Nokea
Select the client who is at greatest risk for the development of cancer.
- A. A 76 year old female client who has a history of alcohol abuse.
- B. A 76 year old female client who has a history of diabetes.
- C. A 64 year old male client who has a history of impaired oxygen transport.
- D. A 64 year old male client who has hypotension.
Correct Answer: A
Rationale: Alcohol abuse is a known risk factor for several cancers, including liver, esophageal, and breast cancer, due to chronic inflammation and carcinogenic effects of alcohol metabolites.
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The mother of a child with moderate diarrhea asks how to manage her child's illness. Which of the following should the nurse suggest?
- A. Begin clear liquids for 24 hours.
- B. Feed the child bananas, rice, applesauce, and toast.
- C. Offer foods that are low in fat.
- D. Continue the child's regular diet.
Correct Answer: B
Rationale: The BRAT diet (bananas, rice, applesauce, toast) is recommended for moderate diarrhea in children to provide easily digestible, low-fiber foods that help firm stools.
A client with a history of asthma reports increased wheezing. Which medication should the nurse prepare to administer?
- A. Prednisone.
- B. Albuterol.
- C. Montelukast.
- D. Cromolyn sodium.
Correct Answer: B
Rationale: Albuterol, a short-acting beta-agonist, is the first-line treatment for acute asthma exacerbations to relieve bronchospasm.
A newborn diagnosed with respiratory distress syndrome (RDS) is prescribed surfactant replacement therapy. The nurse evaluates the infant 1 hour after the therapy and determines that the infant's condition has improved somewhat. Which finding indicates improvement?
- A. An audible respiratory grunt
- B. Slight increase in the respiratory rate
- C. Arterial blood pH increases to ≥ 7.35
- D. Fine inspiratory crackles heard over both lungs
Correct Answer: C
Rationale: RDS causes hypoperfusion with hypoxemia that results in tissue hypoxia and metabolic acidosis. If the arterial blood pH increases to ≥ 7.35, the metabolic acidosis is resolving and the newborn's condition is improving. Within a few hours, respiratory distress becomes more obvious in RDS. The respiratory rate continues to increase (to 80 to 120 breaths/min), so a gradual increase in rate does not mean that the condition is improving. Also, an audible respiratory grunt and fine inspiratory crackles heard over both lungs are not signs the condition is improving.
The nurse assesses the environmental safety of a client receiving home oxygen therapy. Which observation by the nurse indicates that the client needs further teaching to ensure safety?
- A. Oxygen used 30 feet from a gas stove
- B. Oxygen tank stored in the tank holder
- C. No smoking' sign posted at the front door
- D. Oxygen concentrator propped against a wall
Correct Answer: D
Rationale: The oxygen concentrator should be free and clear of walls or other enclosed spaces to allow adequate air circulation around the unit; otherwise, the unit can overheat and increase the risk of fire. Clients should avoid using oxygen within 10 feet of open flames because oxygen fuels a fire. Oxygen tanks are secured in a holder to stabilize and protect the tank, and a 'no smoking' sign should be in view to alert visitors about the risk.
Which of the following types of restraints is best for the nurse to use for a child in the immediate postoperative period after cleft palate repair?
- A. Safety jacket.
- B. Elbow restraints.
- C. Wrist restraints.
- D. Body restraints.
Correct Answer: B
Rationale: Elbow restraints are most appropriate post-cleft palate repair to prevent the child from touching or damaging the surgical site while allowing some mobility.