A client with advanced breast cancer is prescribed tamoxifen (Nolvadex). When teaching the client about this drug, the nurse should emphasize the importance of reporting which adverse reaction immediately?

Correct Answer: A

Rationale: The correct answer is A: Vision changes. Tamoxifen can cause serious ocular side effects like retinopathy and corneal changes. These adverse reactions can lead to vision impairment or loss, which is crucial to report immediately to prevent permanent damage. Headache (B), hearing loss (C), and anorexia (D) are not typically associated with tamoxifen use and do not pose immediate threats to the client's health compared to vision changes. It is important for the nurse to prioritize educating the client on recognizing and reporting vision changes promptly to ensure timely intervention and prevent irreversible consequences.

Correct Answer: D

Rationale: The correct answer is D: Whole grains and meats. Zinc is found in high amounts in these foods. Meats, especially red meats and seafood, are rich sources of zinc. Whole grains like wheat, rice, and oats also contain significant amounts of zinc. Other choices are incorrect because fruits and vegetables are not typically good sources of zinc. Yeast and legumes are good sources of other minerals but not specifically zinc. It is important for the cancer patient to consume zinc-rich foods to support their immune system and overall health during recovery.

Correct Answer: D

Rationale: The correct answer is D because all the treatment modalities listed - surgery, radiotherapy, and chemotherapy - play essential roles in managing breast cancer. Surgery removes the primary tumor, radiotherapy targets any remaining microscopic disease, and chemotherapy systematically destroys cancer cells throughout the body. Each modality addresses a different aspect of the disease, making a comprehensive treatment approach necessary for the best outcomes. Choices A, B, and C alone do not cover all necessary aspects of breast cancer treatment, hence D is the correct choice.

Correct Answer: D

Rationale: The correct answer is D: Understands discharge instructions. This is crucial for patient safety and recovery post-surgery. Understanding discharge instructions ensures patients know how to care for themselves at home, manage medications, recognize warning signs, and follow-up instructions. Choice A is incorrect as patients should not drive after surgery due to potential impairment. Choice B is incorrect as IV narcotics administration timing is not a discharge criterion. Choice C is irrelevant to the patient's readiness for discharge. Understanding discharge instructions is the key factor in ensuring the patient's well-being and recovery after ambulatory surgery.

Correct Answer: D

Rationale: The correct answer is D because morphine helps in acute pulmonary edema by decreasing peripheral resistance, pulmonary capillary pressure, and transudation of fluid. Morphine causes vasodilation, reducing peripheral resistance, which helps redistribute blood flow to the periphery. It also reduces pulmonary capillary pressure by decreasing preload and afterload, leading to decreased fluid transudation into the alveoli. Choices A, B, and C individually do not cover all the effects of morphine in acute pulmonary edema, making them incorrect.