Nokea
The nurse assesses that the client who is receiving radiation for cervical cancer continues to have diarrhea. Which nursing advice is most appropriate for this client?
- A. Eat a low-residue diet and take sitz baths twice daily.
- B. Drink fluids low in potassium and take frequent tub baths.
- C. Consume more milk products and take frequent showers.
- D. Drink high-sodium fluids and apply hydrocolloid pads to rectum.
Correct Answer: A
Rationale: A. The client with diarrhea should eat a low-residue diet to decrease roughage and bowel irritability and take sitz (or tub) baths twice daily to increase comfort. B. Intake of fluids that are high in potassium (not low) is recommended to replace electrolytes lost through diarrhea. C. Milk products are discouraged because they increase bowel irritability. D. Intake of fluids high in sodium should be avoided because it contributes to water retention, but hydrocolloid pads may be used on reddened areas to promote healing.
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The nurse explains “watchful waiting” (ongoing visits to a physician for observation of signs and symptoms without treatment) to the client with prostate cancer. Which client is a candidate for “watchful waiting”?
- A. 50-year-old with prostate cancer that has metastasized to the bone
- B. 75-year-old expected to live 5 years and has low-grade disease
- C. 45-year-old who has extension of the tumor outside of the prostate
- D. 59-year-old who is asymptomatic with an elevated prostate-specific antigen
Correct Answer: B
Rationale: A. The client with prostate cancer that has metastasized to the bone generally requires aggressive therapy. B. The client is a candidate for “watchful waiting” when older than age 70 with a life expectancy of less than 10 years and with low-grade disease. C. The client with extension of the tumor outside of the prostate generally requires aggressive therapy. D. The client who is asymptomatic with an elevated prostate-specific antigen generally requires aggressive therapy.
The client with COPD has developed polycythemia vera, and the nurse completes teaching on measures to prevent complications. During a home visit, the nurse evaluates that the client is correctly following the teaching when which actions are noted?
- A. Tells the nurse about discontinuing iron supplements.
- B. States increasing alcohol intake to decrease blood viscosity.
- C. Presents a record that shows a daily fluid intake of 3000 mL.
- D. Discusses yesterday’s phlebotomy treatment to remove blood.
- E. Shows the nurse 3 menu plan for eating three large meals daily.
- F. Wears antiembolic stockings and sits in a recliner with legs uncrossed
Correct Answer: A, C, D, F
Rationale: Iron supplements, including those in multi-vitamins, should be avoided because the iron stimulates RBC production. B. Alcohol increases the risk of bleeding. C. Increasing fluid intake to 3000 mL daily will help decrease blood viscosity. D. Phlebotomy is performed on a routine or intermittent basis to diminish blood viscosity, deplete iron stores, and decrease the client’s ability to manufacture excess erythrocytes. E. Frequent, small meals are better tolerated, especially if the liver is involved. F. Elevating the legs, avoiding constriction or crossing the legs, and wearing antiembolic stockings help prevent DVT.
Which medication is contraindicated for a client diagnosed with leukemia?
- A. Bactrim, a sulfa antibiotic.
- B. Morphine, a narcotic analgesic.
- C. Epogen, a biologic response modifier.
- D. Gleevec, a genetic blocking agent.
Correct Answer: C
Rationale: Epogen (C) stimulates RBC production, risky in leukemia due to blast proliferation. Bactrim (A) treats infections, morphine (B) manages pain, and Gleevec (D) targets CML.
The HCP has ordered one (1) unit of packed RBCs for the client who is right-handed. Which area would be the best place to insert the intravenous catheter?
- A. A
- B. B
- C. C
- D. D
Correct Answer: C
Rationale: For a right-handed client, the non-dominant (left) arm is preferred for IV access (C) to maintain function. Specific sites (A, B, D) depend on image, but C is typically left forearm/antecubital.
The nurse is preparing to administer the chemotherapeutic agent cisplatin IV to the client with ovarian cancer. The dose is 100 mg/m2 in 2 liters of DSW to be infused over 8 hours. What is the rate in milliliters (mL) per hour that the nurse should set the infusion pump to deliver the medication? __________ mL/hour (Record your answer as a whole number.)
Correct Answer: 250
Rationale: first convert liters to milliliters: 1000 mL/1L= XmL/2L. 1000mL* 2L= 1L * x mL;
2000 mL = X. Next ,CALCULATE the mL per hour 2000 mL /8 Hours =250mL/hour