Following a transsphenoidal hypophysectomy, the nurse should assess the client care fully for which of the following conditions?

Correct Answer: A

Rationale: The correct answer is A: Hypocortisolism. After a transsphenoidal hypophysectomy, the pituitary gland is removed or partially removed, leading to decreased cortisol production. Signs of hypocortisolism include weakness, fatigue, hypotension, weight loss, and electrolyte imbalances. Hyperglycemia (B) is not typically associated with this procedure. Hypoglycemia (C) is not a common concern post-hypophysectomy. Hypercalcemia (D) is not directly related to pituitary gland removal. Therefore, assessing for hypocortisolism is crucial for early detection and management post-surgery.

Correct Answer: D

Rationale: The correct answer is D: “I will receive parenteral vitamin B12 therapy for the rest of my life.” This statement is correct because pernicious anemia is a lifelong condition requiring ongoing vitamin B12 supplementation. Patients with pernicious anemia lack intrinsic factor, which is needed to absorb vitamin B12 from food. Therefore, they need lifelong B12 therapy to prevent complications such as anemia and neurological damage. Choices A, B, and C are incorrect because they suggest a limited duration of therapy. Pernicious anemia is a chronic condition that necessitates continuous treatment. Choice A implies therapy until signs and symptoms disappear, which may not address the underlying cause of the deficiency. Choice B mentions therapy until vitamin B12 levels normalize, which may not prevent recurrence. Choice C suggests monthly therapy for a fixed period, which may not be sufficient for lifelong management.

Correct Answer: B

Rationale: The correct answer is B: inadequate supply of oxygen to the myocardium. Angina pectoris is chest pain or discomfort caused by reduced blood flow to the heart muscle. This lack of oxygenated blood supply to the myocardium leads to ischemia, resulting in the characteristic chest pain. Choice A is incorrect as it refers to a decrease in alveolar surface area for gas exchange, which is related to conditions like emphysema, not angina. Choice C is incorrect as it pertains to pulmonary circulation, not coronary circulation. Choice D is incorrect as an increase in alveolar surface area would not be a cause of angina pectoris.

Correct Answer: D

Rationale: The correct answer is D: All of the above. Malignant melanoma, basal cell epithelioma, and squamous cell carcinoma are all forms of skin cancer associated with prolonged sun exposure. Melanoma is the deadliest form, originating in melanocytes; basal cell and squamous cell carcinomas are more common but less aggressive. All three types can develop due to cumulative UV radiation exposure. Therefore, all options are correct in this context.

Correct Answer: A

Rationale: The correct answer is A: Smoking. Smoking presents the greatest threat for respiratory disease due to the harmful chemicals in tobacco that can damage the lungs and lead to conditions like COPD and lung cancer. Smoking is a well-known risk factor for various respiratory issues. Exposure to radiation (B) can increase cancer risk but is not as directly linked to respiratory diseases. High-fat diet (C) may impact overall health but is not a primary risk factor for respiratory diseases. Alcohol consumption (D) can contribute to respiratory issues, but smoking is considered the most significant risk factor.

Correct Answer: C

Rationale: The correct answer is C: An incision near the diaphragm. Following a splenectomy, an incision near the diaphragm can lead to respiratory complications due to potential irritation or injury to the diaphragm. This can result in impaired breathing and increased risk of respiratory issues such as pneumonia. A: A low platelet count is not directly related to respiratory complications following a splenectomy. B: Early ambulation is generally encouraged to prevent complications such as blood clots but does not specifically impact respiratory complications. D: Early discharge may not directly lead to respiratory complications, as long as the patient is adequately monitored postoperatively.

Correct Answer: D

Rationale: The correct answer is D: Stop the infusion. This is the best action because the client is likely experiencing a transfusion reaction. Stopping the infusion immediately is crucial to prevent further complications. Reporting the signs and symptoms to the healthcare provider (A) can cause a delay in addressing the reaction. While monitoring vital signs (B) and assessing respiratory status (C) are important, stopping the infusion takes precedence to ensure the client's safety and prevent a severe reaction.

Correct Answer: B

Rationale: The correct answer is B: Observe the patient for bleeding. Before a bone marrow biopsy, it is crucial to monitor the patient for bleeding tendencies as the procedure can cause bleeding. This step ensures early detection and prompt intervention if bleeding occurs. Explanation for other choices: A: Explaining the procedure to the family is important for informed consent but not the most crucial before the procedure. C: Administering an analgesic may be necessary for pain management but monitoring for bleeding takes precedence. D: Draping the biopsy site is important for maintaining a sterile field but does not directly impact patient safety like monitoring for bleeding.

Correct Answer: C

Rationale: The correct answer is C: Human, T-cell lymphotrophic virus, as it is the causative agent for HIV/AIDS. This virus specifically targets and infects the body's T-cells, weakening the immune system. Trichomonas vaginalis, Treponema pallidum, and Chlamydia trachomatis are all different pathogens that do not cause HIV/AIDS. Trichomonas vaginalis is a protozoan parasite that causes trichomoniasis, Treponema pallidum causes syphilis, and Chlamydia trachomatis causes chlamydia. Therefore, the correct answer is C based on the specific viral agent responsible for HIV/AIDS.