Nokea
The nurse is teaching a 28-year-old male client about testicular cancer. Which statement by the client indicates understanding of the nurse's teaching?
- A. Testicular cancer is one of the hardest cancers to treat and cure.
- B. Testicular cancer is the most common cancer in men ages 25-35.
- C. A lump larger than a quarter should be reported to my health care provider.
- D. The best time to perform testicular self-examination is just after bathing because the scrotum is more relaxed.
Correct Answer: D
Rationale: Testicular self-examination is best post-bathing due to scrotal relaxation. Testicular cancer is common in 15-35-year-olds but highly treatable, and any lump should be reported.
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A child is seen in the health care clinic, and testing for human immunodeficiency virus (HIV) is performed because of the child's exposure to HIV infection. Which home care instruction should the nurse provide to the parents of the child?
- A. Avoid sharing toothbrushes.
- B. Avoid all immunizations until the diagnosis is established.
- C. Wipe up any blood spills with a rag, and allow them to air-dry.
- D. Wash your hands with half-strength bleach if they come in contact with the child's blood.
Correct Answer: A
Rationale: Parents should avoid sharing toothbrushes to prevent potential HIV transmission through blood or bodily fluids. Immunizations should be kept up to date to protect the child. Blood spills should be cleaned with a paper towel, followed by soap and water, then a bleach solution, not just a rag and air-drying. Washing hands with soap and water is sufficient; bleach is too caustic for skin.
A 28-year-old client has just given birth. At one minute the baby appears healthy, with the exception of bluish hands. Which of the following would the nurse midwife pronounce?
- A. The Apgar score is 11.
- B. The Apgar score is 9.
- C. The Apgar score is 6.
- D. The Apgar score is 4.
Correct Answer: B
Rationale: The Apgar score assesses appearance, pulse, grimace, activity, and respiration, with a maximum of 10. Bluish hands indicate acrocyanosis, common in newborns, deducting 1 point from appearance, resulting in a score of 9 if other parameters are normal. Option A is impossible, and C and D are too low for a healthy baby.
A client diagnosed with anxiety disorder is prescribed buspirone orally. When the client reports that it is difficult to swallow the tablets, the nurse provides which instruction to promote compliance?
- A. Crush the tablets before taking them.
- B. Mix the tablet uncrushed in applesauce.
- C. Purchase the liquid preparation with the next refill.
- D. Call the primary health care provider for a change in medication.
Correct Answer: A
Rationale: Buspirone tablets may be crushed and administered without regard to meals, making this the most effective instruction to promote compliance for a client who finds swallowing difficult. Mixing the tablet uncrushed in applesauce does not address the swallowing issue. Buspirone is not available in liquid form, and calling the primary health care provider for a medication change is premature before trying this intervention.
The nurse is performing an assessment on a 3-year-old child with chickenpox. The child's mother tells the nurse that the child keeps scratching at night, and the nurse teaches the mother about measures that will prevent an alteration in skin integrity. Which statement by the mother indicates that teaching was effective?
- A. I need to place white gloves on my child's hands at night.
- B. I will apply generous amounts of a cortisone cream to prevent itching.
- C. I will give my child a glass of warm milk at bedtime to help my child sleep.
- D. I need to keep my child in a warm room at night so that the covers will not cause my child to scratch.
Correct Answer: A
Rationale: Placing white gloves on the child's hands at night prevents scratching during sleep, which helps maintain skin integrity and reduces the risk of secondary infections. Applying cortisone cream is not recommended without a prescription, as it may not be appropriate for chickenpox and could increase the risk of complications. Warm milk may help with sleep but does not directly address scratching or skin integrity. Keeping the child in a warm room does not prevent scratching and may increase discomfort, as cooler environments are often better for reducing itching.
A client with hyperkalemia may exhibit peaked T waves on an electrocardiogram. This manifestation is an early sign of high potassium levels, but the diagnosis should not be based on this aspect alone. Untreated, hyperkalemia can lead to progressively worsening cardiac instability.
- A. A lumbar puncture takes a sample of cerebrospinal fluid from the back, which will be analyzed by the lab.
- B. The physician will insert a needle at the level of L4-L5 in the spinal cord.
- C. The client should lie flat on their back for a specific period following the procedure.
- D. The risks of the procedure include headache, back pain, and infection.
Correct Answer: B
Rationale: A lumbar puncture is performed to obtain cerebrospinal fluid for analysis to investigate various conditions affecting the client. During the procedure, the client is typically positioned on their side or sitting leaning over a table with their back rounded. The physician inserts a needle into the back around the L4-L5 vertebrae to collect the sample. Option A is incorrect because a lumbar puncture does not draw blood but instead collects cerebrospinal fluid. Option C is incorrect as the client should not necessarily lie flat for 24 hours post-procedure. Option D is incorrect as the common risks of a lumbar puncture include headache, back pain, and potential infection, not nausea, rash, or hypotension.