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The client diagnosed with menorrhagia complains to the nurse of feeling listless and tired all the time. Which scientific rationale would explain why these symptoms occur?
- A. The pain associated with the menorrhagia does not allow the client to rest.
- B. The client’s symptoms are unrelated to the diagnosis of menorrhagia.
- C. The client probably has been exposed to a virus that causes chronic fatigue.
- D. Menorrhagia has caused the client to have decreased levels of hemoglobin.
Correct Answer: D
Rationale: Menorrhagia causes blood loss, lowering hemoglobin (D), leading to fatigue/listlessness. Pain (A) is not primary, symptoms are related (B), and viral fatigue (C) is less likely.
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The nurse writes a diagnosis of 'activity intolerance' for a client diagnosed with anemia. Which intervention should the nurse implement?
- A. Encourage isometric exercises.
- B. Assist the client with activities of daily living (ADLs).
- C. Provide a high-protein diet.
- D. Refer to the physical therapist.
Correct Answer: B
Rationale: Assisting with ADLs (B) conserves energy in anemia-related activity intolerance. Isometric exercises (A) strain oxygen capacity, diet (C) is medical, and PT (D) is collaborative.
The nurse is administering a transfusion of packed red blood cells to a client. Which interventions should the nurse implement? List in order of performance.
- A. Start the transfusion slowly.
- B. Have the client sign a permit.
- C. Assess the IV site for size and patency.
- D. Check the blood with another nurse at the bedside.
- E. Obtain the blood from the laboratory.
Correct Answer: E,C,B,D,A
Rationale: 1. Obtain blood (E): Retrieve from lab. 2. Assess IV site (C): Ensure 18-gauge patency. 3. Sign permit (B): Obtain consent. 4. Check blood (D): Verify with another nurse. 5. Start slowly (A): Infuse at 10–15 mL/hr initially.
The nurse is teaching the client who is to undergo diagnostic testing for possible gastric cancer. Teaching the client about which specific diagnostic test would be most helpful?
- A. Bronchoscopy
- B. Sigmoid colonoscopy
- C. Esophagogastroduodenoscopy
- D. Multigated acquisition (MUGA) scan
Correct Answer: C
Rationale: A. Bronchoscopy includes insertion of a bronchoscope to examine the lungs. B. Colonoscopy is used to inspect the large intestines. C. EGD is an invasive procedure in which a lighted instrument (scope) is lowered into the stomach and duodenum to examine gastric tissues and obtain biopsies for cancer cell analysis. Because it is the preferred test to diagnose gastric cancer, the nurse should teach the client about this test. D. A MUGA scan creates video images of the ventricles of the heart to evaluate their correct function in pumping blood. A person who is to receive chemotherapy for cancer treatment may have a MUGA scan completed to identify preexisting heart conditions.
The female client, who has Hodgkin’s lymphoma with cervical and axillary node involvement, is to receive chemotherapy and radiation. The nurse evaluates that the client is coping positively when the client makes which statement?
- A. “I’ve a wig that matches my hair color, but I’ll miss my own hair.”
- B. “I am so glad that the treatments won’t cause me to lose my hair.”
- C. “I’m happy that the drug-radiation combination prevents mucositis.”
- D. “I’ve faith that my doctor will cure me and I’ll never have cancer again.”
Correct Answer: A
Rationale: A. The client is expressing feelings about hair loss but has acted positively related to her feelings and obtained a wig. This statement indicates positive coping. B. This statement reflects that either the client is in denial or is uninformed regarding the effects of chemotherapy and radiation treatments. Chemotherapy and radiation will involve the cervical lymph nodes; side effects will include alopecia. C. Chemotherapy and radiation will involve the cervical lymph nodes; side effects will include mucositis. D. The risk for other cancers is increased after chemotherapy and radiation for Hodgkin’s lymphoma, so long-term surveillance is crucial.
Which situation might cause the nurse to think that the client has von Willebrand’s (vW) disease?
- A. The client has had unexplained episodes of hematemesis.
- B. The client has microscopic blood in the urine.
- C. The client has prolonged bleeding following surgery.
- D. The client developed abruptio placentae.
Correct Answer: C
Rationale: vWD impairs clotting, causing prolonged bleeding post-surgery (C). Hematemesis (A) and hematuria (B) are less specific, and abruptio placentae (D) is unrelated.