Nokea
The nurse is caring for a 25-year-old client who will undergo bilateral orchiectomy for testicular cancer. Considering the nature of the illness, the nurse should make it a priority to explore which potential psychological concern with this client?
- A. Postoperative pain
- B. Postoperative swelling
- C. Loss of reproductive ability
- D. Length of recuperative period
Correct Answer: C
Rationale: Although the client will need factual information about the postoperative period and recuperation, the nurse should place priority on addressing loss of reproductive ability as a psychological concern. The radical effects of this surgery in the reproductive area make it likely that the client may have some difficulty in adjustment to this consequence of surgery.
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A 19-year-old G1 P0 is being discharged home after hospitalization for hyperemesis gravidarum and is being referred to home health care. The nurse should develop a discharge plan that includes which of the following? Select all that apply.
- A. Refer client to a nutritionist for the following day.
- B. Ensure that the client has a prescription for an antiemetic.
- C. Ask the health care provider (HCP) for an anxiolytic prescription.
- D. Encourage return to normal routine when client feels ready.
- E. Coordinate follow-up appointment with provider in 6 weeks.
- F. Discuss plan of care and discharge instructions with client.
Correct Answer: A, B, D, F
Rationale: For hyperemesis gravidarum, a nutritionist referral, antiemetic prescription, gradual return to routine, and discussing discharge instructions are essential. Anxiolytics may not be indicated, and a 6-week follow-up is too delayed.
Which member of the multidisciplinary team would you most likely collaborate with when your pediatric client has had a traumatic amputation one or more months ago?
- A. A Pedorthist
- B. A pediatric nurse practitioner
- C. A trauma certified clinical nurse specialist
- D. A prosthetist
Correct Answer: D
Rationale: A prosthetist specializes in designing and fitting prosthetic limbs, making them the most appropriate team member to collaborate with for a pediatric client with a traumatic amputation.
The nurse should consider which of the following principles when developing a plan of care to manage a client's pain from cancer?
- A. Individualize the pain medication regimen for the client.
- B. Select medications that are least likely to lead to addiction.
- C. Administer pain medication as soon as the client requests it.
- D. Change pain medications periodically to avoid drug tolerance.
Correct Answer: A
Rationale: Individualizing the regimen ensures effective pain control tailored to the client's needs, considering cancer pain's variable nature.
A 6-month-old infant is admitted with a diagnosis of bacterial meningitis. The nurse should expect to observe which of the following symptoms?
- A. Positive Babinski reflex.
- B. High-pitched cry.
- C. Hypothermia.
- D. Kernig's sign.
Correct Answer: B
Rationale: A high-pitched cry is a common symptom of bacterial meningitis in infants, indicating neurological irritation.
A client who is brought to the emergency department has experienced a burn covering greater than 25% of his total body surface area (TBSA). When reviewing the laboratory results drawn on the client, which value should the nurse most likely expect to note?
- A. Hematocrit 65% (0.65)
- B. Albumin 4.0 g/dL (40 g/L)
- C. Sodium 140 mEq/L (140 mmol/L)
- D. White blood cell (WBC) count 6000 mm^3 (6 x 10^9/L)
Correct Answer: A
Rationale: Extensive burns covering greater than 25% of the TBSA result in generalized body edema in both burned and nonburned tissues and a decrease in circulating intravascular blood volume. Hematocrit levels elevate in the first 24 hours after injury (the emergent phase) as a result of hemoconcentration from the loss of intravascular fluid. The normal hematocrit is 42 to 52% (0.42-0.52) in the male and 37 to 47% (0.37-0.47) in the female. The normal albumin is 3.5-5 g/dL (35-50 g/L). The normal sodium level is 135 to 145 mEq/L (135-145 mmol/L). The normal WBC count is 5000 to 10,000 mm^3 (5-10 x 10^9/L).