Nokea
The nurse is evaluating the client's learning about combination chemotherapy. Which of the following statements by the client about reasons for using combination chemotherapy indicates the need for further explanation?
- A. Combination chemotherapy is used to interrupt cell growth cycle at different points.'
- B. Combination chemotherapy is used to destroy cancer cells and treat side effects simultaneously.'
- C. Combination chemotherapy is used to decrease resistance.'
- D. Combination chemotherapy is used to minimize the toxicity from using high doses of a single agent.'
Correct Answer: B
Rationale: Combination chemotherapy targets cancer cells at different cell cycle stages, reduces resistance, and minimizes toxicity by using lower doses of multiple drugs. It does not treat side effects; supportive care does. This statement indicates a need for further explanation.
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Which of the following client statements identifies a knowledge deficit about cast care?
- A. I'll elevate the cast above my heart initially.'
- B. I'll exercise my joints above and below the cast.'
- C. I can pull out cast padding to scratch inside the cast.'
- D. I'll apply ice for 10 minutes to control edema for the first 24 hours.'
Correct Answer: C
Rationale: Pulling out cast padding can cause skin irritation or pressure sores, indicating a knowledge deficit.
The nurse is assessing a client who has had a myocardial infarction (MI). The nurse notes the cardiac rhythm shown on the electrocardiogram strip below. The nurse identifi es this rhythm as which of the following?
- A. Atrial fi brillation
- B. Ventricular tachycardia.
- C. Premature ventricular contractions (PVCs).
- D. Third-degree heart block.
Correct Answer: C
Rationale: PVCs are early depolarizations originating in the ventricles, and they present exactly as seen in your strip.
The nurse evaluates the effectiveness of the client's postoperative plan of care. Which of the following would be an expected outcome for a client with an ileal conduit?
- A. The client verbalizes the understanding that his physical activity must be curtailed.
- B. The client states that he will place an aspirin in the drainage pouch to help control odor.
- C. The client demonstrates how to catheterize the stoma.
- D. The client states that he will empty the drainage pouch frequently throughout the day.
Correct Answer: D
Rationale: Frequent pouch emptying is an expected outcome, preventing complications like leakage or infection. Aspirin is unsafe, and stoma catheterization is not typical.
The nurse reviews an arterial blood gas report for a client with chronic obstructive pulmonary disease (COPD). pH 7.35; PCO2 62; PO2 70; HCO3 34. The nurse should:
- A. Apply a 100% non-rebreather mask.
- B. Assess the vital signs.
- C. Reposition the client.
- D. Prepare for intubation.
Correct Answer: B
Rationale: The ABG shows compensated respiratory acidosis (normal pH, high PCO2, high HCO3) with mild hypoxemia (PO2 70). Assessing vital signs evaluates stability before escalating care. A non-rebreather mask or intubation is premature. Repositioning may help but is less urgent.
The nurse is teaching a client with polycythemia vera about potential complications from this disease. Which manifestations should the nurse include in the client's teaching plan? Select all that apply.
- A. Hearing loss.
- B. Visual disturbance.
- C. Headache.
- D. Orthopnea.
- E. Gout.
- F. Weight loss.
Correct Answer: B,C,D,E
Rationale: Polycythemia vera increases blood viscosity and red cell mass, leading to complications like visual disturbances (due to retinal hemorrhage), headaches (from hypertension or thrombosis), orthopnea (from heart failure), and gout (from increased uric acid due to cell turnover). Hearing loss and weight loss are not typical complications.