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While reading the progress notes on a client with cancer, the nurse notes a TNM classification of T1, N1, M0. What does this classification indicate?
- A. The tumor is in situ, no regional lymph nodes are involved, and there is no metastasis.
- B. No evidence of primary tumor exists, lymph nodes can't be assessed, and metastasis can't be assessed.
- C. The tumor is extended, with regional lymph node involvement and distant metastasis.
- D. The tumor is extended and regional lymph nodes are involved, but there is no metastasis.
Correct Answer: D
Rationale: T1 indicates a small tumor, N1 indicates regional lymph node involvement, and M0 indicates no distant metastasis. Option A is incorrect (T1 is not in situ), B is incorrect (T0, not T1, means no tumor), and C is incorrect (M0 means no metastasis).
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Which complaint is frequently expressed by a client with macular degeneration?
- A. Problems with activities requiring focused vision such as sewing
- B. Severe eye and face pain accompanied by nausea and vomiting
- C. Seeing halos around lights
- D. Veil-like loss of vision
Correct Answer: A
Rationale: Macular degeneration affects central vision, impairing activities like sewing or reading that require focused vision. Severe pain with nausea is typical of acute glaucoma, halos suggest cataracts or glaucoma, and veil-like vision loss is more associated with retinal detachment.
When discussing the relationship between exercise and insulin requirements, a 26-year-old client with IDDM should be instructed that:
- A. When exercise is increased, insulin needs are increased
- B. When exercise is increased, insulin needs are decreased
- C. When exercise is increased, there is no change in insulin needs
- D. When exercise is decreased, insulin needs are decreased
Correct Answer: B
Rationale: Exercise decreased the blood sugar by promoting uptake of glucose by the muscles. Consequently, less insulin is needed to metabolize ingested carbohydrates. Extra food may be required for extra activity.
Upon arrival to the nursery, Ilotycin (erythromycin) eyedrops are instilled in the newborn's eyes. The nurse understands that the medication will:
- A. Make the eyes less sensitive to light
- B. Help prevent neonatal blindness
- C. Strengthen the muscles of the eyes
- D. Improve accommodation to near objects
Correct Answer: B
Rationale: Erythromycin eyedrops are used prophylactically in newborns to prevent ophthalmia neonatorum, which can cause blindness.
The client is admitted with a diagnosis of preterm labor. Which symptom is most characteristic?
- A. Uterine contractions
- B. Fetal macrosomia
- C. Maternal fever
- D. Painless vaginal bleeding
Correct Answer: A
Rationale: Uterine contractions (regular frequent) are the hallmark of preterm labor occurring before 37 weeks. Fetal macrosomia maternal fever and painless bleeding are not characteristic.
A five-year-old child is hospitalized for correction of congenital hip dysplasia. During the assessment of the child, the nurse can expect to find the presence of:
- A. Scarf sign
- B. Harlequin sign
- C. Cullen's sign
- D. Trendelenburg sign
Correct Answer: D
Rationale: Trendelenburg sign, where the pelvis tilts downward on the unaffected side when standing on the affected leg, is associated with congenital hip dysplasia due to weak hip abductors. The other signs are unrelated.