Nokea
In assessing cancer risk, which woman is at greatest risk of developing breast cancer?
- A. A 35-year-old multipara who never breastfed.
- B. A 50-year-old whose mother had unilateral breast cancer.
- C. A 55-year-old whose mother-in-law had bilateral breast cancer.
- D. A 20-year-old whose menarche occurred at age 9.
Correct Answer: B
Rationale: The correct answer is B because family history of breast cancer, specifically in the mother, is a significant risk factor for developing breast cancer. The age of 50 is also a risk factor for breast cancer. Choice A is less likely as breastfeeding can actually reduce the risk of breast cancer. Choice C is less relevant since the risk is higher with a direct family member. Choice D, although early menarche is a risk factor, the age of the individual is much lower compared to the other age-related risk factors.
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A client is placed on a mechanical ventilator following a cerebral hemorrhage, and vecuronium bromide (Norcuron) 0.04 mg/kg q12 hours IV is prescribed. What is the priority nursing diagnosis for this client?
- A. Impaired communication related to paralysis of skeletal muscles.
- B. High risk for infection related to increased intracranial pressure.
- C. Potential for injury related to impaired lung expansion.
- D. Social isolation related to inability to communicate.
Correct Answer: A
Rationale: The priority nursing diagnosis for a client on a mechanical ventilator receiving vecuronium bromide is 'Impaired communication related to paralysis of skeletal muscles.' Vecuronium is a skeletal muscle relaxant that causes diaphragmatic paralysis, leading to the inability of the client to communicate effectively. This is a crucial nursing concern as it impacts the client's ability to express needs and participate in care. Option B 'High risk for infection related to increased intracranial pressure' is not the priority in this scenario as the client's condition is related to the effects of the medication and mechanical ventilation, not directly to increased intracranial pressure. Option C 'Potential for injury related to impaired lung expansion' is important but not the priority over impaired communication. Option D 'Social isolation related to inability to communicate' is not the priority nursing diagnosis in this situation as it focuses more on psychosocial aspects rather than the immediate physiological concern of communication impairment.
A female client taking oral contraceptives reports to the nurse that she is experiencing calf pain. What action should the nurse implement?
- A. Determine if the client has also experienced breast tenderness and weight gain.
- B. Encourage the client to begin a regular, daily program of walking and exercise.
- C. Advise the client to notify the healthcare provider for immediate medical attention.
- D. Tell the client to stop taking the medication for a week to see if symptoms subside.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
In a 46-year-old female client admitted for acute renal failure secondary to diabetes and hypertension, which test is the best indicator of adequate glomerular filtration?
- A. Serum creatinine.
- B. Blood urea nitrogen (BUN).
- C. Sedimentation rate.
- D. Urine specific gravity.
Correct Answer: A
Rationale: The correct answer is A: Serum creatinine. Creatinine is a product of muscle metabolism that is filtered by the glomerulus. Blood levels of creatinine are not affected by dietary or fluid intake, making it a reliable indicator of kidney function. An elevated creatinine level strongly suggests nephron loss, indicating decreased glomerular filtration rate. Choice B, Blood Urea Nitrogen (BUN), reflects the amount of urea nitrogen in the blood and can be influenced by factors other than kidney function, such as protein intake and liver health, making it less specific for evaluating glomerular filtration. Choice C, Sedimentation rate, is a measure of how quickly red blood cells settle in a test tube and is not a direct marker of kidney function. Choice D, Urine specific gravity, mainly reflects the kidney's ability to concentrate urine and is not a direct indicator of glomerular filtration rate. Therefore, Serum creatinine is the most appropriate test to assess glomerular filtration in this scenario.
A client who just returned from the recovery room after a tonsillectomy and adenoidectomy is restless, and her pulse rate is increased. As the nurse continues the assessment, the client begins to vomit a copious amount of bright-red blood. The immediate nursing action is to:
- A. Notify the surgeon
- B. Continue the assessment
- C. Check the client's blood pressure
- D. Obtain a flashlight, gauze, and a curved hemostat
Correct Answer: A
Rationale: In the scenario described, the client's presentation with bright-red blood vomiting after a tonsillectomy and adenoidectomy is highly concerning for an immediate postoperative hemorrhage, which can be life-threatening. The priority action for the nurse is to notify the surgeon immediately. Prompt communication with the surgeon is vital to ensure swift intervention and appropriate management to address the hemorrhage effectively. Continuing the assessment, checking the client's blood pressure, or obtaining equipment are all secondary actions in this critical situation and would delay the necessary urgent intervention required to manage the hemorrhage effectively.
A 57-year-old male client is scheduled to have a stress-thallium test the following morning and is NPO after midnight. At 0130, he is agitated because he cannot eat and is demanding food. Which response is best for the nurse to provide to this client?
- A. I'm sorry sir, you have a prescription for nothing by mouth from midnight tonight.
- B. I will let you have one cracker, but that is all you can have for the rest of tonight.
- C. What did the healthcare provider tell you about the test you are having tomorrow?
- D. The test you are having tomorrow requires that you have nothing by mouth tonight.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.