Nokea
The client diagnosed with cancer of the pancreas is being discharged to start chemotherapy in the HCP's office. Which statement made by the client indicates the client understands the discharge instructions?
- A. I will have to see the HCP every day for six (6) weeks for my treatments.
- B. I should write down all my questions so I can ask them when I see the HCP.
- C. I am sure this is not going to be a serious problem for me to deal with.
- D. The nurse will give me an injection in my leg and I will get to go home.
Correct Answer: B
Rationale: Writing down questions ensures effective communication with the HCP, indicating understanding. Daily visits, downplaying severity, and leg injections are incorrect.
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Which finding would be the greatest cause for concern to the nurse during the early postoperative period following a thyroidectomy?
- A. Temperature of 100°F
- B. A sore throat
- C. Carpal spasm when the blood pressure is taken
- D. Complaints of pain in the area of the surgical incision
Correct Answer: C
Rationale: Carpal spasm (Trousseau’s sign) indicates hypocalcemia, a serious complication post-thyroidectomy due to parathyroid gland injury.
Which documentation finding provides the best indication that the client has successfully avoided an adrenal (addisonian) crisis after surgery?
- A. The client's pedal edema has lessened.
- B. Capillary blood glucose level is within normal limits.
- C. Vital signs are within preoperative ranges.
Correct Answer: C
Rationale: Stable vital signs indicate the absence of adrenal crisis, characterized by hypotension and shock.
The nurse is discussing complications of chronic pancreatitis with a client diagnosed with the disease. Which complication should the nurse discuss with the client?
- A. Diabetes insipidus (DI).
- B. Crohn's disease.
- C. Narcotic addiction.
- D. Peritonitis.
Correct Answer: C
Rationale: Chronic pancreatitis often requires long-term pain management, risking narcotic addiction. DI, Crohn’s, and peritonitis are unrelated complications.
The client diagnosed with acute pancreatitis is being discharged home. Which statement by the client indicates the teaching has been effective?
- A. I should decrease my intake of coffee, tea, and cola.
- B. I will eat a low-fat diet and avoid spicy foods.
- C. I will check my amylase and lipase levels daily.
- D. I will return to work tomorrow but take it easy.
Correct Answer: B
Rationale: A low-fat, non-spicy diet prevents pancreatitis exacerbation, indicating effective teaching. Caffeine reduction is secondary, amylase/lipase are not self-monitored, and early work return is risky.
The nurse identified a concept of metabolism for a client diagnosed with diabetes mellitus type 2. Which interventions should the nurse include in the plan of care? Select all that apply.
- A. Teach the client to perform self glucose monitoring.
- B. Instruct the client about complications of high-glucose levels.
- C. Instruct the client to inspect the feet daily.
- D. Explain the need to carry a source of quick-acting proteins.
- E. Encourage the client to have regular eye exams.
Correct Answer: A,B,C,E
Rationale: Glucose monitoring, complication education, foot inspections, and eye exams manage type 2 diabetes and prevent complications. Quick-acting proteins are incorrect; carbohydrates treat hypoglycemia.