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Questions 149

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Question 1 of 5

The nurse is assessing the client admitted for possible oral cancer. The nurse identifies which of the following to be a late-occurring symptom of oral cancer?

Correct Answer: C

Rationale: Pain is a late symptom of oral cancer, often occurring as the disease progresses and affects surrounding tissues.

Question 2 of 5

A client with an esophageal tamponade develops symptoms of respiratory distress, including inspiratory stridor. The nurse should give priority to:

Correct Answer: B

Rationale: Respiratory distress with stridor suggests airway obstruction from the tamponade, requiring immediate tube removal after deflation to restore airway patency.

Question 3 of 5

A client with a laryngectomy returns from surgery with a nasogastric tube in place. The primary reason for placement of the nasogastric tube is to:

Correct Answer: B

Rationale: A nasogastric tube decompresses the stomach, preventing nausea and aspiration post-laryngectomy.

Question 4 of 5

A client with pancreatitis has been transferred to the intensive care unit. The nurse assesses a pulmonary arterial wedge pressure (PAWP) of 14 mmHg. Based on this finding, the nurse would want to further assess for:

Correct Answer: B

Rationale: A PAWP of 14 mmHg is slightly elevated, suggesting possible fluid overload, which could lead to pulmonary edema, indicated by rales on chest auscultation.

Question 5 of 5

The school nurse is teaching a group of preschool mothers about poison prevention in the home. Which of the following statements, if made by a mother to the nurse, indicates that further teaching is necessary?

Correct Answer: B

Rationale: vomiting contraindicated when child ingests hydrocarbons due to danger of aspiration

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