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A nurse is caring for a patient with benign prostatic
hypertrophy (BPH) that has
been refractory to management with medicines. The nurse
anticipates the
patient will undergo which
procedure?
a) Transurethral needle ablation
b) Transurethral microwave thermotherapy
c) Photoselective vaporization of the prostate
d) Transurethral resection of the prostate (TURP) - ANSWER -d)
Transurethral resection of the prostate (TURP)
Transurethral resection of the prostate is considered the gold
standard for BPH treatment. Although transurethral needle
ablation, transurethral microwave thermotherapy, and
photoselective vaporization of the prostate are all used to treat
BPH, TURP is the preferred method.
,When a client is experiencing hypovolemic shock with
decreased tissue
perfusion, the nurse expects that the body initially attempts to
compensate by:
a) Producing less antidiuretic hormone (ADH)
b) Producing more red blood cells
c) Maintaining peripheral vasoconstriction
d) Decreasing mineralocorticoid production - ANSWER -c)
Maintaining peripheral vasoconstriction
With shock, arteriolar vasoconstriction occurs, raising the total
peripheral vascular resistance and shifting blood to the major
organs. With shock, more ADH is produced to promote fluid
retention, which will elevate the blood pressure. Although
producing more red blood cells is a response to hypoxia,
peripheral vasoconstriction is a more effective compensatory
mechanism. With shock the mineralocorticoids increase to
promote fluid retention, which elevates the blood pressure.
Test-Taking Tip: Many times the correct answer is the longest
alternative given, but do not count on it. NCLEX item writers
(those who write the questions) are also aware of this and
attempt to avoid offering you such "helpful hints."
A client was diagnosed with cancer of the head of the pancreas
two months ago. The client is admitted to the hospital with
weight loss, severe epigastric pain, and jaundice. When
,performing the client's assessment, the nurse expects the
client's stool to be what color?
a)
Green
b)
Brown
c) Red-
tinged
d) Clay-colored - ANSWER -d) Clay-
colored
Tumors of the head of the pancreas usually obstruct the
common bile duct where it passes through the head of the
pancreas to join the pancreatic duct and empty at the ampulla
of Vater into the duodenum. The feces will be claycolored when
bile is prevented from entering the duodenum. Green stools
may occur with prolonged diarrhea associated with
gastrointestinal inflammation. The feces are brown when there
is unobstructed bile flow into the duodenum. Inflammation or
ulceration of the lower intestinal mucosa results in blood-
tinged stools.
Test-Taking Tip: Note the number of questions and the total time
allotted for the
test to calculate the times at which you should be halfway and
three-quarters
finished with the test. Look at the clock only every 10
minutes or so.
, What clinical manifestations does a nurse expect a client with
systemic lupus
erythematosus (SLE) most likely to
exhibit?
a) Joint pain
b) Facial rash
c) Pericarditis
d) Weight gain
e) Hypotension - ANSWER -a) Joint pain
b) Facial rash
c) Pericarditis
SLE is a chronic, autoimmune disease that affects connective
tissue; joint pain is common. A butterfly rash is characteristic
of SLE. Pericarditis is the most common cardiac indicator of
SLE. Weight loss, not gain, is a classic sign of SLE because of
gastrointestinal effects. Renal impairment with SLE may cause
hypertension, not hypotension.
What client factor does the nurse consider to have the
greatest impact on the
effectiveness of bariatric
surgery?
a) Freedom from concurrent high-risk
conditions.