The physician orders cystoscopy and random biopsies of the bladder for a client who reports painless hematuria. Test results reveal carcinoma in situ in several bladder regions. To treat bladder cancer, the client will have a series of intravesical instillations of bacillus Calmette-Guerin (BCG), administered 1 week apart. When teaching the client about BCG, the nurse should mention that this drug commonly causes:

Correct Answer: C

Rationale: The correct answer is C: Hematuria. Bacillus Calmette-Guerin (BCG) is a type of immunotherapy used to treat bladder cancer by stimulating the immune system to attack cancer cells. One common side effect of BCG instillations is hematuria, which is the presence of blood in the urine. This occurs because BCG irritates the bladder lining, leading to inflammation and bleeding. It is important for the nurse to educate the client about this potential side effect so they are aware and can report any excessive bleeding to their healthcare provider promptly. Other choices are incorrect: A: Renal calculi - BCG therapy is not known to cause renal calculi. B: Delayed ejaculation - BCG therapy is not associated with delayed ejaculation. D: Impotence - BCG therapy is not linked to impotence.

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.

Correct Answer: A

Rationale: Rationale: Right-sided heart failure leads to fluid backup in the body causing dependent pitting edema due to fluid accumulation in the lower extremities. Orthopnea and exertional dyspnea are typically seen in left-sided heart failure. Hemoptysis is associated with conditions like pulmonary embolism or lung cancer, not right-sided heart failure. Therefore, the correct answer is A as it directly correlates with the symptoms of right-sided heart failure.