Your patient complains of left upper quadrant pain, fever, extreme fatigue, and spontaneous bruising. The clinician should recognize that these symptoms are often related to:
A. Hematopoetic disorders
B. Hepatomegaly
C. Esophageal varices
D. Pleural effusion
ANS: A
LUQ pain can be associated with stomach or spleen disorders; however, it is often associated with causes that are outside the abdomen. Hematopoietic malignancies, such as lymphomas and leukemias, and other hematologic disorders, such as thrombocytopenia, polycythemia, myelofibrosis, and hemolyticanemia, often cause enlargement of the spleen, leading to LUQ pain. In addition to questions about the specific characteristics of the pain, it is important to ask the patient about fever, unusual bleeding or bruising, recent diagnosis of mononucleosis, fatigue, malaise, lymphadenopathy, cough, arthralgias, anorexia, weight loss, jaundice, high blood pressure, and headache.
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The nurse is caring for a woman newly diagnosed with breast cancer who asks the nurse to explain the difference between a mastectomy and a radical mastectomy. The nurse's best response is:
1. "They are both the same except that a radical mastectomy removes muscles from the chest wall." 2. "Both remove the breast tissue, but a radical mastectomy removes muscles and lymph nodes." 3. "The radical mastectomy takes more tissue from the chest and improves the chances of survival." 4. "The mastectomy removes more tissue and reduces the risk of metastasis, thereby improving survival rates."
The nurse knows the usual progression of sleep is:
a. NREM 1-4 then REM, then back through NREM 1 and 2. b. REM then NREM 1-4, then back through NREM 2 and 3. c. NREM 1-4 then back through NREM 3 and 2 then REM. d. REM then NREM 1-4 then back through NREM 3.
Two nurses, one male and one female, were discussing client assignments. Which of the following best illustrates gender differences between these two colleagues?
a. Male: "I think the client needs to have a nursing assistant assigned on a one-to-one basis." Female: "I agree with you." b. Male: "I think the client is experiencing a loss related to the fact that he is no longer the breadwinner of the family." Female: "I think the client is grieving." c. Male: "I wonder if the client has expressed to his family his feelings of loss." Female: "I think he is dealing with his feelings." d. Male: "I plan to care for the client as part of my assignment—he will confide in me because I am a male." Female: "I am just as competent to care for the client as you are."
The client asks the nurse to explain stress and its effect on the body. Which of the following will the nurse include? Select all that apply
A) Stress begins in children at about age 2. B) All stress has a negative effect on the human body in some form. C) Stress begins in utero. D) Stress is ever-present. E) Some forms of stress are positive events.