The nurse is caring for a client who has had a stroke and who has received tissue plasminogen activator (t-PA) on admission. The family member requests to bring in a razor for the client to use. Which response from the family would indicate an understanding teaching related to t-PA? The family member states, "I will

be careful with the straight razor."

insist the nurse use multiple razor blades."

bring in an electric razor for nurse to use for shaving."

bring in disposable razors blades to use for, shaving."

Answer and Explanation

The Correct Answer is C

A.   This response shows some awareness but does not indicate a sufficient understanding of the risks. Straight razors can pose a significant risk of cuts and bleeding, especially in a patient who has received t- PA, which can increase the likelihood of bleeding.
B.   This response suggests a misunderstanding. Using multiple razor blades does not inherently reduce the risk of bleeding and could increase the chance of cuts or nicks. This response does not indicate an appropriate understanding of safety precautions related to t-PA.
C.   This response indicates an understanding of safety precautions. Electric razors are safer for clients who are at risk of bleeding because they do not have sharp blades that can easily cause cuts. This choice minimizes the risk of injury while allowing for personal grooming.
D.   While disposable razors may seem convenient, they still carry a risk of cuts and bleeding. This response does not reflect a full understanding of the precautions necessary for a client who has received t-PA, as it does not prioritize safety in the same way that using an electric razor does.

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Correct Answer is B

Explanation

A. A carotid endarterectomy does not involve bypassing the plaques; rather, it directly addresses the blockage.
B. Carotid endarterectomy is a surgical procedure that involves making an incision in the neck to access the carotid artery, where the surgeon removes the atherosclerotic plaques that are causing narrowing and restricting blood flow. This helps reduce the risk of stroke.
C. Carotid endarterectomy is not brain surgery; it is performed on the carotid arteries in the neck. The procedure aims to prevent strokes by improving blood flow to the brain, but it does not involve surgery on the brain itself.
D. This description does not accurately reflect carotid endarterectomy. The procedure does not involve resecting an artery in the brain or using a graft; rather, it focuses on removing plaques from the carotid artery in the neck.

A. Apply bacitracin liberally to the affected areas B. Request a medical prescription for diphenhydramine or hydroxyzine C. Instruct client to shower with cool water and use a mild soap D. Clip fingernails and encourage the use of prescribed lotions

Correct Answer is ["B","C","D"]

Explanation

A. Bacitracin is an antibiotic ointment typically used to prevent or treat bacterial infections in minor cuts and scrapes. It is not appropriate for treating a pruritic rash associated with GVHD. The rash may not be due to an infection but rather an immune response, so using bacitracin would not address the underlying issue.
B. Diphenhydramine (Benadryl) and hydroxyzine are antihistamines that can help alleviate itching and provide relief from pruritus. Requesting a prescription for one of these medications is an appropriate response to manage the symptoms of GVHD.
C. Showering with cool water can soothe irritated skin and reduce itching. Using mild soap helps to avoid further irritation or dryness that harsher soaps can cause. This intervention supports skin care and helps manage pruritus effectively.
D. Clipping fingernails can help prevent skin damage from scratching, which could lead to secondary infections. Encouraging the use of prescribed lotions can help keep the skin moisturized and alleviate dryness, further addressing the pruritus associated with GVHD.

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Naxlex Comprehensive Predictor Exams

The physician recommends a carotid endarterectomy for a client with atherosclerosis and a history of transient ischemic attacks (TIAS). The nurse explains that this procedure involves:

Correct Answer is B

Explanation

The client has developed graft versus host disease (GVHD) during treatment for acute lymphoblastic leukemia (ALL). The client has a generalized pruritic rash on the trunk and the extremities. What nursing measures should the nurse use to address this problem?

Correct Answer is ["B","C","D"]

Explanation

The nurse is assessing a client experiencing motor loss as the result of a left-sided stroke. Which of the following clinical manifestations related to motor loss would the nurse document?

In educating clients about ovarian cancer, the nurse emphasizes death rates for ovarian cancer are high because:

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