Nokea
During the initial stage of adaptation to the diagnosis of cancer and its treatment, the nurse can facilitate the client's adaptation by:
- A. Encouraging the client to maintain her usual role.
- B. Facilitating family-related disagreements and conflicts.
- C. Supporting the client in her use of denial as a coping strategy.
- D. Arranging transportation and child care on treatment days.
Correct Answer: D
Rationale: Arranging transportation and child care addresses practical barriers, facilitating the client's ability to focus on treatment and adapt to the diagnosis.
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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.
When monitoring a client who is receiving t-PA, the nurse should have resuscitation equipment available because reperfusion of the cardiac tissue can result in which of the following?
- A. Cardiac arrhythmias.
- B. Hypertension.
- C. Seizure.
- D. Hypothermia.
Correct Answer: A
Rationale: Reperfusion from t-PA can cause arrhythmias due to myocardial irritability as blood flow is restored, necessitating resuscitation equipment.
A client with bladder cancer reports fatigue and weight loss. The nurse should assess for:
- A. Metastasis.
- B. Dehydration.
- C. Infection.
- D. Anemia.
Correct Answer: A
Rationale: Fatigue and weight loss in bladder cancer may indicate metastasis, as the disease progresses.
A terminally ill 82-year-old client in hospice care is experiencing nausea and vomiting because of a partial bowel obstruction. To respect the client's wishes for conservative management of the nausea and vomiting, the nurse should recommend the use of:
- A. A nasogastric (NG) suction tube.
- B. I.V. antiemetics.
- C. Antibiotic laxatives.
- D. A clear liquid diet.
Correct Answer: B
Rationale: I.V. antiemetics are a conservative, effective way to manage nausea and vomiting in hospice care, aligning with the client's preference for non-invasive treatment.
A nurse is admitting a client who has been admitted with a diagnosis of upper GI bleeding to the hospital. The nurse should assess the client for which of the following? Select all that apply.
- A. Dry, flushed skin.
- B. Decreased urine output.
- C. Tachycardia.
- D. Widening pulse pressure.
- E. Rapid respirations.
- F. Thirst.
Correct Answer: A,B,C,E,F
Rationale: Upper GI bleeding can lead to hypovolemia, causing dry, flushed skin, decreased urine output, tachycardia, rapid respirations, and thirst. Widening pulse pressure is not typically associated with hypovolemia.