Nokea
Which factor in a client’s health history increases their risk for cancer?
- A. Family history and environment
- B. Alcohol and smoking
- C. Alcohol consumption and smoking
- D. Proximity to an electric plant and water source
Correct Answer: B
Rationale: The correct answer is 'Alcohol and smoking.' Both alcohol consumption and smoking are well-known risk factors for various types of cancer. They have a synergistic effect, meaning their combined impact raises the risk significantly. Family history and environment (Choice A) may play a role in certain cancers, but alcohol and smoking are more directly linked to increased cancer risk. Proximity to an electric plant and water source (Choice D) is not typically associated with an increased risk of cancer compared to alcohol and smoking.
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After discontinuing a peripherally inserted central line (PICC), what information is most important for the nurse to record?
- A. How the client tolerated the procedure.
- B. The length and intactness of the central line catheter.
- C. The amount of fluid left in the IV solution container.
- D. That a dressing was applied to the insertion site.
Correct Answer: B
Rationale: The most important information for the nurse to record after discontinuing a peripherally inserted central line (PICC) is the length and intactness of the central line catheter. This is crucial for assessing any potential complications or safety issues post-removal. Choices A, C, and D are not as critical as ensuring the condition of the central line catheter. While noting the client's tolerance of the procedure is relevant for their care assessment, evaluating the central line's integrity takes precedence in this scenario.
A 70-year-old male who is recovering from a stroke exhibits signs of unilateral neglect. Which behavior is suggestive of unilateral neglect?
- A. The client is observed shaving only one side of his face.
- B. The client is unable to distinguish between two tactile stimuli presented simultaneously.
- C. The client is unable to complete a range of vision without turning his head side to side.
- D. The client is unable to carry out cognitive and motor activity at the same time.
Correct Answer: A
Rationale: Unilateral neglect is a condition where a person ignores one side of their body. In this case, the behavior of shaving only one side of the face indicates neglect of the other side. This behavior is suggestive of unilateral neglect as the individual is failing to attend to one side of their body. Choices B, C, and D are not associated with unilateral neglect. Choice B refers to tactile agnosia, a condition where a person cannot recognize objects by touch, not related to ignoring one side of the body. Choice C describes a visual field cut, which is a different visual deficit. Choice D relates to dual-task interference, not specific to ignoring one side of the body.
A client admitted with an episode of bleeding esophageal varices is receiving propranolol (Inderal LA). The nurse knows to monitor for?
- A. Hypertension
- B. Hyperkalemia
- C. Bradycardia
- D. Arthralgia
Correct Answer: C
Rationale: The correct answer is 'Bradycardia.' Propranolol is a beta-blocking agent used to decrease the heart rate. In the case of bleeding esophageal varices, propranolol is given to reduce the risk of bleeding by keeping the heart rate around 55 beats per minute. Monitoring for bradycardia is essential as the medication's intended effect is to lower the heart rate. Choices A, B, and D are incorrect because propranolol would not typically cause hypertension, hyperkalemia, or arthralgia.
A client arrives in the emergency department after severely lacerating the left hand with a knife. HR 96, BP 150/88, R36. The client is extremely anxious and crying uncontrollably. Based on this assessment, the nurse anticipates that this client would be in which acid-base imbalance?
- A. Respiratory acidosis
- B. Respiratory alkalosis
- C. Metabolic acidosis
- D. Metabolic alkalosis
Correct Answer: B
Rationale: The correct answer is respiratory alkalosis. Hyperventilation due to anxiety, pain, shock, severe infection, fever, or liver failure can lead to respiratory alkalosis. In this scenario, the client is extremely anxious and crying uncontrollably, indicating an increased respiratory rate and CO2 loss. Respiratory acidosis (choice A) is incorrect as it is characterized by an increase in CO2 levels, not a loss. Metabolic acidosis (choice C) involves a decrease in blood pH due to an accumulation of acids or loss of bicarbonate, which is not the case here. Metabolic alkalosis (choice D) results from excess bicarbonate or a loss of acids, not from increased CO2 loss due to hyperventilation.
A client returns to the nursing unit post-thoracotomy with two chest tubes in place connected to a drainage device. The client's spouse asks the nurse about the reason for having two chest tubes. The nurse's response is based on the knowledge that the upper chest tube is placed to:
- A. Remove air from the pleural space
- B. Create access for irrigating the chest cavity
- C. Evacuate secretions from the bronchioles and alveoli
- D. Drain blood and fluid from the pleural space
Correct Answer: A
Rationale: The correct answer is 'Remove air from the pleural space.' When a client has two chest tubes in place post-thoracotomy, the upper chest tube is typically positioned to remove air from the pleural space. Air rises, so placing the tube at the top allows for efficient removal of air that has accumulated in the pleural cavity. Choice B, creating access for irrigating the chest cavity, is incorrect as chest tubes are not primarily used for irrigation. Choice C, evacuating secretions from the bronchioles and alveoli, is incorrect as chest tubes are not designed for this purpose. Choice D, draining blood and fluid from the pleural space, is also incorrect as the upper chest tube in this scenario is specifically for removing air, not blood or fluid.