Nokea
Which teaching strategies should the nurse plan to use for a baby boomer patient (select all that apply)?
- A. Podcast
- B. Role playing
- C. Group teaching
- D. Lecture-discussion
Correct Answer: B
Rationale: The correct answers are 'Role playing,' 'Group teaching,' and 'Lecture-discussion.' Baby boomers often prefer interactive and structured learning environments. Podcasts and games may not resonate as well with this demographic.
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During an assessment, a client with a long history of smoking and suspected laryngeal cancer will most likely report which early manifestation?
- A. Dysphagia
- B. Hoarseness
- C. Dyspnea
- D. Weight loss
Correct Answer: B
Rationale: The correct answer is B: Hoarseness. Hoarseness is a common early manifestation of laryngeal cancer due to vocal cord involvement. Smoking is a major risk factor for laryngeal cancer. Dysphagia (choice A) is more commonly associated with esophageal cancer. Dyspnea (choice C) is usually a late manifestation of laryngeal cancer when it causes airway obstruction. Weight loss (choice D) may occur later in the disease progression but is not typically an early sign. Thus, hoarseness is the most likely early manifestation due to its direct connection to the vocal cords and smoking history.
A client with a chest tube connected to a closed drainage system needs to be transported to the x-ray department. Which of the following actions should the nurse take?
- A. Clamp the chest tube prior to transferring the client to a wheelchair.
- B. Disconnect the chest tube from the drainage system during transport.
- C. Keep the drainage system below the level of the client's chest at all times.
- D. Empty the collection chamber prior to transport.
Correct Answer: C
Rationale: The correct answer is C: Keep the drainage system below the level of the client's chest at all times. This is important to prevent backflow of air or fluid into the client's chest, which can lead to complications such as a pneumothorax or hemothorax. Gravity ensures that the drainage system functions properly and prevents any potential harm to the client.
A: Clamping the chest tube prior to transferring the client is incorrect as it can cause a dangerous buildup of pressure in the chest.
B: Disconnecting the chest tube from the drainage system can also lead to complications and disrupt the drainage process.
D: Emptying the collection chamber is important but not the priority during transport; keeping the drainage system below the chest level is crucial for the client's safety.
A client is scheduled for a pneumonectomy in the morning. The client has had a previous negative surgical experience, is talking rapidly, and has an increased pulse and respiratory rate. Nursing interventions for this client should include:
- A. providing opportunities for questions and talking about the client's concerns.
- B. providing distractions such as reading or watching television.
- C. assuring the client that everything will be all right.
- D. reminding the client that the surgery is not as extensive as the client's past surgery.
Correct Answer: A
Rationale: Providing an opportunity for an open discussion will help to clarify any misunderstandings about the surgery and gives the client a chance to verbalize any concerns about the surgery. Distractions will not alleviate the client's preoperative anxiety; it denies the anxiety the client is experiencing. Giving false assurance is not appropriate and it denies that anxiety is a normal response to the threat of surgery. Psychological responses are not directly related to the severity of the surgery; they are influenced by the client's experience.
Priority Decision: The husband and daughter of a Hispanic woman dying from pancreatic cancer refuse to consider using hospice care. What is the first thing the nurse should do?
- A. Assess their understanding of what hospice care services are.
- B. Ask them how they will care for the patient without hospice care.
- C. Talk directly to the patient and family to see if she can change their minds.
- D. Accept their decision since they are Hispanic and prefer to care for their own.
Correct Answer: A
Rationale: The nurse should assess their understanding of hospice care services to ensure they are making an informed decision based on accurate information rather than assumptions or cultural biases.
Tom reports a history of carpal tunnel syndrome. What else would you expect to find in his history?
- A. Crepitus (grating feeling on palpation over joint during range of motion) due to loss of articular cartilage and bony overgrowth in joint.
- B. Excessive forward curvature of the thoracic spine (kyphosis) due to pathologic vertebral fractures and collapsing of the anterior portion of the vertebral bodies in the thoracic area.
- C. Pain and numbness or tingling sensation in the hand over the palmar surface of the thumb, index, and middle fingers, and lateral aspect of the ring finger, that is worse at night.
- D. Acute onset of excruciating pain in joint due to accumulation of uric acid within the joint.
Correct Answer: C
Rationale: Carpal tunnel syndrome affects the median nerve, causing pain and numbness in specific areas.