A client who is receiving radiation treatment for laryngeal cancer has developed xerostomia and mucositis.

The nurse determines the client has an imbalanced nutritional intake and is consuming less than body requirements.

Which factor is the most likely cause for this problem?

Nausea.

Fatigue.

Pain when eating.

Altered taste sensation.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Nausea can be a significant factor contributing to decreased food intake, but it is not the most likely cause in this scenario. Xerostomia (dry mouth) and mucositis are mentioned as symptoms in the question stem. Nausea alone does not explain why the client is consuming less than their body requirements.

Choice B rationale:

Fatigue can also contribute to decreased food intake, but it is not the most likely cause in this case. While fatigue can be a side effect of cancer treatment and may lead to reduced appetite, the question specifically mentions xerostomia and mucositis as issues contributing to imbalanced nutritional intake.

Choice C rationale:

Pain when eating is the most likely cause of imbalanced nutritional intake in this scenario. The client's laryngeal cancer and the development of mucositis indicate that eating is likely painful for them. This discomfort can significantly deter the client from eating, leading to decreased nutritional intake.

Choice D rationale:

Altered taste sensation can affect food preferences, but it is not the most likely cause in this case. Pain when eating is a more direct and immediate barrier to food intake, especially in the context of mucositis and laryngeal cancer.

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Correct Answer is A

Explanation

Based on the provided audio clip, the sound heard is a high-pitched, continuous, musical sound. This sound is characteristic of wheezing, which is caused by the narrowing of the airways due to inﬂammation, bronchoconstriction, or the presence of mucus. Wheezing is commonly associated with conditions such as asthma, chronic obstructive pulmonary disease (COPD), or bronchitis.

Let's evaluate the other options:

b) Rhonchi: Rhonchi are low-pitched, coarse, ratling sounds that typically indicate the presence of mucus or ﬂuid in the larger airways. Rhonchi are often heard in conditions such as pneumonia or bronchitis, but they are diﬀerent from the high-pitched wheezing sound heard in the audio clip.

c) Stridor: Stridor is a high-pitched, harsh, and crowing sound that is heard during inspiration. It is often associated with upper airway obstruction, such as in cases of croup, epiglottitis, or a foreign body obstruction. The sound in the audio clip does not match the characteristics of stridor.

d) Fine crackles: Fine crackles are discontinuous, high-pitched, and brief sounds that are typically heard during inspiration. They are often described as "velcro-like" or "rice crispies" and are associated with conditions such as pulmonary fibrosis or congestive heart failure. The sound in the audio clip does not resemble fine crackles.

In summary, the sound in the provided audio clip is best described as wheezing, characterized by a high- pitched, continuous, musical sound. Therefore, the practical nurse (PN) should document this sound as "wheeze."

Correct Answer is ["30"]

Explanation

The correct answer is 30 mL/hour.

Step 1 is to calculate the total amount of norepinephrine in the IV bag: 4 mg norepinephrine ÷ 1000 mL = 0.004 mg/mL

Step 2 is to convert the patient's weight from pounds to kilograms: 176 pounds ÷ 2.2 = 80 kilograms

Step 3 is to calculate the total amount of norepinephrine the patient will receive per minute: 2 mcg/min × 60 min = 120 mcg/min

Step 4 is to convert micrograms (mcg) to milligrams (mg): 120 mcg ÷ 1000 = 0.12 mg

Step 5 is to calculate the total volume of norepinephrine needed per hour: 0.12 mg ÷ 0.004 mg/mL = 30 mL/hour

Therefore, the nurse should program the infusion pump to deliver 30 mL/hour.

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A client who is receiving radiation treatment for laryngeal cancer has developed xerostomia and mucositis. The nurse determines the client has an imbalanced nutritional intake and is consuming less than body requirements. Which factor is the most likely cause for this problem?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The practical nurse (PN) is auscultating a client's lung sounds. Which description should the PN use to document this sound? (Please listen to the audio clip provided). Audio: [Wheezing sound]

Correct Answer is A

Explanation

A client who weighs 176 pounds receives a prescription for norepinephrine 2 mcg/min intravenously (IV). The IV bag is labeled, "Norepinephrine 4 mg in dextrose 5% in water (D;W) 1,000 mL." How many mL/hour should the nurse program the infusion pump? (Enter numerical value only.).

Correct Answer is ["30"]

Explanation

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A client who is receiving radiation treatment for laryngeal cancer has developed xerostomia and mucositis.

The nurse determines the client has an imbalanced nutritional intake and is consuming less than body requirements.

Which factor is the most likely cause for this problem?