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Which of the following statements indicates the client understands the expected course of Ménière'sdisease?
- A. The disease process will gradually extend to the eyes.
- B. Control of the episodes is usually possible, but a cure is not yet available.
- C. Continued medication therapy will cure the disease.
- D. Bilateral deafness is an inevitable outcome of the disease.
Correct Answer: B
Rationale: Ménière'sdisease is a chronic condition with no cure, but episodes can often be managed with medications, diet, and lifestyle changes, though hearing loss may progress over time.
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The nurse is assessing a client with heart failure who is receiving home health care monitoring using electronic devices including scales, blood pressure monitoring, and structured questions to which the client responds daily on a touch-screen monitor. The nurse reviews data obtained within the last 3 days. The nurse calls the client to follow up. The nurse should ask the client which of the following first:
- A. How are you feeling today?'
- B. Are you having shortness of breath?'
- C. Did you calibrate the scales before using them?'
- D. How much fluid did you drink during the last 24 hours?'
Correct Answer: B
Rationale: A 5-lb weight gain in 3 days and rising blood pressure suggest fluid retention. Asking about shortness of breath first assesses for pulmonary edema, a serious complication.
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.
A client with osteoporosis is prescribed alendronate (Fosamax). Which instruction should the nurse include?
- A. Take the medication at bedtime.
- B. Remain upright for 30 minutes after taking.
- C. Crush the tablet for easier swallowing.
- D. Take with a full meal.
Correct Answer: B
Rationale: Remaining upright for 30 minutes after taking alendronate prevents esophageal irritation.
What should the nurse assess first in a client with a recent head injury?
- A. Pupil response.
- B. Blood pressure.
- C. Pain level.
- D. Reflexes.
Correct Answer: A
Rationale: Pupil response is assessed first to detect neurological changes, such as increased intracranial pressure, in a head injury.
A family member asks the nurse why their loved one with end-stage liver cancer is so restless. The nurse's best response is:
- A. Restlessness is a side effect of pain medications.
- B. It may be due to decreased oxygen to the brain.
- C. It's a normal part of the dying process.
- D. It's caused by dehydration.
Correct Answer: C
Rationale: Restlessness is a common symptom in the dying process, often due to metabolic changes or psychological factors, and explaining this normalizes the family's experience.