Nokea
The nurse is preparing a client with multiple sclerosis (MS) for discharge from the hospital to home. The nurse should tell the client:
- A. "You will need to accept the necessity for a quiet and inactive lifestyle."
- B. "Keep active, use stress reduction strategies, and avoid fatigue."
- C. "Follow good health habits to change the course of the disease."
- D. "Practice using the mechanical aids that you will need when future disabilities arise."
Correct Answer: B
Rationale: Encouraging activity, stress reduction, and fatigue management supports the client's quality of life and symptom control. Inactivity, changing disease course, or premature focus on aids are less appropriate.
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The nurse is caring for a client receiving hydromorphone via patient-controlled analgesia (PCA). The nurse should prioritize assessing the client's
- A. blood pressure.
- B. pain level.
- C. activity tolerance.
- D. bowel patterns.
Correct Answer: B
Rationale: Pain level is the priority assessment for a client on PCA with hydromorphone to ensure effective pain management and adjust dosing if needed.
Which of the following nursing interventions is likely to provide the most relief from the pain associated with renal colic?
- A. Applying moist heat to the flank area.
- B. Administering meperidine (Demerol).
- C. Encouraging high fluid intake.
- D. Maintaining complete bed rest.
Correct Answer: B
Rationale: Meperidine, an opioid, provides the most effective relief for the severe pain of renal colic by directly addressing pain pathways.
The nurse should instruct a young female adult with sickle cell anemia to do which of the following? Select all that apply.
- A. Drink plenty of fluids when outside in hot weather.
- B. Avoid travel to cities where the oxygen level is lower.
- C. Compare that since she is homozygous for HbS, she carries the sickle cell trait.
- D. Know that pregnancy with sickle cell disease increases the risk of a crisis.
- E. Avoid flying on commercial airlines.
Correct Answer: A,B,D
Rationale: Sickle cell anemia requires preventive measures to avoid crises. Drinking fluids in hot weather prevents dehydration, a trigger for sickling. Avoiding high-altitude cities reduces hypoxia risk, another trigger. Pregnancy increases the risk of crises due to increased metabolic demands. The statement about being homozygous for HbS is incorrect, as it indicates sickle cell disease, not the trait. Flying on commercial airlines is generally safe if the client is stable.
A client who has been diagnosed with bladder cancer is scheduled for an ileal conduit. Preoperatively, the nurse reinforces the client's understanding of the surgical procedure by explaining that an ileal conduit:
- A. Is a temporary procedure that can be reversed later.
- B. Diverts urine into the sigmoid colon, where it is expelled through the rectum.
- C. Conveys urine from the ureters to a stoma opening on the abdomen.
- D. Creates an opening in the bladder that allows urine to drain into an external pouch.
Correct Answer: C
Rationale: An ileal conduit diverts urine from the ureters to an abdominal stoma, where it is collected in an external pouch, a permanent procedure for bladder cancer management.
During a home visit, a diabetic client begins to cry and says, 'I just cannot stand the thought of having to give myself a shot every day.' Which of the following would be the best response by the nurse?
- A. If you do not give yourself your insulin shots, you will die.'
- B. We can teach your daughter to give the shots so you will not have to do it.'
- C. I can arrange to have a home care nurse give you the shots every day.'
- D. What is it about giving yourself the insulin shots that bothers you?'
Correct Answer: D
Rationale: Exploring the client's concerns about insulin injections promotes understanding and helps address fears, supporting adherence to treatment.