Nokea
Which of the following individuals are at risk for acquiring acute lymphocytic leukemia (ALL)? The client who is:
- A. 20 to 30 years.
- B. 40 to 50 years.
- C. 60 to 70 years.
- D. None of the above
Correct Answer: A
Rationale: ALL is most common in children and young adults, with a peak incidence in those aged 20–30 years. Older adults (40–70 years) are more likely to develop AML or CLL.
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A client who is scheduled for an open cholecystectomy has a 20-pack-year history of smoking. For which postoperative complication is the client most at risk?
- A. Deep vein thrombosis.
- B. Atelectasis and pneumonia.
- C. Delayed wound healing.
- D. Prolonged immobility.
Correct Answer: B
Rationale: Smoking impairs lung function and ciliary clearance, increasing the risk of atelectasis and pneumonia post-surgery due to reduced lung expansion and mucus clearance.
The cyanosis that accompanies bacterial pneumonia is primarily caused by which of the following?
- A. Decreased cardiac output.
- B. Pleural effusion.
- C. Inadequate peripheral circulation.
- D. Decreased oxygenation of the blood.
Correct Answer: D
Rationale: Cyanosis in pneumonia results from decreased blood oxygenation due to impaired gas exchange in the lungs. Cardiac output, pleural effusion, and peripheral circulation may contribute but are not primary causes.
A nurse is teaching a client with type 1 diabetes mellitus who jogs daily about the preferred sites for insulin absorption. What is the most appropriate site for a client who jogs?
- A. Arms.
- B. Legs.
- C. Abdomen.
- D. Iliac crest.
Correct Answer: C
Rationale: The abdomen is the preferred insulin injection site for active individuals like joggers, as it provides consistent absorption and is less affected by exercise compared to the legs.
The nurse is teaching a client about isoniazid (INH). Which of the following statements should the nurse include?
- A. This medication may turn your secretions reddish/orange.
- B. Yellowing of your eyes is a normal side-effect.
- C. A B-complex vitamin should be taken to help with the neuropathy.
- D. This medication will need to be taken every day for at least one week.
Correct Answer: C
Rationale: Isoniazid (INH) can cause peripheral neuropathy, and a B-complex vitamin (especially vitamin B6) is often recommended to help prevent or manage this side effect. Choice A is incorrect because reddish/orange secretions are associated with rifampin, not INH. Choice B is incorrect because yellowing of the eyes (jaundice) is a sign of hepatotoxicity, a serious adverse effect, not a normal side effect. Choice D is incorrect because INH treatment for tuberculosis typically lasts 6-9 months, not just one week.
A client is being prepared to have a craniotomy for a brain tumor. As a client advocate, the nurse is evaluating the client's understanding of the informed consent before witnessing the client's signature on the operative consent form. Which of the following indicates that the nurse needs to contact the surgeon for further communication with the client?
- A. We talked about the effect of my diabetes on healing.'
- B. œThe surgeon explained how the craniotomy was done.'
- C. œThere are no major risks from this surgery.'
- D. œI will die if the tumor is not removed from my brain.'
Correct Answer: C
Rationale: Stating there are no major risks indicates a misunderstanding, as craniotomy carries significant risks (e.g., bleeding, infection). The nurse must contact the surgeon to clarify risks for informed consent.