A client with carcinoma of the lung is complaining of weakness and has a serum sodium level of 117 mEq/L. Which nursing problem should the nurse include in this client's plan of care?

Correct Answer: C

Rationale: In this scenario, the correct nursing problem to include in the client's plan of care is "Fluid volume excess" (Option C). The client's low serum sodium level of 117 mEq/L (hyponatremia) indicates a potential imbalance of fluids in the body. Hyponatremia can occur in lung cancer patients due to syndrome of inappropriate antidiuretic hormone secretion (SIADH), a common paraneoplastic syndrome associated with certain malignancies like lung cancer. This syndrome leads to the retention of water and dilution of sodium levels in the blood, resulting in fluid volume excess. Option A, "Altered urinary elimination," is incorrect as the primary issue in this case is not related to the client's ability to eliminate urine but rather to the imbalance of fluid and electrolytes. Option B, "Impaired gas exchange," is also incorrect as the client's symptoms of weakness and hyponatremia are not primarily indicative of respiratory issues. Option D, "Decreased cardiac output," is not the most appropriate choice as the client's symptoms and lab results are more suggestive of a fluid imbalance rather than a cardiac output problem. Educationally, understanding the connection between lung cancer, hyponatremia, and fluid volume excess is crucial for nursing practice. Nurses must recognize the signs and symptoms of electrolyte imbalances in cancer patients and be able to prioritize nursing interventions to address fluid volume excess effectively. By selecting Option C as the correct answer, nurses can implement appropriate interventions such as fluid restriction, monitoring electrolyte levels, and collaborating with the healthcare team to manage the underlying cause of hyponatremia in the client with lung cancer.

Correct Answer: B

Rationale: The correct answer is option B) A 65-year-old fair-skinned male who is a construction worker. Fair-skinned individuals have less melanin in their skin, making them more susceptible to skin damage from UV radiation, which increases the risk of developing skin cancer. Additionally, working outdoors as a construction worker exposes him to prolonged sun exposure, further increasing his risk. Option A) A 16-year-old dark-skinned female who tans in tanning beds once a week is at risk for skin damage and premature aging but has a lower risk of developing skin cancer compared to fair-skinned individuals due to higher melanin levels. Option C) A 25-year-old dark-skinned male whose mother had skin cancer may have a genetic predisposition to skin cancer, but his dark skin provides natural protection against UV radiation, lowering his risk compared to fair-skinned individuals. Option D) A 70-year-old fair-skinned female who works as a secretary is at risk due to her fair skin, but her indoor job likely exposes her to less sun compared to an outdoor worker like the construction worker, reducing her risk compared to option B. In an educational context, understanding individual risk factors for skin cancer based on skin type, sun exposure, and genetic predisposition is crucial for healthcare providers to educate patients on preventive measures such as sun protection and regular skin screenings. This knowledge helps in personalized patient care and early detection of skin cancer.

Correct Answer: B

Rationale: The correct answer is B) Practice inhaling through the nose and exhaling slowly through pursed lips. This technique, known as pursed lip breathing, helps to slow down breathing, improve oxygen exchange, and reduce shortness of breath in patients with emphysema. It prevents small airways from collapsing, making breathing more efficient. Option A is incorrect because allowing additional time for physical activities does not directly address dyspnea management in emphysema. It may help reduce oxygen demand but does not teach the client a specific technique to manage dyspnea. Option C is incorrect as using a humidifier may be beneficial for some respiratory conditions, but it is not the most effective strategy for managing dyspnea in emphysema. Emphysema is characterized by air trapping in the lungs, not necessarily related to air humidity. Option D is also incorrect because strengthening abdominal muscles through leg raises does not directly target dyspnea management in emphysema. While overall physical fitness is important, specific breathing techniques like pursed lip breathing are more effective for dyspnea control in emphysema. In an educational context, it's important for nurses to understand and teach evidence-based strategies for managing respiratory conditions like emphysema. Teaching patients effective breathing techniques empowers them to take control of their symptoms and improve their quality of life. Nurses play a crucial role in educating patients on self-management strategies to promote better health outcomes.

Correct Answer: C

Rationale: In this scenario, option C is the most useful information in determining the possible cause of the exacerbation of eczema symptoms. The presence of a new dog can trigger allergic reactions in individuals with eczema due to pet dander and potential allergens present in the dog's fur or saliva. This information is crucial as it points towards a potential trigger for the worsening of symptoms. Option A is incorrect as the presence of a friend with eczema does not directly correlate with the exacerbation of the client's symptoms unless there was direct contact leading to an allergic reaction. Option B is less likely to be the cause as receiving an influenza immunization typically does not exacerbate eczema symptoms unless the client has a specific allergic reaction to the vaccine components. Option D is also less likely to be the cause as corticosteroid cream is a common treatment for eczema and should not worsen symptoms unless the cream itself is expired or contaminated. From an educational perspective, this question highlights the importance of understanding potential triggers for eczema exacerbations, such as exposure to new allergens like pet dander. It emphasizes the need for nurses to conduct thorough assessments and gather relevant information to identify and address the root cause of a client's worsening symptoms effectively.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Pain when swallowing, which warrants immediate intervention by the nurse. The rationale for this choice is that pain when swallowing can indicate potential complications such as esophagitis or opportunistic infections like candidiasis, which are common in individuals with AIDS. These conditions can further compromise the client's respiratory status and lead to serious complications, making it crucial for the nurse to address this symptom promptly to prevent further deterioration in gas exchange. Option A) Elevated temperature is a common sign of infection, which is important to monitor but may not directly impact gas exchange as urgently as pain when swallowing in this context. Option B) Generalized weakness is a non-specific symptom that may be seen in various conditions and does not directly address the immediate respiratory concerns. Option C) Diminished lung sounds could indicate respiratory compromise, but given the client's specific condition of impaired gas exchange from a respiratory infection, the symptom of pain when swallowing takes precedence in terms of urgency for intervention. In an educational context, understanding the priority of symptoms and assessments in clients with complex conditions like AIDS is crucial for nurses caring for these individuals. Recognizing the significance of certain symptoms over others based on their potential impact on the client's health is a key aspect of providing effective and timely nursing care in such cases. By prioritizing interventions based on the client's specific needs and condition, nurses can optimize patient outcomes and ensure high-quality care delivery.