Nokea
The client is a survivor of non-Hodgkin's lymphoma. Which of the following statements indicates the client needs additional information?
- A. Regular screening is very important for me.'
- B. The survivor rate is directly proportional to the incidence of second malignancy.'
- C. The survivor rate is indirectly proportional to the incidence of second malignancy.'
- D. It is important for survivors to know the stage of the disease and their current treatment plan.'
Correct Answer: B
Rationale: The survival rate for non-Hodgkin's lymphoma is inversely proportional to the incidence of second malignancies, as secondary cancers reduce survival. The statement that it is directly proportional indicates a misunderstanding. Regular screening, knowing disease stage, and treatment plans are correct.
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A client with colon cancer undergoes surgical removal of a segment of colon and creation of a sigmoid colostomy. What assessments by the nurse indicate the client is developing complications within the first 24 hours? Select all that apply.
- A. Coarse breath sounds auscultated bilaterally at the bases.
- B. Dusky appearance of the stoma.
- C. No drainage in the ostomy appliance.
- D. Temperature greater than 101.2°F (38.5°C).
- E. Decreased bowel sounds.
Correct Answer: B,C,D
Rationale: A dusky stoma (B) indicates poor blood supply, no drainage (C) suggests obstruction or dysfunction, and fever (D) may indicate infection, all of which are complications post-colostomy. Coarse breath sounds (A) and decreased bowel sounds (E) are not necessarily indicative of immediate complications.
A client with ascites and peripheral edema is at risk for impaired skin integrity. To prevent skin breakdown, the nurse should:
- A. Institute range-of-motion (ROM) exercise every 4 hours.
- B. Massage the abdomen once a shift.
- C. Use an alternating air pressure mattress.
- D. Elevate the lower extremities.
Correct Answer: C
Rationale: An alternating air pressure mattress (C) prevents pressure ulcers in clients with edema. ROM exercises (A) and elevation (D) are helpful but secondary. Abdominal massage (B) is not indicated.
The nurse is admitting a 68-year-old male to the medical floor. The echocardiogram report revealed left ventricular enlargement. The nurse notes 2+ pitting edema in the ankles when getting the client into bed. Based on this finding, what should the nurse do first?
- A. Assess respiratory status.
- B. Draw blood for laboratory studies.
- C. Insert a Foley catheter.
- D. Weigh the client.
Correct Answer: A
Rationale: Edema and left ventricular enlargement suggest heart failure, which can cause pulmonary edema. Assessing respiratory status first detects signs of respiratory distress.
The nurse overhears a surgical team member discussing a client's procedure in the hospital cafeteria. The nurse should:
- A. Report the breach to the hospital's privacy officer.
- B. Confront the team member immediately.
- C. Document the incident in the client's chart.
- D. Ignore the conversation as it was unintentional.
Correct Answer: A
Rationale: Discussing client information in a public area violates HIPAA. Reporting to the privacy officer ensures proper handling of the confidentiality breach.
What should the nurse teach a client about stoma care?
- A. Clean with hydrogen peroxide.
- B. Measure stoma size weekly.
- C. Apply adhesive remover.
- D. Change pouch every day.
Correct Answer: B
Rationale: Measuring stoma size weekly ensures proper appliance fit as swelling subsides.