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Questions 164

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Question 1 of 5

An adult client is showing signs of developing hypovolemic shock. Which finding is most likely to be present?

Correct Answer: C

Rationale: Hypovolemic shock reduces circulating volume, decreasing renal perfusion and causing oliguria (decreased urine output). Blood pressure typically narrows, heart rate increases, and respiratory rate rises.

Question 2 of 5

The nurse is caring for a client with suspected colorectal cancer. Which of the following findings would support a diagnosis of colorectal cancer? Select all that apply.

Correct Answer: A,B,C,D

Rationale: Colorectal cancer often presents with fatigue (
A) due to anemia or systemic effects, blood in the stool (
B) from tumor bleeding, changes in bowel habits (
C) like diarrhea or constipation, and unintentional weight loss (
D) from malignancy-related cachexia. Elevated hemoglobin (E) is unlikely, as anemia is more common due to chronic blood loss.

Question 3 of 5

The nurse is caring for a client with COPD who becomes dyspneic. The nurse should

Correct Answer: C

Rationale: Use pursed-lip breathing during periods of dyspnea to control rate and depth of respiration and improve respiratory muscle coordination.

Question 4 of 5

The client with malignant left pleural effusion undergoes a thoracentesis and 900 mL of excess pleural fluid is removed. Which of these manifestations, if noted on the post-procedure assessment, should the nurse report to the health care provider immediately?

Correct Answer: A

Rationale: Asymmetrical chest expansion and decreased breath sounds (
A) suggest pneumothorax, a serious post-thoracentesis complication. Hypotension (
B), pain (
C), and mild tachypnea (
D) are less urgent or expected.

Question 5 of 5

A client is diagnosed as having secondary Cushing's syndrome. The nurse knows that the client has most likely been taking which medication?

Correct Answer: D

Rationale: Secondary Cushing's syndrome is often caused by long-term prednisone use, a corticosteroid mimicking cortisol excess. Estrogen, penicillin, or lovastatin do not cause this condition.

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