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Which of the following are expected outcomes for a client with pulmonary disease?
- A. A relatively matched ventilation-to-perfusion ratio.
- B. A low ventilation-to-perfusion ratio.
- C. A high ventilation-to-perfusion ratio.
- D. An equal PaO2 and PaCO2 ratio.
Correct Answer: A
Rationale: A matched ventilation-to-perfusion ratio is the goal in pulmonary disease for efficient gas exchange. Low or high ratios indicate mismatch. Equal PaO2 and PaCO2 is not a standard outcome.
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Which of the following variables is most important to assess when determining the impact of the cancer diagnosis and treatment modalities on a long-term survivor's quality of life?
- A. Occupation and employability.
- B. Functional status.
- C. Evidence of disease.
- D. Individual values and beliefs.
Correct Answer: B
Rationale: Functional status, including physical and emotional capabilities, is the most important variable affecting a long-term cancer survivor's quality of life, as it reflects their ability to engage in daily activities.
A client with acute renal failure has an increase in the serum potassium level. The nurse should monitor the client for:
- A. Cardiac arrest.
- B. Pulmonary edema.
- C. Circulatory collapse.
- D. Hemorrhage.
Correct Answer: A
Rationale: Elevated potassium can cause cardiac arrhythmias, potentially leading to cardiac arrest, requiring close monitoring.
The client who has undergone a bilateral adrenalectomy is ready to return home. She tells the nurse that she is concerned about persistent body changes and the fact that her moods are still so unpredictable. She says, 'I thought surgery was supposed to fix all that.' The nurse should tell the client that:
- A. The body changes are permanent and the client will not be the same as before this condition.'
- B. The body and mood will gradually return to normal.'
- C. The physical changes are permanent, but the mood swings will disappear.'
- D. The physical changes are temporary, but the mood swings are permanent.'
Correct Answer: B
Rationale: Post-adrenalectomy, with proper hormone replacement, physical changes and mood swings gradually resolve as hormone levels normalize.
After a client who has had a laparoscopic cholecystectomy receives discharge instructions, which of the following client statements would indicate that the teaching has been successful? Select all that apply.
- A. I can resume my normal diet when I want.
- B. I need to avoid driving for about 4 weeks.
- C. I may experience some pain in my right shoulder.
- D. I should spend 2 to 3 days in bed before resuming activity.
- E. I can wash the puncture site with mild soap and water.
Correct Answer: C,E
Rationale: Right shoulder pain (C) can occur due to referred pain from diaphragmatic irritation. Washing the puncture site with mild soap and water (E) is correct for hygiene. Resuming a normal diet immediately (A) is incorrect; a low-fat diet is advised. Avoiding driving for 4 weeks (B) is excessive; 1-2 weeks is typical. Bed rest for 2-3 days (D) is unnecessary as early ambulation is encouraged.
To help minimize the risk of postoperative respiratory complications after a hypophysectomy, during preoperative teaching, the nurse should instruct the client how to:
- A. Use blow bottles.
- B. Turn in bed.
- C. Take deep breaths.
- D. Cough.
Correct Answer: C
Rationale: Deep breathing exercises post-hypophysectomy help expand lungs and prevent atelectasis, reducing respiratory complications.