Which laboratory test value is elevated in clients who smoke and can’t be used as a general indicator of cancer?
- A. Acid phosphatase level
- B. Alkaline phosphatase level
- C. Serum calcitonin level
- D. Carcinoembryonic antigen level
Correct Answer: C
Rationale: The correct answer is C: Serum calcitonin level. Smoking can elevate serum calcitonin levels due to the effect of nicotine. However, an elevated serum calcitonin level is not a general indicator of cancer. Step 1: Understand that smoking can increase serum calcitonin levels. Step 2: Recognize that elevated serum calcitonin levels are not specific to cancer and can be influenced by other factors. Step 3: Differentiate between a marker that is specific to cancer (such as carcinoembryonic antigen) and one that can be affected by smoking but not necessarily indicative of cancer (serum calcitonin). Thus, while smoking can elevate serum calcitonin levels, it is not a reliable indicator of cancer.
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A 36-year-old man is scheduled for a unilateral orchiectomy for treatment of testicular cancer. He is withdrawn and does not interact with the nurse. Which action is most appropriate?
- A. Identify the problem with a nursing diagnosis of impaired communication related to the diagnosis of cancer
- B. Set a patient outcome that the patient will verbalize his concerns about his diagnosis
- C. Ask the patient whether he is worried about future sexual functioning
- D. Say, “You seem quiet. Are you feeling concerned about your diagnosis or treatment?”
Correct Answer: D
Rationale: Step-by-step rationale for choosing answer D as correct:
1. Acknowledges patient's withdrawn behavior
2. Demonstrates empathy and concern
3. Open-ended question allows patient to express feelings
4. Encourages patient to communicate concerns
Summary:
- Option A assumes a specific problem without patient input
- Option B focuses on verbalization, not necessarily addressing underlying concerns
- Option C makes assumptions about patient's worries without allowing him to express himself
Which instruction about insulin administration should the nurse give to a client?
- A. “Always follow the same order when drawing the different insulin into the syringe.”
- B. “Shake the vial before withdrawing the insulin.”
- C. “Store unopened vials of insulin in the freezer at temperatures well below freezing.”
- D. “Discard the intermediate-acting insulin if it disappears cloudy.”
Correct Answer: A
Rationale: The correct answer is A because maintaining consistency in the order of drawing different types of insulin into the syringe helps prevent medication errors. When mixing insulins, drawing them in the same sequence ensures the correct dose and prevents contamination.
Explanation:
A: Following the same order ensures accurate dosing and minimizes the risk of mixing up insulins.
B: Shaking the vial can cause air bubbles which can affect the accuracy of the dose.
C: Storing insulin in the freezer can damage the medication and alter its effectiveness.
D: Cloudiness in intermediate-acting insulin is normal and does not indicate it should be discarded.
Minda, a 65-year old female has been admitted with a left hemisphere stroke. Which behavioral change would the nurse expect to find upon assessment?
- A. impulsive, unsafe activity
- B. motor deficits on the right eye
- C. motor deficits on the left side of the body
- D. error in word choices
Correct Answer: D
Rationale: The correct answer is D: error in word choices. In left hemisphere stroke, language and speech centers are usually affected, leading to aphasia. This results in errors in word choices, difficulty expressing thoughts, and understanding language. Impulsivity and unsafe activities (choice A) are more commonly associated with frontal lobe damage. Motor deficits on the right eye (choice B) and left side of the body (choice C) are typical in strokes affecting the motor cortex, which is located in the contralateral hemisphere.
A pregnant client with hypertension and cardiac dysrhythmias is admitted to the hospital. Which of the following imbalances should the nurse check for?
- A. Metabolic acidosis
- B. Hypernatremia
- C. Hypomagnesemia
- D. Hypercalcemia
Correct Answer: C
Rationale: The correct answer is C: Hypomagnesemia.
1. Hypertension and cardiac dysrhythmias can be exacerbated by low magnesium levels.
2. Magnesium plays a crucial role in maintaining normal heart rhythm and blood pressure.
3. Hypomagnesemia can lead to cardiac arrhythmias and worsen hypertension.
4. Metabolic acidosis (A) is not directly related to hypertension and dysrhythmias.
5. Hypernatremia (B) and hypercalcemia (D) are less likely to be associated with cardiac issues in this context.
In summary, checking for hypomagnesemia is essential due to its direct impact on the client's hypertension and cardiac dysrhythmias.
Which of the following tests would the nurse use as an initial screening test to determine hearing loss?
- A. Romberg test
- B. Caloric test
- C. Otoscopic examination
- D. Whisper voice test
Correct Answer: D
Rationale: The correct answer is D: Whisper voice test. This test is used as an initial screening for hearing loss because it is simple, quick, and easily administered by a nurse. The nurse would whisper words or numbers at a specific distance from the patient to assess their ability to hear and repeat the whispered sounds accurately. This test provides a quick indication of potential hearing impairment.
The other choices are incorrect:
A: Romberg test assesses balance and not hearing.
B: Caloric test evaluates the vestibular system, not hearing.
C: Otoscopic examination is used to examine the ear canal and tympanic membrane, not to screen for hearing loss.