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The client tells the nurse about being diagnosed with a 2-cm cancerous tumor in the liver. The client wants to know about the treatment. Which statement should be the basis for the nurse’s response?
- A. The use of chemotherapy is the first-line treatment for liver cancer.
- B. Liver transplantation is not an option for clients with liver cancer.
- C. Radiofrequency ablation can be successful in treating tumors of this size.
- D. A tumor of this size can only be removed through an open surgical approach.
Correct Answer: C
Rationale: A. Chemotherapy is only used for clients who are not likely to benefit from other therapies. B. Liver transplantation is used when the tumor is large or localized. C. Radiofrequency ablation is a treatment technique that uses high-frequency alternating electrical current to heat tissue cells and destroy them. It can be successfully used to treat tumors less than 5 cm in size because these tumors tend to be slow growing and encapsulated. D. Surgical resection of the tumor is used when the tumor is large or localized.
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Which data should the nurse expect to assess in the client who had an upper gastrointestinal (UGI) series?
- A. Chalky white stools.
- B. Increased heart rate.
- C. A firm, hard abdomen.
- D. Hyperactive bowel sounds.
Correct Answer: A
Rationale: A UGI series uses barium, which can cause chalky white stools as it is excreted. Heart rate, abdominal firmness, and bowel sounds are not typically affected.
The nurse is caring for clients in an outpatient clinic. Which information should the nurse teach regarding the American Cancer Society's recommendations for the early detection of colon cancer?
- A. Beginning at age 60, a digital rectal examination should be done yearly.
- B. After reaching middle age, a yearly fecal occult blood test should be done.
- C. Have a colonoscopy at age 50 and then once every five (5) to 10 years.
- D. A flexible sigmoidoscopy should be done yearly after age 40.
Correct Answer: C
Rationale: The American Cancer Society recommends a colonoscopy starting at age 45–50, then every 5–10 years for average-risk individuals, as it effectively detects polyps and cancer. Other options are outdated or incorrect.
The client has dark, watery, and shiny-appearing stool. Which intervention should the nurse implement first?
- A. Check for a fecal impaction.
- B. Encourage the client to drink fluids.
- C. Check the chart for sodium and potassium levels.
- D. Apply a protective barrier cream to the perianal area.
Correct Answer: D
Rationale: Dark, watery stool risks perianal skin breakdown, so applying a barrier cream is the first intervention. Impaction is unlikely, fluids are secondary, and labs follow assessment.
A client with cirrhosis is about to have a paracentesis for relief of ascites. Which activity is essential prior to the procedure?
- A. Administer thorough mouth care.
- B. Ask the client to empty his bladder.
- C. Be sure his bowels have moved recently.
- D. Have the client bathe with betadine.
Correct Answer: B
Rationale: Emptying the bladder prevents accidental puncture during paracentesis, which involves inserting a needle into the abdominal cavity.
The client is one (1) day postoperative major abdominal surgery. Which client problem is priority?
- A. Impaired skin integrity.
- B. Fluid and electrolyte imbalance.
- C. Altered bowel elimination.
- D. Altered body image.
Correct Answer: B
Rationale: Fluid and electrolyte imbalance is the priority due to risks of dehydration or imbalances from surgery, impacting hemodynamic stability. Skin integrity, bowel elimination, and body image are secondary in the immediate postoperative period.