The practical nurse (PN) is working in a cancer detection mobile clinic. Four individuals come for screening with a complaint of hoarseness, a danger sign for cancer of the larynx. Which client has the highest risk for development of cancer of the larynx that the PN should refer to the healthcare provider?

An office manager whose mother has laryngeal cancer

A farmer who smokes a half pack of cigarettes daily,

An older male who drinks a six pack of beer nightly and smokes heavily

An opera singer who does not smoke but drinks a glass of wine each day.

Answer and Explanation

The Correct Answer is C

A. An office manager whose mother has laryngeal cancer: Family history can increase risk slightly, but environmental and lifestyle factors, particularly smoking and heavy alcohol use, are stronger contributors to laryngeal cancer.

B. A farmer who smokes a half pack of cigarettes daily: Smoking increases risk, but the level of exposure is relatively low compared with heavy, long-term use combined with alcohol consumption.

C. An older male who drinks a six-pack of beer nightly and smokes heavily: Chronic heavy alcohol use combined with long-term heavy smoking significantly increases the risk of laryngeal cancer. This client exhibits multiple high-risk behaviors and should be prioritized for referral.

D. An opera singer who does not smoke but drinks a glass of wine each day: Moderate alcohol consumption without smoking or other risk factors represents a lower risk for laryngeal cancer compared with heavy alcohol use and smoking.

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Free Nursing Study Resources

Correct Answer is ["B","D","E","F"]

Explanation

A. When spouse died: This is related to remote memory, not orientation to person, place, or time. While it may help assess long-term memory, it does not indicate the client’s current orientation.

B. Season of the year: This assesses orientation to time, helping determine whether the client is aware of the current temporal context, which is essential for evaluating cognitive status.

C. Past surgeries: This evaluates past medical history and long-term memory rather than current orientation. It does not reflect awareness of person, place, or time.

D. Client's name: Asking the client’s name assesses orientation to self (person), a core component of determining cognitive awareness and mental status.

E. Reason for hospitalization: This question evaluates orientation to situation or circumstance, indicating whether the client understands why they are in the hospital and the purpose of current care.

F. Present location: Asking where the client is assesses orientation to place, confirming awareness of the immediate environment and safety awareness.

A. Write an incident report and submit it to the unit manager. B. Try not to listen to the conversation since it is confidential. C. Approach the individuals involved and ask them to stop. D. Tell the client of the UAP's concern for him.

Correct Answer is C

Explanation

A. Write an incident report and submit it to the unit manager: Filing an incident report is appropriate for serious breaches of protocol, but the immediate priority is to stop the inappropriate discussion to protect client confidentiality.

B. Try not to listen to the conversation since it is confidential: Ignoring the conversation does not address the violation of privacy that is occurring. The PN has a professional responsibility to intervene when confidentiality is breached.

C. Approach the individuals involved and ask them to stop: Directly intervening ensures the conversation ceases and reinforces the importance of client confidentiality. Immediate action protects the client’s privacy and maintains professional standards of care.

D. Tell the client of the UAP's concern for him: Sharing details of the conversation with the client would further breach confidentiality and is inappropriate. The PN’s focus should be on stopping the discussion among staff.

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Naxlex Comprehensive Predictor Exams

To determine a hospitalized client's orientation, the practical nurse should ask the client questions related to which information? (Select all that apply.)

Correct Answer is ["B","D","E","F"]

Explanation

The practical nurse (PN) overhears a conversation between an unlicensed assistive personnel (UAP) and another staff member in the hospital cafeteria line concerning a client's reaction to being given a diagnosis of terminal cancer. What is the best nursing action?

Correct Answer is C

Explanation

The practical nurse (PN) observes an unlicensed assistive personnel (UAP) obtain a client's vital signs. The PN should intervene when observing the UAP performing which technique?

At bedtime, a female client with dementia becomes increasingly confused and agitated because she believes that someone is standing behind the privacy curtain. Which action should the practical nurse (PN) take?

In administering nystatin suspension to the gums of an infant with a candida infection, which approach should the practical nurse (PN) use?

When a small fire breaks out in the kitchen of a long-term care facility, which task should be performed by the practical nurse (PN) rather than the unlicensed assistive personnel (UAP)?

Morphine sulfate via intravenous patient-controlled analgesia (PCA) pump is prescribed for a client with severe chronic back pain. Thirty minutes after initiating the PCA pump, the practical nurse (PN) notes that the client has become lethargic. Which action should the PN take?

The practical nurse (PN) is assigned to care for a client who had an endoscopic procedure in which a local anesthetic was sprayed on the throat. Which priority action should the PN include in this client's plan of care?

A client who is a primigravida tells the practical nurse (PN), "My baby seems to be sleeping, but look at the funny movements he is making." The PN notices that the infant is making hand-to-hand movements, smacking his lips, and turning his head. Which is the best response for the PN to make?

The practical nurse (PN) assisting a walker-dependent client to ambulate in the hall notices another client lying on the floor. Which is the best action for the PN to take?