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Question 1 of 5

A client with a history of breast cancer is receiving tamoxifen (Nolvadex). Which adverse effect should the nurse monitor for?

Correct Answer: B

Rationale: Tamoxifen increases the risk of endometrial hyperplasia, a serious adverse effect due to its estrogenic effects on the uterus. Weight loss (
A), hypotension (
C), and hair loss (
D) are not typical.

Question 2 of 5

The nurse is teaching a client with ulcerative colitis who has been prescribed sulfasalazine (Azulfidine). What clinical manifestations will the nurse tell the client to be particularly alert for when taking this drug?

Question Image

Correct Answer: A, B, C, E

Rationale: Sulfasalazine side effects include flu-like symptoms (
A), purplish rash (
B), skin blisters (
C), and nausea (E). Anorexia (
D) is less common.

Question 3 of 5

Which method of transmission would most likely result in contamination with botulism?

Question Image

Correct Answer: B, D

Rationale: Botulism is caused by Clostridium botulinum toxin, typically from contaminated food (e.g., perforated cans,
B) or wound contamination (
D). It is not transmitted person-to-person (
A), via mosquitoes (
C), goat saliva (E), or cat litter dust (F).

Question 4 of 5

Following a gastric resection, which of the following actions would the nurse reinforce with the client in order to alleviate the distress from dumping syndrome?

Correct Answer: D

Rationale: A low-carbohydrate diet prevents a hypertonic bolus, reducing dumping syndrome. The other options exacerbate the condition.

Question 5 of 5

A 48-year-old client is being seen in her physician's office for complaints of indigestion, heartburn, right upper quadrant pain, and nausea of 4 days' duration, especially after meals. The nurse realizes that these symptoms may be associated with cholecystitis and therefore would check for which specific sign during the abdominal assessment?

Correct Answer: C

Rationale: This sign is a faint blue discoloration around the umbilicus found in clients who have hemorrhagic pancreatitis. This sign indicates areas of inflammation within the peritoneum, such as with appendicitis. It is a deep palpation technique used on a nontender area of the abdomen, and when the palpating hand is removed suddenly, the client experiences a sharp, stabbing pain at an area of peritoneal inflammation. This sign is considered positive with acute cholecystitis when the client is unable to take a deep breath while the right upper quadrant is being deeply palpated. The client will elicit a sudden, sharp gasp, which means the gallbladder is acutely inflamed. This is a sign of acute hemorrhagic pancreatitis and manifests as a green or purple discoloration in the flanks.

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