1.Which outcome would be identified by the RN for the nursing diagnosis Ineffective Breathing Pattern in a patient diagnosed with chronic obstructive...
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1.   Which outcome would be identified by the RN for the nursing diagnosis

Ineffective Breathing Pattern in a patient diagnosed with chronic obstructive pulmonary disease (COPD)?


The patient will:
Maintain an oxygen saturation of 95% or greater on room air.
Have clear breath sounds in both upper and both lower lobes.
Ambulate 100 feet without dyspnea.
Demonstrate pursed-lip breathing.


2. Which nursing interventions should the RN implement to prevent atelectasis? Select all that apply.
Limit the use of opioids to manage pain.
Encourage early ambulation.
Change patient position frequently.
Obtain order for daily chest x-ray.
Assist with coughing and deep breathing exercises.


3. Which etiology would the RN identify for the nursing diagnosis Imbalanced nutrition: less than body requirements in a patient with pneumonia?
Elevated body temperature.
Shortness of breath.
Retained secretions.
Insensible fluid loss.
 
4. The RN administers the prescribed sedation to the intubated patient with acute respiratory distress syndrome (ARDS). What is the primary rationale for this intervention?
To decrease oxygen consumption.
To promote lung volume expansion.
To prevent mechanical ventilator malfunction.
To reduce the production of secretions.


5. The RN is assessing a patient with pneumonia who is reporting chest pain during inspiration and coughing. Which assessment data would be associated with this symptom?
Distant heart sounds.
 breath sounds.
 
6. The RN assesses a patient admitted to the Emergency Department following a motor vehicle accident. The RN notes a paradoxical chest rise, multiple bruises across the chest and torso, crepitus and tachypnea. Which intervention will the patient need first?
Application of a chest binder.
Administration of analgesics
Insertion of a chest tube.
Stabilization of the airway.


7. Which patient would the RN identify as being at increased risk for aspiration?
The patient in a side lying position following an endoscopy.
The patient with a non functioning nasogastric tube.
The patient with an endotracheal tube with a cuff pressure of 25 cm H2O.
The patient with a tube feeding with the head of the bed at a 45 degree angle.


8. Which information should the RN provide when educating a patient with chronic obstructive pulmonary disease (COPD) that is prescribed two metered dose inhalers, salmeterol and fluticasone?
Exhale through the device after administering the medication.
Rinse the mouth after administering each medication.
Wait at least one minute between each medication.
Self-administer the bronchodilator last.


9. Which outcome is most appropriate for the nursing diagnosis Activity intolerance for the patient with chronic obstructive pulmonary disease (COPD)?
The patient will:
Ambulate 100 feet without experiencing dyspnea
Drink at least 2,500 mL of water each day.
Shower immediately after waking up in the morning.
Demonstrate pursed-lip breathing.


10. The RN observes the assistive personnel (AP) removing the nasal cannula from the patient with chronic obstructive pulmonary disease (COPD) while ambulating the patient to the bathroom. Which action should the RN take?
Praise the AP since this prevents the patient from tripping on the oxygen tubing.
Explain to the AP in front of the patient that oxygen must be left in place at all times.
Place the oxygen on the patient and speak to the AP in private concerning their actions.
Discuss the action of the AP with the charge nurse so appropriate action can be taken.


11. The charge nurse is making patient assignments. Which patient should the RN assign to the licensed practical nurse (LPN)?
The patient who had a bronchoscopy 4 hours ago and has stable vital signs.
The patient with pneumonia who has a pulse oximetry reading of 90%.
The patient with a pulmonary contusion that has a constant cough and new confusion.
The patient with a chest tube who has jugular venous distention and a blood pressure of 96/60.


12. Which assessment finding in the client diagnosed with COPD would support a nursing diagnosis of Impaired gas exchange?
Coarse crackles in bilateral upper and bilateral lower lobes.
Capillary refill of less than 3 seconds on index finger.
Use of pursed lip breathing and three-point positioning.
Decrease in oxygen saturation when sleeping.
 
13. Which nursing interventions would the RN implement for a patient with a nursing diagnosis of Risk for Bleeding related to thrombocytopenia? Select all that apply.
Measure temperature using a rectal thermometer.
Apply pressure for 5 minutes to injections sites.
Encourage a diet high in fiber.
Administer aspirin to manage fever.
Assess neurological status with vital signs.


14. The patient who has had bariatric surgery is experiencing fatigue and paresthesias of the feet. Which medication will the nurse administer to manage these symptoms?
Corticosteroids
Folic acid
Vitamin B12
Ferrous sulfate
 
15. The nurse is reviewing the following laboratory results for a client:
Serum Laboratory Test
Patient Value
WBC
8.0  K/µL
Neutrophils
42%
Lymphocytes
45%
Monocytes
10%
Eosinophils
1%
Basophils
0%
RBC
2.0 million cells/µL
Hemoglobin
9.2 g/dL
Hematocrit
29%
Platelets
200 K/µL
 
Which outcome should the nurse expect this client to achieve?
The client will:
 
Pace activity according to energy level.
Avoid eating raw fruits and vegetables.
Use a soft bristle toothbrush.
Take all prescribed antibiotics.


16. The RN admits a patient with sickle-cell disease in vaso-occlusive crisis. What is the priority nursing intervention for this patient?
Maintain adequate hydration.
Keep the environment warm.
Administer pain medication.
Transfuse packed red blood cells.
 
17. Which data collected by the RN during the health history of an adolescent supports the medical diagnosis of Hodgkin's lymphoma?
Frequent nose bleeds.
Edema of the face.
Pain in the neck.
Drenching night sweats.
 
18. Which meal choice would indicate to the RN that the patient with iron deficiency anemia understands the discharge teaching provided by the nutritionist concerning recommended changes in diet?
Tuna salad sandwich on white bread and milk.
Egg white omelet, bacon, and orange juice.
Grilled calves liver, steamed broccoli and spinach salad.
Roast chicken, mashed potatoes and gravy.


19. Which statement made by the patient following a bone marrow biopsy indicates to the RN that more discharge teaching is necessary?
"I may see some bruising in the area of the biopsy."
"I will take some aspirin to help manage the pain."
"I can take a nice warm tub bath to relieve the ache in my hip."
"I can remove the dressing after 24 hours."
unanswered
20. A patient receiving a vinca alkaloid to manage cancer reports feeling very clumsy and having trouble using buttons on clothing to the home health RN. Which statement is the RN's best response?
"Are you weak and dizzy when you try to stand up?"
"This is normal and will go away when your therapy is complete."
"Have you noticed any change in your bowel movements?"
"There is no reason to worry about a minor side effect of the medication."




21. Which outcome should the RN select for the nursing diagnosis of Deficient fluid volume in a patient diagnosed with disseminated intravascular coagulation (DIC)? 
The patient will:
Have capillary refill less than 3 seconds in both great toes.
Have a urine output of 0.5 mL/kg per hour or more..
Have an oxygen saturation of 95% or greater.
Have clear breath sounds in upper and lower lobes.
 


22. Which patient statement indicates to the RN a need for further education about the primary prevention of cancer?
"I will call my primary care provider to schedule a mammography."
"I will try to eat more fruits and vegetables."
"I will be sure to apply sunscreen when playing golf."
"I will join a smoking cessation class tomorrow."
 
23. Which nursing intervention is a priority to prevent tumor lysis syndrome in a patient receiving chemotherapy for lymphoma?
Monitor blood urea nitrogen (BUN) and creatinine daily.
Administer corticosteroids.
Hydrate before and after the chemotherapy.
Maintain normal nutritional intake of calcium
 


24. During an interview with the RN, the patient diagnosed one year ago with colorectal cancer expresses the desire to "eat healthy" and points to an area of impaired skin integrity around the sigmoid colostomy stoma. Which areas need to be included in this patient's survivorship plan of care?  Select all that apply.
Pain management.
Colonoscopy.
Liver function tests.
Nutrition counseling.
Ostomy care.
 
25. Which interventions should the RN implement for a patient with prostate cancer that is experiencing spinal cord compression? Select all that apply.
Administer corticosteroids.
Increase fluid intake.
Limit position changes.
Passive range of motion.
Pain management.
 
26. The RN is developing an informational presentation for an outpatient clinic. Which information should be included regarding the early detection of colon cancer?
A colonoscopy should be performed at least every ten years after age 50.
A fecal occult blood test should be performed annually after age 45.
A digital rectal examination should be performed annually after age 40.
A flexible sigmoidoscopy should be performed at least every five years after age 40.
 


27. The RN is obtaining a health history of a school age child diagnosed with a brain tumor. Which assessment data supports this diagnosis?
Vomiting in the morning.
Constant pain that prevents sleep.
Catecholamines in the urine.
Raised anterior fontanel.


28. A student who wants to play basketball tells the school nurse that his parents won't let him play because a child they know developed osteosarcoma when he was injured playing the sport. What is the best response by the RN?
"An inadequate amount of calcium intake was the cause of the cancer."
"The sports injury most likely led to the diagnosis of the tumor but was not the cause."
"Osteosarcoma is more common in females so you can play basketball."
"Evidence has shown that bone cancer is associated with active, organized sports."
 
29. A patient with stage IV cancer of the pancreas is admitted with a small bowel obstruction and consents to surgery to relieve the obstruction. Which statement made by the patient indicates to the RN that further teaching is needed?
"I look forward to spending more time with my family."
"I can learn to manage an ileostomy if necessary."
"I will be so glad to be free of this cancer."
"I know that this surgery will only relieve my symptoms."
 


30. The RN is caring for a patient with prostate cancer immediately following a transurethral prostatectomy (TURP) and notes a distinct, round swelling above the pubis. What is the priority nursing intervention?
Assess the dressing for drainage.
Ambulate the patient.
Notify the provider when urine changes from pink to amber in color.
Gently irrigate the urinary catheter.


31. A patient with pneumonia is prescribed a cough suppressant containing dextromethorphan. Which statement made by the patient indicates to the RN that more teaching is needed?
"I can take this medication every 4 to 8 hours as needed to control coughing."
"This medication can result in addiction if taken for long periods of time."
"I need to call my doctor if the cough lasts more than one week."
"It is not safe drink alcohol while using this medication."


32. The RN is preparing a patient for discharge following the removal of a basal cell carcinoma lesion on the ear. Which discharge instruction should the RN include?
Schedule monthly follow up appointments with primary provider.
Arrange for a consultation with an oncologist.
Wash hands before changing the dressings.
Avoid sunscreen on the surgical wound after it is healed.


33. The RN is providing education the patient undergoing radiation therapy to the chest for lung cancer. Which statement made by the patient indicates an understanding of the teaching?
"I can use a cold pack to help relieve the soreness on my chest."
"I will gently wash the skin to remove the radiation marks from my chest."
"I need to apply a lotion containing aloe to the red areas on my chest."
"I should wear a loose-fitting soft shirt to cover my chest."
 
34. The patient with leukemia has neutropenia following treatment with chemotherapy. Which action should the RN take?
Assess the oral mucosa for redness and swelling.
Eliminate fresh fruits and vegetables with meals.
Administer broad spectrum antibiotics as ordered.
Limit bathing to every other day to maintain skin integrity.
 
36. A patient has a left modified radical mastectomy with axillary lymph node dissection for breast cancer. Which intervention should the RN implement during the postoperative period to promote left arm function?
Encourage range-of-motion exercises for the left shoulder.
Apply a heating pad to increase circulation to the left arm.
Place ice packs in the left axilla to help minimize lymphedema.
Teach passive exercise with the left arm in a dependent position.


37. The RN assesses that extravasation of a chemotherapy agent has occurred. Which intervention should the RN perform first?
Inject an antidote, if required.
Apply a warm compress to the area.
Discontinue the infusion.
Place ice over the site of the infiltration.


38. Which outcome would be most appropriate for the patient receiving chemotherapy with a nursing diagnosis of Imbalanced nutrition: less than body requirements related to nausea and vomiting?
The patient will:
Conduct a calorie count.
Administer an antiemetic.
Eat 75% of the food on each meal tray.
Exhibit no tenting of skin over clavicle.


39. The RN is preparing discharge teaching for a patient with a new colostomy following surgery for colorectal cancer. Which information should be included in the teaching?
The stoma should be dark in color.
Change the appliance every day.
Follow a low-residue diet for the first 6 weeks after surgery.
Empty the colostomy appliance when it is full.


40. The RN is to administer filgrastim (Neupogen) 5 mcg per kg subcutaneously to a patient that weighs 110 pounds
How many mcg of filgrastim will the RN administer?
Record your answer as a whole number. (Round any fractions to the nearest whole number using standard rounding rules.) Do not include words or abbreviations in your answer.




[x] mcg
   
 
41. A patient with colorectal cancer has a new colostomy and a nursing diagnosis of Deficient Knowledge. Which outcome would be a priority for this patient?
The patient will
Watch the RN to change the ostomy appliance.
Demonstrate techniques of ostomy care.
Ask the family member to change the ostomy appliance.
Look at the stoma.
 


42. The RN contacts a patient with metastatic lung cancer for follow up care and records several reported findings. Which finding would suggest to the RN that the patient has superior vena cava syndrome?
Inability to button shirt collar.
Several reddened areas on the chest.
Report of fatigue.
Pain exacerbated by movement.
 
43. A patient develops a temperature of 101.3°F (38.5°C) after receiving 25 percent of a second unit of packed red blood cells. Which action would the RN perform first when caring for this patient?
Administer an antipyretic.
Notify the blood bank.
Assess respiratory status.
Stop the transfusion immediately.
 
44. The RN and the assistive personnel (AP) are caring for a group of patients on a medical unit. Which information reported to the RN by the AP requires immediate attention by the RN?
The patient with lung cancer has a small amount of blood in the sputum cup.
The patient receiving a blood transfusion has a temperature of 100°F (37.8°C).
The patient with COPD is sitting on the side of the bed leaning on the bedside table.
The patient receiving glucocorticoids is reporting nausea after eating breakfast.
 
45. The RN obtains assessment data for a patient diagnosed with acute myeloid leukemia (AML). Which finding should the RN address first?
Weakness and fatigue.
Burning pain in the mouth.
T 99°F (37.2°C), P 100, BP 132/64 mm/Hg.
Ecchymosis and petechiae on the arms.


46. Which nursing intervention should the RN implement to maintain accurate and effective communication with a patient after a total laryngectomy?
Teach the patient and family sign language.
Encourage family and staff to speak in a loud voice.
Provide the patient an artificial larynx immediately after surgery.
Determine alternate method of communication in the preoperative period.
 
47. Which statement made by the patient with osteosarcoma of the left tibia indicates to the RN that additional teaching is needed?
"I should stay in bed except for when I need to use the bathroom."
"I can do range of motion exercises to keep my right leg muscles strong."
"I need to avoid putting weight on my left leg when moving around."
"I will drink more water instead of milk."
 
48. The parent of a child with sickle-cell disease is very anxious about the upcoming hematopoietic stem cell transplant. Which statement made by the RN best exemplifies patient-centered care?
"If you can hold your child still during the procedure, the pain will pass more quickly for her."
"We will go to great lengths to make sure your child doesn't develop an infection."
"Your child will need to lie still while the new bone marrow infuses into her bones."
"Your child will not need any further bone marrow aspirations after this procedure."


49. Which assessment finding would cause the home care RN to revise the plan of care for the patient who had a total gastrectomy for gastric cancer?
Skin turgor is non-tenting over clavicle.
Abdominal incision is without redness or drainage.
Pain score is 2 when using the 0 to 10 numeric pain scale.
Weight loss of 5 pounds in seven days.
 
50. Which intervention should the RN implement for the client diagnosed with a pulmonary embolism who is receiving thrombolytic therapy?
Avoid invasive procedures.
Keep protamine sulfate readily available.
Apply manual pressure for 5 minutes on puncture sites.
Continue anticoagulant therapy during thrombolytic infusion.


51. Which outcome would the RN identify for the patient diagnosed with a malignant brain tumor that has a nursing diagnosis of Self-care deficit?
Verbalize fear of unknown.
Maintain body weight within two pounds of baseline.
Develop coping strategies to gain some control.
Perform ADLs independently as long as possible.
 
52. The parents of a child diagnosed with a brain tumor need to find resources to support the cost of chemotherapy. Which member of the interprofessional team would be best prepared to help this family?
Oncologist
Social worker
Registered nurse
Pharmacist


53. A patient diagnosed with cancer of the pancreas is refusing surgery. Which intervention by the RN demonstrates best ethical practice?
Listen to the patient explain why they are refusing the procedure.
Insist that the surgery will save the patient's life.
Refer the patient to a counselor for help making the decision.
Ask a family member to sign the consent form for surgery.
 


Which information provided by the licensed practical nurse (LPN) requires immediate 54. intervention by the RN?
The patient with a patient controlled analgesia (PCA) pump following a right upper lobe lobectomy is reporting pain.
The patient diagnosed with cancer of the lung is reporting shortness of breath and feeling tired.
The patient with a radical neck dissection has a continuous amount of bright red drainage underneath the neck dressing.
The patient with a chest tube connected to a wet suction has continuous bubbling in the middle chamber of the chest drainage system.


55. What teaching should the RN provide for the patient with thyroid cancer during the pre-operative period?
Practice placing the hands under the chin to reduce tension on the neck.
Consume a diet low in protein, carbohydrates and caffeine.
Take prescribed thyroid replacement medication as directed.
Participate in quiet, restful activities such as reading.


56. Which intervention should the RN assign to the licensed practical nurse (LPN)?
Administer the prescribed intravenous antineoplastic medications.
Prepare the patient that is going for an MRI of the kidneys.
Monitor the patient that has a white blood cell count of 22,000/mm3.
Assess the patient who has a new Kock pouch.


57. Which information should the school nurse include when teaching a class on testicular self-examination (TSE) to high school students? Select all that apply.
Testicular self-examination should be performed every week.
Perform the examination after a warm shower.
Call the primary provider if a lump is felt.
The normal testicle is smooth and uniform in consistency.
A testicular examination should be performed annually by a clinician.


58. Which statement made by the parent of a child with a prescription for an oral chemotherapy agent indicates the need for further education about the parent's personal safety?
"I know that the pills have to be given on a regular schedule."
"I will wash my hands before handling the medication."
"I know the side effects and will watch carefully for them."
"I will call the oncologist if my child refuses to take the pill."


59. The RN observes a student nurse placing a pillow under the knees of a patient that has had a radical vulvectomy. Which intervention should the RN take?
Take the student aside and explain the possible consequences of this intervention.
Report the student's intervention to the instructor and remove the pillow.
Document the error in the patient record and notify the primary provider.
Remove the pillow and say nothing to the student.


60. Which intervention should the RN emphasize when teaching a parent of a child with sickle cell disease how to prevent crisis?
Call the primary provider for any sign of infection.
Eat foods that contain large amounts of iron.
Take additional amounts of vitamin supplements.
Limit physical activity to 30 minutes per day.


61. Which statement made by the patient who is at risk for alopecia due to chemotherapy indicates to the RN that more teaching is needed?
"I need to choose a wig or hair piece before any hair loss begins."
"I can wash and blow dry my hair every day."
"I should use a wide tooth comb when combing my hair."
"I will be sure to put on a hat before spending time in the sun."


62. Which intervention would the RN implement first when a patient hospitalized following brachytherapy reports the implant is lying in the bed?
Move the patient to another bed in another room.
Notify radiation therapy and the radiation oncologist.
Assess for skin irritation in the area nearest to the exposed implant.
Remove any visitors from the patient room.
 
62. Which intervention would the RN implement for the client with cancer that is experiencing persistent fatigue?
Heparin:
Perform yoga exercises once a week.
Increase dietary protein, fat, and calories..
Collaborate with a palliative care specialist.
Encourage prolonged napping during the day.


64. During a health assessment, which question should the RN ask the patient to help determine a nutritional cause of anemia?
"Do you have any pain?"
"Have you noticed an increase in the number of bruises?"
"What color are your stools?"
"Are you experiencing any numbness or tingling?"


The adult patient with iron-deficiency anemia is prescribed 80 mg of ferrous sulfate (FeoSol) three times per day.




How many mg of ferrous sulfate will the patient receive each day?
Record your answer as a whole number. (Round any fractions to the nearest whole number using standard rounding rules.) Do not include words or abbreviations in your answer.




[x] mg
   
 


65. The RN should collaborate with which member of the interprofessional team to assist the patient with severe stomatitis?
Hospice nurse.
Physical therapist.
Dietician.
Social worker.
 
66. The student nurse wants to develop a presentation about skin cancer prevention in adolescents. Which resource would help the student develop a presentation that represents national health goals?
Healthy People 2020
WebMD
National Cancer Institute
American Cancer Society
 
67. The nurse is caring for a client with a chest tube attached to a wet suction chest drainage system. Which assessment made by the RN requires immediate attention?
Bubbling is occurring in the suction chamber.
A dependent loop is hanging off the edge of the bed.
The chest drainage system is positioned below the client's chest level.
The dressing over the chest tube insertion site is occlusive.
unanswered
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68. Which assessment data for the patient receiving the biologic response modifier erythropoietin alpha (Epogen) requires immediate intervention by the RN?
Long bone pain.
Blood pressure 200/124 mm Hg.
Hematocrit 38%.
Apical pulse 60 beats per minute.
 
69. hich statement made by the client being discharged following a hysterectomy to manage ovarian cancer indicates to the nurse that more teaching is needed?
"I should avoid driving until I see my provider."
"I am so glad that I can relax by soaking in the bathtub."
"If my leg gets red or is painful, I need to call my provider."
"I may be more emotional due to the changes in my hormones."
 
70. A patient scheduled for a fine-needle aspiration (FNA) of her breast tells the RN her sister had the same procedure and the mass was no longer palpable after the needle was inserted. She asks what this meant. What information does the RN use to explain as the most likely reason for this occurrence?
The mass may not have been located correctly.
The mass has been absorbed into the breast tissue.
The mass is not palpable because it is an inflammatory lesion.
The mass may be cystic and was ruptured by the needle insertion.
 
71. Which statement made by the client indicates to the RN that more teaching is needed about preventing a recurrent pulmonary embolism?
"When I travel, I should limit the amount of fluids I drink."
"I will avoid crossing my legs when sitting for long periods of time."
"I should carry a medication card that states I am taking warfarin."
"If my stools are dark and tarry, I need to notify my primary provider.'


72. Which information should the RN teach the patient who is scheduled for a bronchoscopy to determine if cancer of the lung is present?
The bronchoscopy will confirm the results of the chest x-ray.
The physician will biopsy the tumor through the scope.
The patient can eat and drink immediately after the test.
There is no discomfort associated with the procedure.


73. A woman at increased risk for breast cancer is considering chemoprevention with tamoxifen. Which intervention should the RN implement to assist the patient with her decision?
Encourage the patient to take every measure available to help prevent this disease.
Inform the patient that medication should not be used to prevent this.
Suggest the patient consider a bilateral mastectomy to prevent this disease.
Provide the patient with information regarding the risks, benefits and possible side effects.
 


74. The patient with a transurethral resection of the prostate (TURP) for prostate cancer who has a continuous irrigation catheter reports the need to urinate. Which action should the RN take first?
Assess the continuous irrigation catheter for patency.
Explain to the patient that this sensation happens frequently.
Notify the physician of the patient's problem.
Administer an opioid analgesic for pain.


75. Which discharge instruction is the priority for the patient following the removal of a basal cell carcinoma from the ear?
Inform the patient that there is no more risk for cancer.
Demonstrate care of the surgical site.
Instruct the patient to apply sunscreen to the area.
Refer the patient to an oncologist for follow up.


76. Which intervention would the nurse consider a priority when providing care for an infant diagnosed with bronchiolitis?
Promoting and maintaining adequate hydration.
Administering prescribed antibiotics.
Administering a cough suppressant as needed.
Assessing peak expiratory flow rate.
 
 
77. How will the RN promote adherence to oral antineoplastic agents for the client diagnosed with cancer that is illiterate? Select all that apply
Send post card reminders to the client weekly.
Use return demonstration of behaviors and devices.
Include family and friends in the education when possible.
Explore the availability of a programmed telephone reminder service.
Instruct patient to bring pill boxes to each follow up visit for pill counts.
 
78. Which member of the interprofessional health care team should the RN collaborate with to transition the patient with a total laryngectomy from the hospital to home?
Medical social worker
Respiratory therapist
Home health nurse
Primary physician
 
79. Which steps would the RN include when teaching the client how to administer a metered-dose inhaler containing budesonide using open-mouth technique? Select all that apply.
Shake the inhaler.
Position the inhaler in your mouth.
Inhale slowly while pressing the inhaler.
Hold your breath for several seconds, then exhale.
Rinse your mouth after using the inhaler.
 
80. Which step is a priority when the RN is applying a reusable pouch system for the client diagnosed with bladder cancer that has an ileal conduit?
Inspecting the skin around the stoma for redness or irritation.
Cleansing the peristomal skin with warm water.
Applying skin protectant around the stoma.
Placing a wick over the stoma to keep the skin dry.
Pleural friction rub.
Expiratory wheeze.
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Step-by-step explanation

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