Question

47. A nurse is reviewing the medical record of a client to identify risk factors for colorectal cancer. The nurse should identify which of the following findings as increasing the client's risk?

1. Age 46 years
2. Diet high in fiber
3. BMI of 24
4. History of Crohn's disease

48. A nurse is providing discharge teaching to a client who will be self-administering insulin at home. Which of the following information should the nurse include regarding needle disposal?

1. "Place your storage container in a recycle bin when it is full."
2. "Remove the needle from the syringe before you place it in the trash."
3. "Secure the cap tightly over the needle before you discard it."
4. "You can discard needles in an empty bleach bottle with a lid."

49. A nurse is assessing a client who has a new diagnosis of type 1 diabetes mellitus. Which of the following findings indicates that the client is experiencing hypoglycemia?
50. Abdominal cramping
51. Increased perspiration
52. Dehydration
53. Fruit odor to breath
54. A client who is deaf and communicates using sign language is being admitted by a nurse who does not know sign language. Which of the following

actions should the nurse take?

1. Familiarize themselves with commonly used signed language.
2. Ask a family member to be present during the admission.
3. Obtain a board that uses colored pictures as communication.
4. Request an interpreter during the initial assessment.

51. A nurse is planning care for a client who is 8 hr postoperative following a coronary artery bypass grafting. Which of the following assessments should the nurse plan to perform first?
    1. Auscultate breath sounds.
    2. Examine the surgical incision for drainage.
    3. Measure the client's core body temperature.
    4. Palpate pulses distal to the graft donor site.

Answer 1

Answers

Q1: Answer is option D- History of Crohn’s disease

Option D is the correct answer because the patients with Crohn’s disease or having a history of Crohn’s disease are at high risk for developing colorectal cancer.

Options A, B, and C are wrong because people with an age more than 50 years are at risk for developing colorectal cancer and it will develop in people with a low fiber diet. Colorectal cancer is common in overweight and obese people who have a BMI above 25. BMI 24 is considered as the normal value.

Q2: Answer is option D- You can discard needles in an empty bleach bottle with a lid.

  Option D is correct because while disposing of the insulin needles choose an empty bleach bottle or laundry detergent bottle with a lid to avoid the exposure of the needles to the outside.

Options A, B, and C are wrong because the sharp container can’t dispose of the recycle bin directly after it becomes full. While disposing of the insulin needle no need to remove the needles separately from the syringe. The syringe can directly dispose of in the container. Don’t recap the needles after the use as it may cause injury while recapping.

Q3: Answer is option B – Increased Perspiration

  Option B is the right answer because the type 1 DM patient with hypoglycemia will experience increased perspiration.

Options A, C, and D are wrong because all those symptoms are appearing in type 1 DM patients with diabetic ketoacidosis.

Q4: Answer is option D - Request an interpreter during the initial assessment.

Option D is the right answer because requesting a sign language interpreter during the assessment will help the patient to explain all the procedures in their own language.

Options A, B and C are incorrect because it is not able to familiarize the sign language easily for the admission process. The family member may know the language of the patient but sometimes it may difficult for them to explain every procedure to the patient. Obtaining a board with the colored picture is not an effective way to communicate with the deaf patient during the assessment.

Q5: Answer is option B- Examine the surgical incision for drainage.  

  Option B is the right answer because receiving a patient after 8 hours of CABG the nurse should first inspect the surgical incision for the drainage and its volume.

Options A, C, and D are correct only but all these monitoring will come as the second part of the assessment.