Nokea
Which of the following factors places a client at greatest risk for skin cancer?
- A. Fair skin and history of chronic sun exposure.
- B. Caucasian race and history of hypertension.
- C. Dark skin and family history of skin cancer.
- D. Dark skin and history of hypertension.
Correct Answer: A
Rationale: Fair skin and chronic sun exposure increase skin cancer risk due to higher UV sensitivity and cumulative damage. Dark skin offers some protection.
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A client with detachment of the retina is to patch both eyes. The expected outcome of patching is to:
- A. Reduce rapid eye movements.
- B. Decrease the irritation caused by light entering the damaged eye.
- C. Protect the injured eye from infection.
- D. Rest the eyes to promote healing.
Correct Answer: A
Rationale: Patching both eyes reduces rapid eye movements, which could worsen retinal detachment by preventing further stress on the retina.
The nurse administers mannitol (Osmitrol) to the client with increased intracranial pressure. Which parameter requires close monitoring?
- A. Muscle relaxation.
- B. Intake and output.
- C. Widening of the pulse pressure.
- D. Pupil dilation.
Correct Answer: B
Rationale: Mannitol is an osmotic diuretic used to reduce ICP by drawing fluid from brain tissue. Monitoring intake and output is critical to assess its effectiveness and prevent dehydration or electrolyte imbalances. Muscle relaxation, pulse pressure, and pupil dilation are not directly related to mannitol's primary effects.
A 250-lb male client recovering from general anesthesia has the following assessment findings: pulse, 150 bpm; blood pressure, 90/50 mm Hg; respiratory rate, 28 breaths/minute; tympanic temperature, 99.8°F (37.7°C); and rigid muscles. The nurse determines that the client is:
- A. Recovering as expected from the anesthesia and continues monitoring him.
- B. Exhibiting the effects of excessive blood loss experienced in the operating room and increases the rate of his I.V. infusion.
- C. In the early stages of malignant hyperthermia and obtains emergency medications and notification.
- D. In pain and offers him pain medication.
Correct Answer: C
Rationale: Tachycardia, hypotension, tachypnea, and muscle rigidity suggest malignant hyperthermia, a life-threatening reaction to anesthesia. Immediate action, including emergency medications like dantrolene, is required.
The client with colon cancer has an abdominal-perineal resection with a colostomy. Which of the following nursing interventions is most appropriate for this client in the postoperative period?
- A. Maintain the client in a semi-Fowler's position.
- B. Assist the client with warm sitz baths.
- C. Administer 30 mL of milk of magnesia to stimulate colostomy activity.
- D. Remove the ostomy pouch as needed so the stoma can be assessed.
Correct Answer: B
Rationale: Appropriate nursing interventions after an abdominal-perineal resection with a colostomy include assisting the client with warm sitz baths three to four times a day to clean the perineal incision. The client will be more comfortable assuming a side-lying position because of the perineal incision. It would be inappropriate to administer milk of magnesia to stimulate colostomy activity. Stool passage will begin as peristalsis returns. It is not necessary to be available to change the ostomy pouch to assess the stoma. The ostomy pouch should be transparent to allow easy observation of the stoma and drainage. CN: Physiological adaptation; CL: Synthesize
Which of the following assessments should be a priority immediately after nasal surgery?
- A. Assessing the client's pain.
- B. Inspecting for periorbital ecchymosis.
- C. Assessing respiratory status.
- D. Measuring intake and output.
Correct Answer: C
Rationale: Respiratory status is the priority post-nasal surgery due to the risk of airway obstruction from packing or swelling. Pain, ecchymosis, and fluid balance are important but secondary to airway patency.