Which statement, made by a client being discharged to home after a radical cystectomy, indicates a need for further clarification by the nurse? "I will:

notify the provider if the urine output is absent."

resume voiding normally within one week."

take a stool softener daily to decrease the chance of straining."

monitor the skin around the surgical site for redness."

Answer and Explanation

The Correct Answer is B

A.   After a radical cystectomy, the client may have a urinary diversion (such as a stoma) and should be vigilant about monitoring urine output. Absence of urine output can indicate a serious issue, and notifying the provider is crucial.
B.   This statement indicates a need for further clarification. After a radical cystectomy, clients typically do not resume normal voiding because the bladder is removed. Instead, they may have a urinary diversion or need to learn how to manage their new urinary output. Normal voiding as before surgery is not possible, so this statement reflects a misunderstanding of the procedure's implications.
C.   After surgery, particularly abdominal surgery like a radical cystectomy, patients are often advised to take stool softeners to prevent constipation. Straining can increase the risk of complications and affect the surgical site, so this is a valid precaution.
D.   Monitoring the surgical site for signs of infection, such as redness, swelling, or discharge, is an essential part of post-operative care. Clients should be educated on how to check their surgical site for any concerning changes.

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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. Ischemic stroke B. Transischemic attack C. Subarachnoid hemorrhage D. Cardioembolic

Correct Answer is C

Explanation

A. An ischemic stroke occurs when a blood vessel supplying blood to the brain is obstructed. Common symptoms include sudden numbness or weakness in the face, arm, or leg, confusion, difficulty speaking, and visual disturbances. However, "thunderclap" headache and neck stiffness are not typical symptoms of an ischemic stroke.
B. A TIA, often referred to as a "mini-stroke," produces similar symptoms to a stroke but lasts for a short duration (typically less than 24 hours) and does not cause permanent damage. Symptoms can include weakness, speech difficulties, and visual changes, but again, "thunderclap" headache and neck stiffness are not characteristic of a TIA.
C. A subarachnoid hemorrhage occurs when there is bleeding into the space between the brain and the tissues covering it, often due to a ruptured aneurysm. A "thunderclap" headache, described as an extremely sudden and severe headache, is a hallmark of this condition.
D. A cardioembolic stroke is a type of ischemic stroke that occurs when a blood clot forms in the heart and travels to the brain. Symptoms are similar to those of an ischemic stroke and do not typically include a "thunderclap" headache or neck stiffness.

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Blood Cell	Normal Ranges
Red blood cells (mature, circulating)	Male 4.51-6.01 million/mm3 Female: 4.01-5.51 million/mm3
Hemoglobin	Adult (15-64 yr) Male 14-17.3 g/dL Female 11.7-15.5 g/dL
Hematocrit	42% -52% in males 36% -48% in females
Reticulocytes	0.5% -2.5% of total RBC count
White blood cells (total)	4.5-11.1 103/mm3
Neutrophils	59% Bands 3% Segs-56%
Eosinophils	2.7%
Basophils	0.5%
Lymphocytes	34%
Monocytes	4%
Platelets	150,000-450,000/mm3

Which statement, made by a client being discharged to home after a radical cystectomy, indicates a need for further clarification by the nurse? "I will:

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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 is admitted with complaints of photosensitivity, neck stiffness, and a "thunderclap" headache. The nurse recognizes that these clinical manifestations would present with which type of stroke?

Correct Answer is C

Explanation

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