As preparation for hysterectomy, Mrs. Washington is having radiation therapy for cancer of the uterus, stage IIa. To promote her self-care during recovery from irradiation, which of the following is correct?

Correct Answer: C

Rationale: The correct answer is C) Instruction in skin care is a priority. During radiation therapy for cancer of the uterus, the skin in the treatment area can become sensitive and prone to irritation. Proper skin care is essential to prevent complications such as burns, blistering, or infection. Educating Mrs. Washington on how to care for her skin during and after irradiation will help her manage any side effects, promote healing, and improve her overall comfort during recovery. Option A) Extensive psychologic support is necessary: While emotional support is important, the immediate need for Mrs. Washington is physical care related to skin protection due to radiation therapy. Option B) Extensive physical care is necessary: While physical care is important, the specific focus on skin care due to the effects of radiation therapy makes this option less correct than option C. Option D) Dietary fiber and roughage should be increased: While a balanced diet is important for overall health, the primary concern during recovery from irradiation in this scenario is skin care, not dietary adjustments. In an educational context, understanding the specific care needs of patients undergoing radiation therapy is crucial for healthcare providers to provide comprehensive support and ensure optimal outcomes for their patients. By prioritizing skin care education, healthcare professionals can empower patients like Mrs. Washington to actively participate in their recovery process and minimize potential complications.

Correct Answer: A

Rationale: In this question, option A, "A crack in the nipple or the areola," is the correct answer that confirms mastitis in a female client. Mastitis is an inflammation of breast tissue that can be caused by a bacterial infection. A crack in the nipple or areola can provide an entry point for bacteria, leading to infection and subsequent inflammation, which are characteristic symptoms of mastitis. Option B, "Multiple lumps within the breast tissue," is incorrect because while lumps can be a sign of various breast conditions, mastitis typically presents with redness, warmth, swelling, and pain rather than distinct lumps. Option C, "Flat and soft breasts," is also incorrect as breast appearance does not typically change significantly in the presence of mastitis. Option D, "Support the arm and the shoulder with pillows," is irrelevant to the diagnosis of mastitis and does not provide any information related to the condition. Educationally, understanding the signs and symptoms of mastitis is crucial for healthcare professionals, especially those working in women's health. By recognizing key indicators like nipple cracks and associated inflammation, proper diagnosis and treatment can be initiated promptly, preventing complications and providing relief to the affected individual. It is important for students to grasp the specific clinical manifestations of mastitis to ensure accurate assessment and management of breast health concerns in female clients.

Correct Answer: B

Rationale: In teaching a male client how to perform a testicular self-exam, it is crucial to impart accurate information regarding normal testicular anatomy. The correct answer, B, "One testis is usually larger than the other," is based on the physiological variation in testicular size, where it is common for one testis to be slightly larger or hang lower than the other due to differences in blood flow or position within the scrotum. This asymmetry is a normal variation and not indicative of pathology. Option A, "Both testes should be the same size," is incorrect because of the natural anatomical differences between the testes in many individuals. Option C, "One testis usually has a lump; the other does not," is incorrect as the presence of a lump on one testis is not a normal finding and should be evaluated by a healthcare provider. Option D, "Both testes usually have lumps," is incorrect as the presence of lumps on the testes would warrant immediate medical attention as it could be a sign of a concerning issue like testicular cancer. Educationally, understanding the normal variations in testicular anatomy is essential for individuals to accurately perform self-examinations and differentiate between normal and abnormal findings. By providing this knowledge, individuals can actively participate in their health care by detecting any abnormalities early and seeking timely medical intervention. Regular testicular self-exams are an important aspect of preventive health care for males, and knowing what is normal can help alleviate unnecessary anxiety and promote early detection of potential issues.

Correct Answer: C

Rationale: In this scenario, the most immediate action required is option C) Client is restless and his bladder is palpable above the symphysis pubis. This indicates acute urinary retention, a potentially serious complication of BPH that requires immediate intervention to prevent further complications like renal damage or bladder distention rupture. Prompt catheterization or medical intervention is necessary to relieve the obstruction. Option A is incorrect as difficulty starting the urinary stream is a common symptom of BPH and does not indicate an acute issue requiring immediate action. Option B, an elevated PSA level, is concerning for prostate pathology but does not necessitate immediate action compared to acute urinary retention. Option D, not voiding for 4 hours after drinking juice, is not as urgent as an acute bladder distention. Educationally, understanding the signs and symptoms of BPH complications like acute urinary retention is vital for healthcare providers working in LTC facilities to ensure timely and appropriate management, preventing potential serious consequences for the client. This case emphasizes the importance of recognizing urgent clinical situations and taking swift action to provide safe and effective care.

Correct Answer: A

Rationale: In this scenario, the correct order of assessment prioritizes the client who is at the highest risk, which is the 68-year-old client experiencing new-onset confusion after a bilateral orchiectomy. Assessing this client first is crucial as sudden confusion can indicate serious underlying issues such as infection, bleeding, or electrolyte imbalances post-surgery. This client's symptoms require immediate attention to prevent any further complications. Assessing the 44-year-old client receiving IV antibiotics for acute pyelonephritis would be the next priority as this client requires monitoring for the effectiveness of the treatment and possible complications related to the infection. The 77-year-old client receiving continuous bladder irrigation after a TURP and the 55-year-old client scheduled for discharge after a TURP can be assessed last as they are in relatively stable conditions compared to the other clients. Educational context: This question helps reinforce the concept of prioritizing patient care based on the urgency and severity of the client's condition. It highlights the importance of critical thinking and clinical judgment in the nursing practice to ensure the safety and well-being of the clients.