Exam 2 PrepU

A nurse is teaching a client about rheumatoid arthritis. Which statement by the client indicates understanding of the disease process?

"It will get better and worse again."

What should the nurse teach the client about assessing for possible breast cancer?

"Perform monthly self-breast exams after menses."

The nurse is working with a group of caregivers of school-aged children diagnosed with attention deficit hyperactivity disorder (ADHD). Which statement would be most appropriate for the nurse to make to this group of caregivers?

"The medications your child is on may cause a decreased appetite."

The nurse is caring for a 48-year-old female client who asks, "How do you know when you have reached menopause?" Which statement is an appropriate response by the nurse?

"You are considered to be menopausal when you have not menstruated for a full year and the hormone that fluctuates with menstruation no longer fluctuates."

A nurse is administering a purified protein derivative (PPD) test to a client. Which statement concerning PPD testing is true?

A positive reaction indicates that the client has been exposed to the disease

The nurse is caring for a client with acute myeloid leukemia (AML) with high uric acid levels. What medication does the nurse anticipate administering that will prevent crystallization of uric acid and stone formation?

Allopurinol

A client complains of not being able to experience satisfactory sexual intercourse. The nurse knows that erectile dysfunction is now recognized as a marker for:

Cardiovascular disease

Mark, age 42, is prescribed sildenafil for the treatment of pulmonary hypertension. The nurse caring for Mark would explain that sildenafil works by what mechanism?

Causing vasodilation in the pulmonary vascular bed

The nurse is reviewing the diagnostic test findings of a client with rheumatoid arthritis. What would the nurse expect to find?

Elevated erythrocyte sedimentation rate

Which is a characteristic of a breast cancer mass?

Firm, hard, embedded in surrounding tissue

Which assessment and laboratory findings would be most closely associated with acute leukemia?

High blast cell counts and fever

Crohn disease is treated by several measures. Treatment with sulfasalazine will focus on which aspect of this disease?

Inflammatory suppression

Which of the following is a characteristic of a malignant tumor?

It gains access to the blood and lymphatic channels.

Which factor differentiates chronic leukemias from acute leukemias?

Leukemic cells are more fully differentiated in chronic than in acute leukemias

What important instruction should the nurse give a pregnant client with tuberculosis?

Maintain adequate hydration.

The nurse is developing a community program since a recent increase in admissions to the acute care facility with tuberculosis infection. What is the most frequent form of tuberculosis that the nurse should focus on?

Mycobacterium tuberculosis

A client is scheduled for a renal arteriogram. When the nurse checks the chart for allergies to shellfish or iodine, she finds no allergies recorded. The client is unable to provide the information. During the procedure, the nurse should be alert for which finding that may indicate an allergic reaction to the dye used during the arteriogram?

Pruritus

The nurse is assessing a 4-year-old child who has multiple bee stings. Which assessment finding requires immediate action by the nurse?

wheezing on auscultation

A nurse is caring for a client who has experienced an acute exacerbation of Crohn's disease. Which statement best indicates that the disease process is under control?

The client exhibits signs of adequate GI perfusion.

A client, being treated for latent tuberculosis (TB) on an out-client basis, tells the nurse, "I've been feeling pretty good lately, so I haven't actually been all that consistent with taking my drugs." Subsequent health education by the nurse should focus on what subject?

The need to consistently take the prescribed drugs in order to cure TB

The parents of a 7-year-old tell the nurse that they are concerned that their child has attention deficit hyperactivity disorder (ADHD) because he can't seem to stay focused when playing in a baseball game. What questions/comments by the nurse are appropriate? Select all that apply.

"How is his attention span during school?" "Do you notice him getting distracted in other activities, like bicycling?"

A male client has been diagnosed with impotence and is started on a regimen of androgens. Which statement by the client indicates that he has understood the teaching?

"If my skin appears yellow or my urine turns dark, I will contact my health care provider."

A pregnant client is screened for tuberculosis during her first prenatal visit. An intradermal injection of purified protein derivative (PPD) of the tuberculin bacilli is given. Which sign would indicate a positive test result?

An indurated wheal over 10 mm in diameter appears in 48 to 72 hours.

A child with attention deficit hyperactivity disorder (ADHD) is prescribed methylphenidate hydrochloride. What should the nurse instruct the parents regarding an adverse effect of this medication?

Anorexia

The thymus gland secretes thymosin and thymopoietin, which aid in developing T lymphocytes, a type of white blood cell involved in immunity. Which of the following best identifies the location of this gland?

In the upper part of the chest above or near the heart

The presence of mucus and pus in the stools suggests which condition?

Ulcerative colitis

Tumors classified on the basis of growth are

benign or malignant

Tumors that are classified on the basis of the cell or tissue of origin are

carcinomas, sarcomas, lymphomas, and leukemias

A patient with acute lymphoblastic leukemia (ALL) is receiving imatinib on an inpatient basis. When planning the care of this patient, what assessment should be specified in the patient's plan of nursing care?

daily weights

Administration of which medication reverses the histamine release and hypotension that are seen in anaphylaxis?

epinephrine

During a routine physical examination on an older female client, a nurse notes that the client is 5 feet, 3/8 inches (1.6 m) tall. The client states, "How is that possible? I was always 5 feet and 1/2? (1.7 m) tall." Which statement is the best response by the nurse?

"After menopause, the body's bone density declines, resulting in a gradual loss of height."

A client has returned to the health care provider's office for follow up after receiving estrogen for symptoms of menopause. Which question should be included in the follow up?

"Can you describe in detail the difference in how you are feeling today and the last visit?"

A client asks the nurse what the difference is between osteoarthritis (OA) and rheumatoid arthritis (RA). Which response is correct?

"OA is a noninflammatory joint disease. RA is characterized by inflamed, swollen joints."

The nurse has just finished teaching a client newly diagnosed with rheumatoid arthritis about the disease. The nurse determines that teaching is effective when the client makes which statement?

"Rheumatoid arthritis includes joint involvement that is usually symmetric and polyarticular."

The nurse is preparing a client for bone marrow biopsy for suspected leukemia. The client tells the nurse, "I already know all the risks and what to expect. I had a bone marrow aspiration a month ago." How should the nurse respond?

A bone marrow biopsy is more invasive than the aspirate. It uses a larger needle to obtain a larger sample so it carries some increased risks.

The nurse is preparing a client for a surgical procedure that will allow visualization of the extent of joint damage of the knee for a client with rheumatoid arthritis and also obtain a sample of synovial fluid. What procedure will the nurse prepare the client for?

Arthroscopy

A client is having a diagnostic workup for reports of frequent diarrhea, right lower abdominal pain, and weight loss. The nurse is reviewing the results of the barium study and notes the presence of "string sign." What does the nurse understand that this is significant of?

Crohn's disease

The nurse in the urology clinic is reviewing the chart of a client with erectile dysfunction. Which factor in the client's history does the nurse recognize is a hormone-based condition that may contribute to erectile dysfunction?

Hypogonadism

A client has developed priapism. For which outcome is this client at risk?

Impotence

What is the most common cause of anaphylaxis?

Penicillin

The nurse is caring for a client with leukemia who is having difficulty with blood clotting after having several transfusions with packed red blood cells. What does the nurse anticipate infusing for this client to assist with controlling the bleeding?

Platelets

The provider is assessing a client with a history of erectile dysfunction (ED) who is requesting a prescription for treatment. When assessing for additional information related to causes of ED, which information should the provider solicit from the client?

Presence of arterial occlusive disease

A 52-year-old male diagnosed with erectile dysfunction (ED) asks the nurse what will be implemented as a first option for treatment. The best response would be:

Psychosexual counseling and PDE-5 inhibitor medications

A group of students are reviewing the drugs available for treating penile erectile dysfunction. The students demonstrate understanding when they identify which drug as a PDE5 inhibitor?

Sildenafil

Chronic lymphocytic leukemia (CLL) commonly causes hypogammaglobulinemia. This makes clients with CLL more susceptible to infection. What is the most common infectious organism that attacks clients with CLL?

Staphylococcus aureus

The nurse is aware that drug therapy is prescribed for children with ADHD under which circumstances? (Select all that apply.)

Symptoms are moderate to severe. Symptoms are present for several months. Symptoms interfere in social, academic, or behavioral functioning.

The nurse is talking with a 9-year-old child diagnosed with acute leukemia who will soon begin chemotherapy. The child expresses worry that when her hair falls out friends won't like her or want to play with her anymore. Which response by the nurse would be best?

Talk with her and her family about wearing a wig, cap, or scarf.

A nurse who works in an oncology practice prepares patients for the side effects of adjuvant hormonal therapy to treat breast cancer. Which of the following is the hormonal agent that has an increased risk of pulmonary embolism and deep vein thrombosis? Deep vein thrombosis, pulmonary embolism, and superficial phlebitis are all thromboembolic events that are adverse reactions to tamoxifen.

Tamoxifen

A nurse is speaking to the peers of a child with attention deficit hyperactivity disorder (ADHD). The nurse finds that these children do not like the child and do not want to include the child during play. What are the likely reasons for the children feeling this way? Select all that apply.

The child is not cooperative while playing. The child constantly interrupts while playing. The child doesn't follow the rules of the game.

A 10-year-old child is being administered CNS stimulants for ADHD. What should the nurse instruct the parents to record periodically?

Weight and growth

The nurse is caring for 9-year-old boy undergoing chemotherapy whose complete blood count (CBC) with differential reports 7% banded and 13% segmented neutrophils with a white blood cell count of 2,540. He has an oral temperature of 38.6°C (101.5°F). Which intervention would be the priority?

administering prescribed broad-spectrum IV antibiotics

The nurse is assessing an adolescent client diagnosed with attention deficit hyperactivity disorder (ADHD) for therapeutic effects of methylphenidate. The nurse should focus on improvement associated with what client functions? Select all that apply.

behavior motor task performance cognitive task performance

Parents are reluctant to accept that their preschooler has attention deficit hyperactivity disorder (ADHD), so the nurse is explaining the commonly seen characteristics of this syndrome. Which characteristics would the nurse include in the explanation? Select all that apply.

easily distracted failure to complete tasks before going on to another one impulsiveness

A 50-year-old man has a long history of type 1 diabetes, which is poorly controlled. What does diabetes greatly increase the man's risk of experiencing?

erectile dysfunction

A 5-year-old child is brought to the emergency department after being stung multiple times on the face by yellow jackets. Which symptom of anaphylaxis requires priority medical intervention?

heart rate less than 60 beats/minute

The nurse is reviewing the history and physical exam of a woman who has come to the clinic for a routine physical. Which factor would the nurse identify as increasing the client's risk for breast cancer?

history of ovarian cancer, women over 50, early menarche (before 12), late onset of menopause (after 55) alcohol, lack of physical activity, taking oral contraceptive pills, 55 and older, genetics, European descent, overweight or obese, family history of breast cancer

The nurse is discussing life management with the client with rheumatoid arthritis in a health clinic. What assessment finding indicates the client is having difficulty implementing self-care?

increased fatigue

The nurse is providing care to a client who has had surgery as treatment for breast cancer. The nurse would be alert for the development of which complication?

lymphedema

A 47-year-old woman is being seen at the local clinic reporting irregular menstrual cycles. The nurse would explain to the client that the irregularity is most likely due to:

menopause.

A woman comes to the clinic for an evaluation. During the visit, the woman tells the nurse that her menstrual cycles have become irregular. She states, "I've also been waking up at night feeling really hot and sweating." How should the nurse interpret these findings?

perimenopause

A 5-year-old needs to undergo a bone marrow biopsy. When educating the parents, which site should the nurse state is the most commonly used?

posterior iliac crest

A 25-year-old female client is prescribed methotrexate to treat rheumatoid arthritis (RA). The nurse should teach the client to:

use an effective contraceptive.