Which laboratory test value is elevated in clients who smoke and can't be used as a general indicator of cancer?

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 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.

Correct Answer: C

Rationale: The correct answer is C: Leukopenia. Combination chemotherapy often leads to low white blood cell counts, known as leukopenia, which increases the risk of infection. Nurse Ruby should monitor Tracy for signs of infection such as fever, chills, and weakness. Ascites (A) is an accumulation of fluid in the abdomen, not a systemic side effect of chemotherapy. Nystagmus (B) is an involuntary eye movement and not typically associated with chemotherapy. Polycythemia (D) is an excessive production of red blood cells, which is not a common side effect of chemotherapy. Monitoring for leukopenia is critical to prevent infections and ensure Tracy's safety during treatment.

Correct Answer: B

Rationale: Step 1: Fowler's position elevates the head of the bed and flexes the knees, which helps expand the chest for better lung ventilation. Step 2: In a partial pneumonectomy, lung function is compromised, so optimal ventilation of the remaining lung is crucial. Step 3: By placing Tonny in Fowler's position, the diaphragm descends, allowing for better expansion of the left lung. Step 4: This position facilitates ventilation of the left lung, aiding in oxygenation and preventing complications like atelectasis. Summary: Choice B is correct as Fowler's position helps improve ventilation of the remaining lung. Choices A, C, and D are incorrect as they do not directly relate to the specific benefits of Fowler's position for post-pneumonectomy care.

Correct Answer: A

Rationale: The correct answer is A: Auscultate bowel sounds. This is the first nursing action because the client is experiencing abdominal pressure and nausea, which could indicate postoperative ileus. Auscultating bowel sounds helps assess if there is normal bowel function and potential complications. Palpating the abdomen (B) can be uncomfortable for the client post-surgery, and it may not provide immediate information on bowel function. Changing the client's position (C) may not address the underlying issue and can be done after assessing bowel sounds. Inserting a rectal tube (D) is not indicated unless there is a specific medical reason for it, which is not evident in this case.