Nokea
Instructions for a patient at risk for testicular cancer include
- A. Restrict potassium, phosphate, sodium, protein in diet.
- B. Self-catheterization of ileal reservoir.
- C. Testicular self-exam.
- D. Change in color of urine is to be expected.
Correct Answer: C
Rationale: Regular self-exams help detect testicular cancer early.
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What is first-line therapy for insomnia?
- A. Complementary therapies such as melatonin
- B. Cognitive-behavioral therapies such as relaxation therapy
- C. Benzodiazepine-receptor-like agents (e.g., zolpidem [Ambien])
- D. Over-the-counter medication such as diphenhydramine (Benadryl)
Correct Answer: B
Rationale: The correct answer is B. Cognitive-behavioral therapy (CBT) is the first-line treatment for insomnia due to its effectiveness and lack of side effects. Melatonin (A) and over-the-counter medications (D) are secondary options, while benzodiazepines (C) are reserved for short-term use.
A 35-year-old female client has returned to her room following surgery on her right femur. She has an IV of D5 1/2 NS infusing at 125 cc/hr, and is receiving morphine sulfate 10-15 mg IM q4h prn for pain. The client last voided 5 1/2 hours ago when she was given her preoperative medication. To monitor and promote the return of urinary function after surgery, the nurse should:
- A. provide food and fluids at the client's request.
- B. maintain the IV, increasing the rate hourly until the client voids.
- C. report to the surgeon if the client is unable to void within 8 hours of surgery.
- D. hold the morphine sulfate injections for pain until the client voids, explaining to the client that morphine sulfate can cause urinary retention.
Correct Answer: C
Rationale: Provision of food and fluids promotes bowel elimination. Postoperative nutritional needs are physician determined, not client determined. Increasing IV fluids postoperatively will not cause a client to void. Any change in the rate of administration of IV fluids is determined by the physician, not the nurse. If the postoperative client with normal kidney function cannot void 8 hours after surgery, the client is retaining urine. The client may need catheterization or medication. The physician will provide orders for either, as necessary. While morphine sulfate can cause urinary retention, withholding pain medication will not ensure that the client will void. The client with uncontrolled pain will probably not be able to void.
When examining a patient who is paralyzed below the T4 level, the medical-surgical nurse expects to find
- A. flaccidity of the upper extremities.
- B. hyperreflexia and spasticity of the upper extremities.
- C. independent use of upper extremities and efficient cough.
- D. impaired diaphragmatic function requiring ventilator support.
Correct Answer: C
Rationale: Patients paralyzed below T4 typically retain independent use of upper extremities.
If the SpO2 level is above 90%, what can be assumed about the PaO2?
- A. Hypoxia
- B. Hypercapnia
- C. Acidosis
- D. Alkalosis
Correct Answer: C
Rationale: Acidosis occurs when blood pH drops below 7.35 due to an accumulation of hydrogen ions, commonly resulting from respiratory or metabolic imbalances.
Why may it pose a challenge to supplement or restrict dietary consumption when providing health-related education to clients from culturally diverse populations?
- A. Cultural beliefs about food may conflict with dietary recommendations.
- B. Clients may prefer traditional healers over modern medicine.
- C. Language barriers may hinder understanding.
- D. All of the above.
Correct Answer: A
Rationale: Cultural beliefs significantly influence dietary habits, requiring sensitivity and adaptation in health education.