A client comes to the clinic complaining of weight loss, fatigue, and a low-grade fever. Physical examination reveals a slight enlargement of the cervical lymph nodes. To assess possible causes for the fever, it would be most appropriate for the nurse to initially ask: a."Have you bee sexually active lately?" b, "Do you have a sore throat at the present time?"

Correct Answer: A

Rationale: When assessing a client with symptoms of weight loss, fatigue, low-grade fever, and lymphadenopathy (enlarged lymph nodes), it is important to investigate potential causes of infection. In this scenario, considering the client's symptoms and signs, asking if they have been exposed recently to anyone with an infection helps in determining the possibility of an infectious etiology for their symptoms. This question can provide valuable information to guide further assessment and diagnostic evaluation.

Correct Answer: B

Rationale: The best response is option B, "You do not have enough hemoglobin to carry oxygen to your tissues." Hemoglobin is the protein in red blood cells that carries oxygen from the lungs to the tissues throughout the body. With a low hemoglobin level of 6 g/dL due to gastrointestinal tract bleeding, there is a reduced capacity to carry oxygen to the body's tissues. This decreased oxygen-carrying capacity leads to symptoms of shortness of breath (SOB) because the body's cells are not receiving an adequate supply of oxygen. It is important to provide a clear and accurate explanation to the patient about the relationship between hemoglobin, oxygen transport, and symptoms of anemia like shortness of breath.

Correct Answer: A

Rationale: Thalassemia is a genetic blood disorder that results in the reduced production of hemoglobin and red blood cells. Nursing interventions for a client with thalassemia aim to manage symptoms and prevent complications. Maintaining the client on bed rest helps conserve energy and prevent fatigue, which is commonly experienced due to anemia. Protecting the client from infections is crucial because individuals with thalassemia are at a higher risk of infections due to their weakened immune system. By minimizing the risk of infections, nurses can help prevent further complications in clients with thalassemia.

Correct Answer: A

Rationale: Following a splenectomy (spleen removal), patients are at an increased risk of developing infections, particularly those caused by encapsulated bacteria such as Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis. The spleen plays a vital role in the immune system by filtering and clearing bacteria and viruses from the bloodstream. Without a functioning spleen, patients are more vulnerable to bacterial infections. Therefore, the nurse should be aware of the potential for infection and provide appropriate education to the client regarding infection prevention strategies, such as vaccinations and prompt medical treatment for any signs of infection.

Correct Answer: B

Rationale: When applying a new system for pain management, it is recommended to choose a site on the lower torso. This area is often a suitable location for applying transdermal pain medication patches because it tends to have fewer hair follicles, making it easier for the patch to adhere properly and be absorbed effectively. The lower torso also typically provides a discreet location for patch placement, helping to maintain patient privacy and comfort.