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The nurse is conducting discharge education with a client newly diagnosed with Addison's disease. Which information should be included in the client and family teaching plan? Select all that apply.
- A. Addison's disease will resolve over a few weeks, requiring no further treatment.
- B. Avoiding stress and maintaining a balanced lifestyle will minimize risk for exacerbations.
- C. Fatigue, weakness, dizziness, and mood changes need to be reported to the physician.
- D. A medical identification bracelet should be worn.
- E. Family members need to be informed about the warning signals of adrenal crisis.
- F. Dental work or surgery will require adjustment of daily medication.
Correct Answer: B,C,D,E,F
Rationale: Addison's is chronic, requiring lifelong management. Stress management, symptom reporting, medical ID, family education, and medication adjustments for procedures are critical.
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A 68-year-old male has been receiving monthly doses of chemotherapy for treatment of stage III colon cancer. He comes to the clinic for his fourth monthly dose. Which laboratory result(s) should be reported to the oncologist before the next dose of chemotherapy is administered? Select all that apply.
- A. Hemoglobin of 14.5 g/dL.
- B. Platelet count of 40,000/mm³.
- C. Blood urea nitrogen (BUN) level of 12 mg/dL.
- D. White blood cell count of 2,300/mm³.
- E. Temperature of 101.2°F (38.4°C).
- F. Urine specific gravity of 1.020.
Correct Answer: B,D,E
Rationale: Low platelet count (B), low white blood cell count (D), and fever (E) indicate thrombocytopenia, neutropenia, and possible infection, respectively, which are contraindications for chemotherapy due to increased risk of bleeding and infection.
A client on hemodialysis reports fatigue. The nurse should assess for:
- A. Anemia.
- B. Hyperkalemia.
- C. Dehydration.
- D. Infection.
Correct Answer: A
Rationale: Anemia is common in renal failure due to decreased erythropoietin.
The sense of hearing is assessed using which standardized test?
- A. Taylor test
- B. Rinne test
- C. Babinski test
- D. APGAR test
Correct Answer: B
Rationale: The Rinne test assesses hearing by comparing air and bone conduction using a tuning fork. The Taylor test is not a standard hearing test, the Babinski test evaluates neurological reflexes, and the APGAR test assesses newborn health.
The nurse is supervising a newly hired nurse administer prescribed medications via a double-lumen nasogastric tube (NGT) with an air vent. Which action by the newly hired nurse requires follow-up?
- A. irrigates the air vent before medication administration with water.
- B. contacts the pharmacy to obtain available medications in liquid form.
- C. flushes the NGT between medications with water.
- D. administers each medication separately through the NGT.
Correct Answer: A
Rationale: The air vent of an NGT should not be irrigated, as it is for air passage, not medication or fluid administration.
A client had a repair of a thoracoabdominal aneurysm 2 days ago. Which of the following findings should the nurse consider unexpected and report to the physician immediately? The client has:
- A. Abdominal pain at 5 on a scale of 0 to 10 for the last 2 days
- B. Heart rate of 100 beats per minute after ambulating 200 feet
- C. Urine output of 2,000 mL in 24 hours
- D. Weakness and numbness in the lower extremities
Correct Answer: D
Rationale: Weakness and numbness in the lower extremities post-thoracoabdominal aneurysm repair suggest spinal cord ischemia or graft-related complications, requiring immediate reporting. Persistent pain, elevated heart rate post-ambulation, and normal urine output are expected or less urgent.