Nokea
The client is scheduled for an intravenous pyelogram (IVP) to determine the location of the renal calculi. Which of the following measures would be most important for the nurse to include in pretest preparation?
- A. Ensuring adequate fluid intake on the day of the test.
- B. Preparing the client for the possibility of bladder, the client is history for allergy to iodine.
- C. Determining when the client last had a bowel movement.
Correct Answer: B
Rationale: Checking for iodine allergy is critical for IVP due to the use of iodine-based contrast, which can cause severe allergic reactions.
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Doxorubicin (Adriamycin) is prescribed for a female client with breast cancer. The client is distressed about hair loss. The nurse should do which of the following?
- A. Have the client wash and massage the scalp daily to stimulate hair growth.
- B. Explain that hair loss is temporary and will quickly grow back to its original appearance.
- C. Provide resources for a wig selection before hair loss begins.
- D. Recommend that the client limit social contacts until hair regrows.
Correct Answer: C
Rationale: Providing resources for wig selection before hair loss begins helps the client prepare for and cope with chemotherapy-induced alopecia, maintaining her self-esteem.
A client with thyrotoxicosis says to the nurse, 'I am so irritable. I am having problems at work because I lose my temper very easily.' Which of the following responses by the nurse would give the client the most accurate explanation of her behavior?
- A. Your behavior is caused by your not following the medical regimen.'
- B. Your behavior is caused by the effects of the disease on your thyroid.'
- C. Your behavior is caused by your not accepting your diagnosis.'
- D. Your behavior is caused by the effects of the disease on your emotional stability.'
Correct Answer: B
Rationale: Thyrotoxicosis, due to excess thyroid hormone, increases metabolism and can affect the nervous system, leading to irritability and emotional lability. This explains the client's behavior as a direct result of the disease's impact on thyroid function.
A client with breast cancer presents with back pain, weakness, and difficulty urinating. The nurse suspects spinal cord compression. The priority nursing action is to:
- A. Administer analgesics immediately.
- B. Notify the physician for urgent evaluation.
- C. Encourage bed rest in a supine position.
- D. Perform a bladder scan.
Correct Answer: B
Rationale: Spinal cord compression is a medical emergency requiring urgent physician evaluation for imaging and interventions like corticosteroids or surgery to prevent permanent neurologic damage.
A 57-year-old with diabetes insipidus is hospitalized for care. Which finding should the nurse report to the physician?
- A. Urine output of 350 mL in 8 hours.
- B. Urine specific gravity of 1.001.
- C. Potassium of 4.0 mEq.
- D. Weight gain.
Correct Answer: B
Rationale: Diabetes insipidus causes excessive dilute urine output. A urine specific gravity of 1.001 (very dilute) indicates worsening of the condition and should be reported. The other findings are within normal or expected ranges.
The nurse is caring for a client with suspected retinal detachment. Which of the following manifestations would not be consistent with a diagnosis of retinal detachment?
- A. Seeing 'floaters' in the field of vision
- B. A sense of having a curtain drawn over the eyes
- C. Flashes of light
- D. Intense pain in the affected eye
Correct Answer: D
Rationale: Retinal detachment typically presents with floaters, a curtain-like shadow, and flashes of light due to the retina pulling away from the underlying tissue. Intense pain is not a common symptom, as retinal detachment is usually painless.