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The nurse is teaching a male client to perform monthly testicular self-examinations. Which of the following points would be appropriate to make?
- A. Testicular cancer is a highly curable type of cancer.
- B. Testicular cancer is very difficult to diagnose
- C. Testicular cancer is the number one cause of cancer deaths in males.
- D. testicular cancer is more common in older men.
Correct Answer: A
Rationale: It is appropriate to inform the male client that testicular cancer is a highly curable type of cancer. Testicular cancer has a high cure rate, especially when detected early through self-examinations. By emphasizing the curability of this cancer, the nurse can empower the client to perform regular self-exams and seek prompt medical attention if any abnormalities are detected. This information can help alleviate fears and encourage proactive health behaviors.
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In a newborn's eyes, strabismus is a normal finding because of:
- A. congenital cataracts.
- B. lack of binocularity.
- C. absence of red reflex.
- D. inability of pupil to react to light.
Correct Answer: B
Rationale: Strabismus, or misalignment of the eyes, is a common condition in newborns due to the lack of binocularity. Binocularity refers to the ability of both eyes to focus simultaneously on a single point, which is not fully developed in newborns. As a result, it is normal for a newborn's eyes to appear misaligned at times. This lack of coordination between the eyes typically resolves as the infant's visual system matures and they develop the ability to focus both eyes together. Therefore, the presence of strabismus in a newborn is usually considered a normal finding related to the immature visual development rather than a sign of pathology such as congenital cataracts, absence of red reflex, or pupil reactivity issues.
Appropriate nursing interventions for J.E. would be
- A. Skin care and position q2h and prn; maintain alignment of extremities; respiratory exercises
- B. Skin care/bathe daily; passive leg exercises daily; respiratory therapy for intermittent positive pressure breathing therapy
- C. Skin care and position q2h; teach use of overhead trapeze; respiratory exercises, and intermittent positive pressure breathing q2h
- D. Skin care q2h; teach use of overhead trapeze; respiratory exercises; use pressure relief devices Situation - Mr. Reyes suffered head injuries in a motor vehicle accident
Correct Answer: A
Rationale: For J.E., who suffered head injuries in a motor vehicle accident, appropriate nursing interventions should focus on holistic care to prevent complications and promote recovery. Option A includes skin care and position changes every 2 hours (q2h) and as needed, which is crucial for preventing pressure injuries in the immobile patient. Maintaining alignment of extremities helps prevent muscle contractures. Respiratory exercises are essential for preventing atelectasis and improving lung function in patients at risk for pneumonia due to decreased mobility. These interventions address the immediate needs of the patient and aim to prevent further complications related to immobility and head injury. Options B, C, and D lack the comprehensive approach to care provided in option A, making it the most appropriate choice for J.E.
An infant with tetralogy of Fallot becomes cyanotic and dyspneic after a crying episode. To relieve the cyanosis and dyspnea, the nurse should place the infant in the:
- A. Orthopneic position
- B. Knee-chest position
- C. Lateral Sims' position
- D. Semi-Fowler's position
Correct Answer: A
Rationale: The orthopneic position is the best position to relieve cyanosis and dyspnea in an infant with tetralogy of Fallot. This position involves sitting up and leaning forward, which helps improve lung expansion and oxygenation. Placing the infant in the orthopneic position will reduce the workload on the heart, improve oxygenation, and relieve symptoms of cyanosis and dyspnea associated with tetralogy of Fallot. It allows for better expansion of the lungs and improves ventilation-perfusion matching, thereby enhancing oxygen exchange and alleviating the cyanotic spell.
A 13-year-old boy is hospitalized for a femur fracture after being hit by a car while racing bikes. The parents are concerned about his judgment. The nurse should tell the parents that this behavior is:
- A. Typical of young teens.
- B. Related to hormonal surges during adolescence.
- C. An isolated incident that will not likely happen again.
- D. Related to underdeveloped judgment and impulse control in adolescence.
Correct Answer: D
Rationale: The adolescent brain is still developing, which can lead to poor judgment and impulsive behavior.
The client with rheumatoid arthritis reports GI irritation after taking piroxicam (Feldene). To prevent GI upset, the nurse should provide which instruction?
- A. Space the administration every 4 hours.
- B. Use the drug for a short time only
- C. Take piroxicam with food or oral antacid
- D. Decrease the piroxicam dosage
Correct Answer: C
Rationale: Piroxicam is a nonselective NSAID (nonsteroidal anti-inflammatory drug) that can irritate the gastrointestinal (GI) tract, leading to symptoms such as heartburn, indigestion, and stomach pain. Taking piroxicam with food or an oral antacid can help reduce GI irritation by providing a protective barrier and reducing acid production within the stomach. Encouraging the client to take piroxicam with a meal or antacid can help prevent or minimize GI upset associated with the medication. Additionally, using a proton pump inhibitor (PPI) or histamine-2 receptor antagonist (H2 blocker) along with piroxicam may further protect the stomach lining from irritation.