Nokea
Which of the following groups would benefit most from education regarding potential risk factors for melanoma?
- A. Adults older than age 35.
- B. Senior citizens who have been repeatedly exposed to the effects of ultraviolet A and ultraviolet B rays.
- C. Parents with children.
- D. Employees of a chemical factory.
Correct Answer: B
Rationale: Senior citizens with repeated exposure to UV rays are at the highest risk for melanoma due to cumulative skin damage. Education on risk factors like UV exposure is most beneficial for this group.
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For which of the following preoperative clients should the nurse assess the glucose level? Select all that apply.
- A. A client with diabetes mellitus controlled by diet.
- B. A client with a high stress response to surgery.
- C. A client receiving corticosteroids for the past 3 months.
- D. A client with a family history of diabetes receiving dextrose 5% in lactated Ringer's solution (D5LR) I.V. fluids.
- E. A client who consumes a high carbohydrate diet.
Correct Answer: A,B,C,D
Rationale: Clients at risk for hyperglycemia include those with diabetes (A), high stress response (B, due to cortisol release), recent corticosteroid use (C, which raises glucose), and those receiving dextrose-containing IV fluids with a family history of diabetes (D). A high carbohydrate diet alone (E) is less likely to warrant immediate glucose monitoring.
When a client with thrombocytopenia has a severe headache, the nurse interprets that this may indicate which of the following?
- A. Stress of the disease.
- B. Cerebral bleeding.
- C. Migraine headache.
- D. Sinus congestion.
Correct Answer: B
Rationale: Thrombocytopenia increases the risk of bleeding, and a severe headache may indicate cerebral bleeding, a life-threatening complication. The nurse should prioritize this possibility over stress, migraine, or sinus issues, which are less likely in this context.
When teaching the client with myocardial infarction (MI), the nurse explains that the pain associated with MI is caused by:
- A. Left ventricular overload.
- B. Impending circulatory collapse.
- C. Extracellular electrolyte imbalances.
- D. Insufficient oxygen reaching the heart muscle.
Correct Answer: D
Rationale: MI pain results from myocardial ischemia due to insufficient oxygen delivery to the heart muscle, caused by coronary artery occlusion.
A client who has had ulcerative colitis for the past 5 years is admitted to the hospital with an exacerbation of the disease. Which of the following factors was most likely of greatest significance in causing an exacerbation of ulcerative colitis?
- A. A demanding job.
- B. Recent travel.
- C. A high-fiber diet.
- D. Stopping corticosteroid therapy.
Correct Answer: D
Rationale: Stopping corticosteroid therapy can lead to an exacerbation of ulcerative colitis, as corticosteroids help control inflammation. A demanding job or recent travel may contribute to stress but are less directly linked. A high-fiber diet is generally beneficial for managing symptoms unless during an acute flare. CN: Physiological adaptation; CL: Analyze
College freshman are participating in a study abroad program. When teaching them about hepatitis B, the nurse should instruct the students on:
- A. Water sanitation.
- B. Single dormitory rooms.
- C. Vaccine for hepatitis B.
- D. Safe sexual practices.
Correct Answer: D
Rationale: Hepatitis B is transmitted through blood and body fluids, so safe sexual practices (D) are critical for prevention. Water sanitation (A) is relevant for hepatitis A, single rooms (B) are unnecessary, and while vaccination (C) is important, the question focuses on behavioral instruction.