Nursing Elites

1. A patient is receiving discharge teaching for esophageal cancer and starting radiation therapy. What instruction should the healthcare provider include?

• A. Remove dye markings after each radiation treatment
• B. Apply a warm compress to the irradiated site
• C. Wear clothing over the area of radiation treatment
• D. Use a washcloth to bathe the treatment area

Correct answer: C

Rationale: The correct instruction for a patient starting radiation therapy for esophageal cancer is to wear clothing over the area of radiation treatment. This helps to prevent irritation and protect the skin. Removing dye markings after each treatment (choice A) is unnecessary and not typically part of the patient's self-care. Applying a warm compress (choice B) can exacerbate skin irritation caused by radiation. Using a washcloth to bathe the treatment area (choice D) can potentially irritate the skin further, making it important to avoid.

2. A nurse is caring for a client receiving radiation treatments for cancer. The client states he is experiencing dryness, redness, and scaling at the treatment area. Which of the following should the nurse instruct the client to do?

• A. Sit in the sun for 15 minutes per day.
• B. Apply moist heat to the area twice daily.
• C. Liberally apply prescribed lotion to the area.
• D. Wash the affected area daily with antimicrobial soap.

Correct answer: C

Rationale: The nurse should instruct the client to liberally apply prescribed lotion to the treatment area. Prescribed hydrating lotions help soothe and protect irradiated skin, reducing dryness, redness, and scaling. Sitting in the sun can further damage the skin. Applying moist heat may exacerbate the skin condition. Washing the area with antimicrobial soap can be too harsh and further irritate the skin.

3. A client is being taught how to use a diaphragm for contraception. Which of the following client statements indicate an understanding of the teaching?

• A. I will leave the diaphragm in place for at least 6 hours after intercourse.
• B. I will remove the diaphragm by catching the rim below the dome with my finger.
• C. I will not apply mineral oil on the diaphragm.
• D. I will place 2 teaspoons of spermicide on the inside of the diaphragm before inserting it.

Correct answer: D

Rationale: The correct answer is D. The client should place spermicide inside the diaphragm before insertion to enhance contraceptive effectiveness. It is recommended to leave the diaphragm in place for at least 6 hours after intercourse, but not more than 24 hours. Choice A is incorrect because the diaphragm should be left in place for at least 6 hours, not 4 hours. Choice B is incorrect as the diaphragm should be removed by hooking the rim below the dome, not above. Choice C is incorrect because mineral oil should not be used with the diaphragm as it can weaken the latex.

4. A client newly prescribed sertraline is being taught by a nurse. Which statement by the client indicates understanding?

• A. I should take this medication with meals.
• B. I might have trouble sleeping when I start this medication.
• C. I should avoid drinking orange juice.
• D. I will feel better immediately after starting the medication.

Correct answer: B

Rationale: Choice B, 'I might have trouble sleeping when I start this medication,' indicates understanding because insomnia is a common side effect of sertraline, especially when initiating the medication. This statement shows the client comprehends a potential adverse effect and is prepared for it. Choices A, C, and D are incorrect. Taking sertraline with or without meals does not significantly affect its efficacy. There is no specific contraindication about drinking orange juice while on sertraline. Feeling better immediately after starting the medication is unlikely as sertraline usually takes some time to exert its therapeutic effects.

5. A nurse is teaching a client about the use of omeprazole. Which of the following should be included?

• A. Take the medication with food
• B. Avoid taking it with NSAIDs
• C. Monitor for gastrointestinal bleeding
• D. It can cause drowsiness

Correct answer: C

Rationale: The correct answer is C. Omeprazole is a proton pump inhibitor that can mask symptoms of gastrointestinal bleeding; clients should be monitored for this. Choices A and B are incorrect because omeprazole is usually taken before meals, and while it is important to avoid NSAIDs if possible due to their effects on the stomach, it is not directly related to omeprazole use. Choice D is also incorrect as omeprazole is not typically associated with causing drowsiness.

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