Lydia undergoes a laryngectomy to treat laryngeal cancer. When teaching the client how to care for the neck stoma, the nurse should include which instruction?

Correct Answer: D

Rationale: The correct answer is D: "Keep the stoma moist." This is because keeping the stoma moist helps prevent dryness and irritation, promotes healing, and helps maintain the patency of the airway. Moisture also aids in preventing crust formation, which can obstruct the airway. A: "Keep the stoma uncovered" is incorrect as covering the stoma helps protect it from debris and infection. B: "Keep the stoma dry" is incorrect as moisture is necessary for proper healing and to prevent blockages. C: "Have a family member perform stoma care initially until you get used to the procedure" is incorrect as the client should learn how to perform stoma care themselves for independence and self-care.

Correct Answer: C

Rationale: The correct answer is C: colchicine. Colchicine is the medication of choice for treating acute gout attacks by reducing inflammation and pain. It works by decreasing the inflammatory response to urate crystals in the joints. Aspirin (A) can worsen gout by increasing uric acid levels. Furosemide (B) can also exacerbate gout by raising uric acid levels. Calcium gluconate (D) is not used in gout treatment. Therefore, colchicine is the most appropriate choice for the client with gout.

Correct Answer: D

Rationale: The correct answer is D. Carcinoembryonic antigen (CEA) level is elevated in clients who smoke but is not a reliable general indicator of cancer. Smoking can increase CEA levels due to inflammation and irritation of the respiratory tract, leading to false positives. Acid phosphatase (A) is associated with prostate cancer, serum calcitonin (B) with medullary thyroid cancer, and alkaline phosphatase (C) with liver or bone diseases. Therefore, they are not elevated solely due to smoking.

Correct Answer: C

Rationale: The correct answer is C: stool for Clostridium difficile test. Rationale: 1. Abdominal pain, fever, and "horse barn" smelling diarrhea can indicate Clostridium difficile infection. 2. Clostridium difficile is a common cause of diarrhea in patients receiving chemotherapy. 3. Early detection and treatment of Clostridium difficile infection are crucial to prevent complications. 4. Stool test for Clostridium difficile can confirm the diagnosis and guide appropriate treatment. Incorrect choices: A: ELISA test - Not indicated for the symptoms described. B: Electrolyte panel and hemogram - Important but not the most immediate concern in this case. D: Flat plate X-ray of the abdomen - Unlikely to provide relevant information for the symptoms presented.

Correct Answer: C

Rationale: The correct answer is C because when using a cane for right-sided weakness, the client should hold the cane in the opposite hand (left hand) to provide support to the weaker side. By moving the cane forward followed by the right leg, the client maintains balance and support on the affected side, allowing for a smoother gait pattern. Moving the left leg after the right leg helps in providing stability and weight-bearing on the stronger side. Choice A is incorrect as the client should hold the cane in the opposite hand of the weakness. Choice B is incorrect as it does not provide support to the weaker side. Choice D is incorrect as it does not promote balance and stability for the client with right-sided weakness.