Which of the ff conditions is evident by persistent hoarseness?
- A. Bacterial infection
- B. Aphonia
- C. Laryngeal cancer
- D. Peritonsillar abscess
Correct Answer: C
Rationale: Persistent hoarseness is often a symptom of laryngeal cancer. Laryngeal cancer affects the voice box, leading to changes in voice quality, such as hoarseness. It is important to seek medical evaluation if hoarseness lasts for more than two weeks, as early detection and treatment of laryngeal cancer can improve outcomes. Bacterial infection, aphonia (loss of voice), and peritonsillar abscess are not typically associated with persistent hoarseness as a primary symptom.
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Olympic gymnast Ms. Slovenski sufferd a great fall and suffered a great fall and fractured her femur. Approximately after 20 hours in the hospital she became dyspneic, tachypneic, and with scattered crackles in her lung fields. She is coughing up large amounts of thick, white sputum. The nurse correctly interprets this as:
- A. respiratory compromise related to inhalation of smoke
- B. pneumonia related to prolonged bedrest
- C. fat embolism syndrome related to femur fracture
- D. hypovolemic shock related to multiple trauma
Correct Answer: C
Rationale: The symptoms described in the scenario - dyspnea, tachypnea, crackles in lung fields, and coughing up thick, white sputum - are indicative of fat embolism syndrome (FES), which occurs as a complication of long bone fractures like the femur fracture in this case. FES is characterized by the release of fat droplets into the bloodstream, which can then travel to the lungs and cause respiratory distress. The onset of symptoms typically occurs within 24-72 hours after the initial injury, making it a likely cause for Ms. Slovenski's condition. This is a medical emergency that requires prompt recognition and intervention to prevent further complications. The other options (A, B, and D) do not align with the clinical picture presented in the scenario and are less likely causes of her current symptoms.
While receiving radiation therapy for the treatment of breast cancer, a client complains of dysphagia and skin texture changes, at the radiation site. Which of the following instructions would be most appropriate to suggest to minimize the risk of complications, and promote healing?
- A. Wash the radiation site vigorously with soap and water to remove dead cells.
- B. Eat a diet high in protein and calories to optimize tissue repair.
- C. Apply coo! compresses to the radiation site to reduce edema,
- D. Drink warm fluids throughout the day to relieve discomfort in swallowing
Correct Answer: B
Rationale: Eating a diet high in protein and calories to optimize tissue repair would be the most appropriate instruction to suggest in this scenario. Dysphagia (difficulty swallowing) and skin texture changes can occur as side effects of radiation therapy for breast cancer. Protein is essential for tissue repair, while calories provide the necessary energy for the body to heal. By consuming a diet high in protein and calories, the client can support their body's healing process, minimize the risk of complications, and promote healing at the radiation site. It is important to note that maintaining proper nutrition is crucial during cancer treatment to support overall health and well-being.
A 62-year old client diagnosed with pyelonephritis and possible septicemia has had five urinary tract infections over the past 2 years. She's fatigued from lack of sleep; urinates frequently, even during the night, and has lost weight recently. Tests reveal the following: sodium level 152mEq/L, osmolarity 340mOsm/L, glucose level 125mg/dl, and potassium level of 3.8mEq/L. Which of the following nursing diagnoses is most appropriate for this client?
- A. Deficient fluid volume related to inability to conserve water
- B. Imbalanced nutrition: Less than body requirements related to hypermetabolic state
- C. Deficient fluid volume related to osmotic diuresis induced by hypernatremia
- D. Imbalanced nutrition: Less than body requirements related to catabolic effects of insulin deficiency
Correct Answer: C
Rationale: The client's elevated sodium level of 152 mEq/L indicates hypernatremia, which can lead to osmotic diuresis, causing excessive urination and subsequent fluid loss. This fluid loss can result in deficient fluid volume. The client's symptoms of frequent urination, fatigue from lack of sleep, and weight loss are indicative of dehydration due to the osmotic diuresis. Therefore, the most appropriate nursing diagnosis for this client is Deficient fluid volume related to osmotic diuresis induced by hypernatremia.
Which communication technique should the nurse avoid when interviewing children and their families? TestBankWorld.org
- A. Using silence
- B. Using cliche
- C. Directing the focus
- D. Defining the problem
Correct Answer: C
Rationale: When interviewing children and their families, nurses should avoid directing the focus. Directing the focus involves steering the conversation in a certain direction, which may hinder open communication and the exploration of important issues. It is essential to allow children and their families to express themselves freely and openly, which can lead to a more comprehensive understanding of their perspectives and needs. Avoiding directing the focus can help build trust and rapport with the children and their families, leading to more effective communication and care.
What is an appropriate nursing intervention to minimize separation anxiety in a hospitalized toddler?
- A. Provide for privacy
- B. Encourage parents to room in
- C. Explain procedures and routines
- D. Encourage contact with children the same age
Correct Answer: B
Rationale: Encouraging parents to room in with the hospitalized toddler is an appropriate nursing intervention to minimize separation anxiety. This allows the child to maintain a sense of security and familiarity by having their primary caregivers close by. Having parents present can provide comfort, reassurance, and emotional support for the child during their hospital stay, which can help alleviate separation anxiety. Additionally, parents can continue to provide their usual care and routines for the child, further promoting a sense of stability and security.