Nokea
The HCP has prescribed two (2) IV antibiotics for the female client diagnosed with diabetes and pneumonia. Which order should the nurse request from the HCP?
- A. Request written information on antibiotic-caused vaginal infections.
- B. Request yogurt to be served on the client’s meal trays.
- C. Request a change of one of the antibiotics to an oral route.
- D. Request L. acidophilus, a probiotic medication, three (3) times a day.
Correct Answer: D
Rationale: Probiotics like L. acidophilus prevent antibiotic-associated vaginal yeast infections. Written information is less proactive, yogurt is insufficient, and changing routes is unnecessary.
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The nurse correctly informs the client that the breast self-examination (BSE) technique involves palpating each breast moving in small concentric circles, following imaginary spokes in a wheel, or moving in rows from superior to inferior stress of the breast. Besides the breast, which other body area is essential to palpate?
- A. The axillae
- B. The sternum
- C. The clavicles
- D. The ribs
Correct Answer: A
Rationale: The axillae (armpits) contain lymph nodes that drain the breast tissue, and palpating this area is essential to detect any abnormal lymph node enlargement, which could indicate breast pathology.
The 67-year-old male client reports difficulty initiating a urinary stream, urinary frequency, and inability to completely empty the bladder. Which procedure would the nurse anticipate the health-care provider (HCP) performing first?
- A. Digital rectal examination (DRE).
- B. Prostate-specific surface antigen (PSA).
- C. Prostate ultrasound.
- D. Biopsy of the prostate.
Correct Answer: A
Rationale: DRE is the initial procedure for assessing prostate enlargement (e.g., BPH), which causes urinary symptoms. PSA, ultrasound, and biopsy are follow-ups if DRE is abnormal.
The client has had an exploratory laparotomy to remove an ovarian tumor. The pathology report classifies the tumor as a 'low malignancy potential' (LMP) tumor. Which statement explains the scientific rationale for this pathology report?
- A. The client does not have cancer but will need adjuvant therapy.
- B. The client would have developed cancer if the tumor had not been removed.
- C. These borderline tumors resemble ovarian cancer but have better outcomes.
- D. The client has a very poor prognosis and has less than six (6) months to live.
Correct Answer: C
Rationale: LMP tumors (borderline ovarian tumors) have malignant features but lower metastatic potential, with better prognosis than invasive ovarian cancer. They are cancerous, not precancerous, and do not inherently require adjuvant therapy or indicate poor prognosis.
Which recommendation is the American Cancer Society's (ACS) 2015 guideline for the early detection of breast cancer?
- A. Beginning at age 18, have a biannual clinical breast examination by an HCP.
- B. Beginning at age 30, perform monthly breast self-exams.
- C. At age 45 through 54, receive a yearly mammogram.
- D. Beginning at age 50, have a breast sonogram every five (5) years.
Correct Answer: C
Rationale: ACS 2015 guidelines recommend annual mammograms for women aged 45–54. Biannual clinical exams at 18, monthly BSEs, and routine sonograms are not part of these guidelines.
The office manager schedules a mandatory staff meeting for all nursing personnel. As the nurse enters the room, several documents containing the client's name, medical records number, mammogram results, and diagnosis are found unattended on the table. Which nursing actions are appropriate in this situation? Select all that apply.
- A. Notify housekeeping to come and dispose of the papers.
- B. Toss the papers in the trash.
- C. Put the papers into the shredder bin.
- D. Try to determine who left the papers unattended.
- E. State the papers neatly, placing them off to the side.
- F. Notify the office manager of the breach in confidentiality.
Correct Answer: C,F
Rationale: Shredding the papers ensures secure disposal of protected health information (PHI), and notifying the office manager addresses the confidentiality breach, as required by HIPAA regulations.