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The nurse is assessing a 60-year-old male who has hoarseness. The nurse should conduct a focused assessment to determine:
- A. Patterns of medication use and history of alcohol consumption.
- B. Exposure to sun and family history of head and neck cancers.
- C. Exposure to wood dust and a high-fat diet.
- D. History of tobacco use and alcohol consumption.
Correct Answer: D
Rationale: Hoarseness in a 60-year-old male is concerning for head and neck cancers, particularly laryngeal cancer. A focused assessment should prioritize tobacco and alcohol use, as these are major risk factors.
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A client with osteoporosis is prescribed alendronate (Fosamax). Which instruction should the nurse include?
- A. Take the medication at bedtime.
- B. Remain upright for 30 minutes after taking.
- C. Crush the tablet for easier swallowing.
- D. Take with a full meal.
Correct Answer: B
Rationale: Remaining upright for 30 minutes after taking alendronate prevents esophageal irritation.
Upon assessment of third degree heart block on the monitor, the nurse should first:
- A. Call a code.
- B. Begin cardiopulmonary resuscitation.
- C. Have transcutaneous pacing ready at the bedside.
- D. Prepare for defibrillation.
Correct Answer: C
Rationale: Third-degree heart block may require pacing. Having transcutaneous pacing ready is the first step to manage symptomatic bradycardia.
Which activity increases the risk of renal calculi?
- A. High fluid intake.
- B. Sedentary lifestyle.
- C. Low-sodium diet.
- D. Frequent urination.
Correct Answer: B
Rationale: A sedentary lifestyle promotes urinary stasis, increasing stone risk.
A nurse is teaching a client about cystoscopy preparation. What instruction should be included?
- A. Fast for 8 hours before the procedure.
- B. Drink plenty of water before the test.
- C. Expect to stay overnight in the hospital.
- D. Empty the bladder before the procedure.
Correct Answer: D
Rationale: Emptying the bladder ensures a clear view during cystoscopy and reduces discomfort.
The nurse administers mannitol (Osmitrol) to the client with increased intracranial pressure. Which parameter requires close monitoring?
- A. Muscle relaxation.
- B. Intake and output.
- C. Widening of the pulse pressure.
- D. Pupil dilation.
Correct Answer: B
Rationale: Mannitol is an osmotic diuretic used to reduce ICP by drawing fluid from brain tissue. Monitoring intake and output is critical to assess its effectiveness and prevent dehydration or electrolyte imbalances. Muscle relaxation, pulse pressure, and pupil dilation are not directly related to mannitol's primary effects.