Nokea
The nurse has completed discharge teaching with a client who has had surgery for lung cancer. The nurse determines that the client needs additional teaching about the elements of home management if the client verbalizes the need to follow which instruction?
- A. Avoid exposure to crowds.
- B. Deal with any increases in pain independently.
- C. Sit up and lean forward to breathe more easily.
- D. Call the primary health care provider if shortness of breath occurs.
Correct Answer: B
Rationale: Clients post-lung cancer surgery should not manage increased pain independently, as it may indicate complications requiring medical attention. Avoiding crowds, sitting up to breathe easier, and reporting shortness of breath are appropriate home management strategies.
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The nurse is demonstrating colostomy care to a client with a newly created colostomy. The nurse demonstrates the correct cutting of the appliance by making the circle how much larger than the client's stoma?
- A. 1/8 inch
- B. 1/4 inch
- C. 1/2 inch
- D. 1 inch
Correct Answer: A
Rationale: The size of the opening for the appliance is generally cut 1/8 inch larger than the size of the client's stoma. This minimizes the amount of exposed skin but does not put pressure on the stoma. The larger sizes leave too much skin area exposed for irritation by gastrointestinal contents.
The nurse is conducting a health screening on a client with a family history of hypertension. Which assessment finding should alert the nurse to the need for further teaching related to stroke (brain attack) prevention?
- A. Eats two bowls of high-fiber grain cereal with skim milk for breakfast
- B. Has a blood pressure of 118/78 mm Hg and has lost 10 pounds recently
- C. Uses condoms for pregnancy and disease prevention and jogs 2 miles daily
- D. Uses oral contraceptives for pregnancy prevention and works as a manager of a busy medical-surgical unit
Correct Answer: D
Rationale: Oral contraceptives increase clot formation risk, a modifiable stroke risk factor, especially with a hypertension family history. High-fiber diet, normal blood pressure, weight loss, and exercise (options A, B, C) reduce stroke risk.
The nurse has provided home-care instructions to a client who is taking lithium carbonate. Which client statement indicates that the client understands the prescribed regimen?
- A. I will restrict my water intake.
- B. I will make sure that my diet contains salt.
- C. I will keep my medication in the refrigerator.
- D. I will be careful to avoid eating foods high in potassium.
Correct Answer: B
Rationale: Lithium is a mood stabilizer used to treat bipolar disorder. It replaces sodium ions in the cells and induces the excretion of sodium and potassium from the body. Client teaching includes the maintenance of sodium intake in the daily diet and increased fluid intake (at least 1 to 1½ L per day) during maintenance therapy. Lithium is stored at room temperature and protected from light and moisture.
A clinic nurse provides information to a married couple regarding measures to prevent infertility. Which statement made by the husband indicates the need for further education?
- A. We need to eat a nutritious diet.'
- B. We need to avoid the excessive intake of alcohol.'
- C. We need to decrease exposure to environmental hazards.'
- D. I need to maintain warmth to my scrotum by taking hot baths frequently.'
Correct Answer: D
Rationale: Keeping the testes cool by avoiding hot baths and tight clothing appears to improve the sperm count. Avoiding factors that depress spermatogenesis (such as the use of drugs, alcohol, and marijuana), maintaining good nutrition, and limiting exposure to occupational and environmental hazards are vital components of preventing infertility.
A client diagnosed with gastritis asks the nurse at a screening clinic about analgesics that will not cause epigastric distress. The nurse should tell the client to take which medication?
- A. Aspirin
- B. Naproxen
- C. Ibuprofen
- D. Acetaminophen
Correct Answer: D
Rationale: The client should be advised to take analgesics that do not contain aspirin, such as acetaminophen. Aspirin is irritating to the gastrointestinal tract of the client with a history of gastritis. Other medications that are irritating to the gastrointestinal tract are the nonsteroidal antiinflammatory drugs naproxen and ibuprofen.