoid beverages containing caffeine. Caffeine is a stimulant that can interfere with sleep, making it difficult for the client to fall asleep at night. Taking sleep medication regularly (choice B) may not address the root cause of the sleep difficulty and can lead to dependency. Watching television in bed (choice C) can actually stimulate the brain and hinder relaxation before sleep. Advising the client to take several naps during the day (choice D) can disrupt the sleep-wake cycle further. Therefore, recommending the avoidance of caffeine-containing beverages is the most appropriate intervention to help the client improve their ability to sleep at night and function better during the day.
Which of the following statement is TRUE about patient's bill of rights?
- A. The client can leave anytime he wants even against medical advice
- B. The client has no right to refuse treatment
- C. The hospital can deny treatment in emergency cases
- D. The client has the right to considerate care only from nurses
Correct Answer: A
Rationale: The client can leave anytime, even against medical advice (A), per autonomy in the bill of rights AMA discharge is legal. No right to refuse (B) is false, hospitals can't deny emergencies (C) per EMTALA, considerate care isn't nurse-only (D). A upholds patient choice, making it true.
Which of the following clinical findings is expected in a patient who has undergone gastric lavage and prolonged vomiting?
- A. Decreased serum pH
- B. Increased serum bicarbonate level
- C. Increased serum oxygen level
- D. Decreased serum osmotic level
Correct Answer: A
Rationale: Prolonged vomiting and gastric lavage lose stomach acid (HCl), causing metabolic alkalosis elevated pH, not decreased (acidosis). Bicarbonate rises as the body compensates, not oxygen or osmolarity, which are unrelated. Nurses monitor for alkalosis symptoms (e.g., tetany), correcting with fluids like saline, restoring acid-base balance disrupted by gastric content loss.
In an emergency department, a provider is assessing a client with an acute head injury following a motor-vehicle crash. Which of the following findings should be prioritized?
- A. A Glasgow Coma Scale score of 13
- B. Clear fluid leaking from the nose
- C. Nausea and vomiting
- D. Anisocoria
Correct Answer: B
Rationale: The priority finding is the clear fluid leaking from the nose, which could indicate a cerebrospinal fluid leak and potential brain injury. This requires immediate attention to assess for possible cerebrospinal fluid leak, which is a serious complication of head trauma and needs prompt intervention to prevent further complications. While a Glasgow Coma Scale score of 13 may indicate a mild alteration in consciousness, it is not as urgent as assessing for a cerebrospinal fluid leak. Nausea and vomiting are common symptoms after head injuries but do not take precedence over assessing for a potential cerebrospinal fluid leak. Anisocoria (unequal pupils) is also important to note but is not as urgent as identifying a possible cerebrospinal fluid leak in this scenario.
The nurse is providing dietary teaching for a client with a history of renal calculi. Which dietary selection reflects an understanding of the nurse's teaching?
- A. Tea, peanut butter sandwich, and grape juice
- B. Cola, fried chicken, and baked potato
- C. Coffee, carrot sticks, and roast beef
- D. Cocoa, spinach salad, and sardines
Correct Answer: C
Rationale: Coffee, carrot sticks, and roast beef suit renal calculi prevention, avoiding oxalate-rich (cocoa, spinach) or calcium-binding (tea, peanut butter) foods cola's phosphates also risk stones. Nurses teach low-oxalate diets, reducing recurrence, supporting kidney health in at-risk clients.