Nokea
The nurse is caring for an elderly client with dementia. The family wishes to take the client home instead of placing her in an assisted living facility. Which information should the nurse include in his discharge teaching? Select all that apply.
- A. the names of community resources that can help families who provide care at home
- B. that the health care provider will not be happy that the client is going to live at home
- C. the advantages of having the client cared for in an assisted living facility instead of at home
- D. the contact information for the social worker in case the family has questions or needs after returning home
- E. home safety information, such as removing trip hazards and having adequate lighting at night for the client
Correct Answer: A, D, E
Rationale: Providing community resources, social worker contact, and home safety information supports the family’s decision and promotes safety. Discussing provider disapproval or assisted living advantages is inappropriate.
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Intra-arterial chemotherapy primarily benefits the client by applying greater concentrations of medication directly to the malignant tumor. An additional benefit of intra-arterial chemotherapy is:
- A. Prevention of nausea and vomiting
- B. Treatment of micro-metastasis
- C. Eradication of bone pain
- D. Prevention of therapy-induced anemia
Correct Answer: B
Rationale: Intra-arterial chemotherapy can treat micro-metastases by delivering high drug concentrations to the tumor and surrounding areas.
The nurse is caring for a client who is having surgery the next morning. The client says, 'I'm really scared about surgery. I've never been put to sleep before and I'm afraid I might not wake up.' Which response by the nurse is the most therapeutic?
- A. Why are you worried about such a minor procedure?
- B. We can call the doctor and cancel the surgery if you would prefer.
- C. It's normal to be afraid of something new like surgery. Tell me how you feel.
- D. Don't worry, you have a really good doctor and he will see to it that nothing goes wrong.
Correct Answer: C
Rationale: Acknowledging fear as normal and inviting the client to express feelings is therapeutic, fostering trust and emotional support.
When planning the care for a client after a posterior fossa (infratentorial) craniotomy, which action is contraindicated?
- A. Keeping the client flat on one side
- B. Elevating the head of the bed 30°
- C. Log-rolling or turning as a unit
- D. Keeping the neck in a neutral position
Correct Answer: B
Rationale: Elevating the head of the bed can increase intracranial pressure in posterior fossa craniotomy clients due to disruption of cerebrospinal fluid flow, making it contraindicated.
A client is complaining of chest pain. Nursing assessment reveals a BP of 78/40, shortness of breath, and third-degree AV block on the heart monitor. What medication would the nurse prepare for initial administration?
- A. Atropine
- B. Verapamil (Calan)
- C. Lidocaine (Xylocaine)
- D. Procainamide (Pronestyl)
Correct Answer: A
Rationale: Third-degree AV block with hypotension (BP 78/40) requires atropine to increase heart rate by blocking vagal activity, improving cardiac output.
A client is admitted with suspected Hodgkin's lymphoma. The diagnosis is confirmed by the:
- A. Overproliferation of immature white cells
- B. Presence of Reed-Sternberg cells
- C. Increased incidence of microcytosis
- D. Reduction in the number of platelets
Correct Answer: B
Rationale: Hodgkin's lymphoma is diagnosed by the presence of Reed-Sternberg cells, large abnormal cells found in lymph node biopsies.