which of the following home care strategies is most likely to negatively impact the body image of a client with cushings syndrome

NCLEX-PN

Best NCLEX Next Gen Prep

1. Which of the following home-care strategies is most likely to negatively impact the body image of a client with Cushing's syndrome?

A. providing safety measures to prevent falls
B. taking medications as prescribed
C. wearing a medical ID indicating Cushing's syndrome
D. having regular health assessments

Correct answer: C

Rationale: All of the strategies listed are essential components of home care for a client with Cushing's syndrome. However, wearing a medical ID indicating Cushing's syndrome is the correct answer as it can have a negative impact on body image. This choice may constantly remind the client of their condition, potentially affecting their self-image and confidence. On the contrary, providing safety measures to prevent falls (Choice A) would enhance body image by promoting safety and preventing injuries. Taking medications as prescribed (Choice B) is likely to improve body image by managing symptoms effectively. Having regular health assessments (Choice D) demonstrates good self-care and can positively contribute to body image by showing a commitment to maintaining health.

2. What causes an older female client's hair to turn gray?

A. ''A loss of melanin occurs in the normal aging process.''
B. ''The number of sweat glands and blood vessels decreases in the normal aging process.''
C. ''The skin on the scalp becomes thin, causing moisture to escape.''
D. ''It is caused by hereditary factors.''

Correct answer: A

Rationale: The correct answer is 'A loss of melanin occurs in the normal aging process.' Graying hair in older adults is primarily due to a decrease in the number of melanocytes responsible for providing pigment and hair color. This reduction in melanin production leads to gray hair. The other choices are incorrect. While it is true that the skin becomes thinner with aging and the number of sweat glands and blood vessels decreases, these changes are not directly related to graying hair. Additionally, hereditary factors can influence when graying starts, but they do not cause the graying of hair itself.

3. When a couple experiencing infertility presents for a fertility workup, which of the following procedures should the nurse prepare the couple to have first?

A. Hysterosalpingography
B. Semen analysis
C. Endometrial biopsy
D. Transvaginal ultrasound

Correct answer: B

Rationale: Semen analysis is the most appropriate initial diagnostic test for a couple experiencing infertility. It is the least invasive of the listed tests, and since male factor infertility contributes to around 35% of cases, assessing semen parameters early is crucial. Hysterosalpingography is a radiographic test to evaluate tubal patency and uterine cavity abnormalities. Endometrial biopsy assesses endometrial receptivity post-ovulation. Transvaginal ultrasound is mainly used in infertility treatment to monitor follicle development, oocyte maturity, and luteal phase defects. Choices A, C, and D are more invasive, require specialized expertise, and are costlier. If semen analysis yields normal results, further tests may be warranted.

4. The nurse receives an order to administer phenytoin through the client's J-tube. The order instructs that tube feedings are stopped at least an hour prior to administering the medication and an hour after the medication is administered. Which of the following considerations may be a reason to discuss this order with the physician?

A. The client has a history of Type II diabetes.
B. The client is on a continuous tube-feeding regimen.
C. The client is on fluid restriction.
D. The pharmacy has provided phenytoin in tablet form.

Correct answer: B

Rationale: For a client on a continuous tube-feeding regimen, stopping tube feedings for two hours to administer this medication may compromise the client's nutritional status. This interruption can lead to inadequate nutrient intake, affecting the client's overall nutritional well-being. The other choices are less relevant in this situation. Type II diabetes does not directly impact the administration of phenytoin through a J-tube. Fluid restriction would not prevent the temporary interruption of tube feedings for medication administration. The form of phenytoin provided by the pharmacy does not impact the need to discuss the order with the physician regarding the client's continuous tube-feeding regimen.

5. A client with an ileus is placed on intestinal tube suction. Which of the following electrolytes is lost with intestinal suction?

A. calcium
B. magnesium
C. potassium
D. sodium chloride

Correct answer: D

Rationale: The correct answer is sodium chloride. Duodenal intestinal fluid is rich in potassium (K+), sodium (Na+), and bicarbonate. When suctioning is used to remove excess fluids due to ileus, it results in the loss of sodium chloride (NaCl) leading to decreased sodium (Na+) levels. Choices A, B, and C are incorrect because calcium, magnesium, and potassium are not typically lost in significant amounts through intestinal tube suction in the context of treating ileus.