Final Exam content
When is the best time for the nurse to begin discharge planning and a community-based plan of care for a client with prostate cancer?
Before surgery
The nurse manager for home health and hospice is scheduling daily client visits. Which client is appropriate for the nursing assistant to visit?
Aggressive brain tumor and needs daily assistance with ambulation and bathing
The nurse is educating a group of young men about testicular self-examination (TSE). Which statement by a member of the group indicates teaching has been effective?
"I will look and feel for any lumps or changes to my testes."
The nurse recognizes signs and symptoms of delirium in an 80-year-old client who is dying from metastatic breast cancer. What does the nurse do initially for this client?
Collaborates with the end-of-life (EOL) care team to evaluate possible medication-induced causes
A client admitted with a non-life-threatening illness says, "I was asked to fill out an advance directive when I was admitted, but I was too stressed. What was it all about?" How does the nurse respond?
"Advance directives allow a client to convey his or her wishes about health care ahead of time."
A 52-year-old client tells the nurse that she has never had a mammogram because she is terrified that she will have cancer. Which response by the nurse is therapeutic?
"Finding a cancer in the early stages increases the chance for cure."
The nurse is giving a group presentation on cancer prevention and recognition. Which statement by an older adult male client indicates understanding of the nurse's instructions?
"I need to report the pain going down my legs to my health care provider."
A client receiving radiation therapy calls the nurse to report rectal urgency, cramping, and passing of mucus and blood. What is the nurse's best response?
"Limit spicy or fatty foods, caffeine, and dairy products."
A client who is scheduled to undergo radiation for prostate cancer is admitted to the hospital by the nurse. Which statement by the client is most important to communicate to the health care provider?
"My legs are numb and weak."
The nurse is teaching a 47-year-old woman about recommended screening practices for breast cancer. Which statement by the client indicates understanding of the nurse's instructions?
"My mother and grandmother had breast cancer, so I am at risk."
A client with prostate cancer asks why he must have surgery instead of radiation, even if his cancer is the least-invasive type. What is the nurse's best response?
"Surgery is the most common intervention for a cure."
Which information must the organ transplant nurse emphasize before a client is discharged?
"Taking immunosuppressant medications increases your risk for cancer and the need for screenings."
A dying client says to the nurse, "I am afraid to die. I did a lot of wrong things in my life." How does the nurse respond?
"Tell me more about that."
The nurse reviews the chart of a client admitted with a diagnosis of glioblastoma with a T1NXM0 classification. Which explanation does the nurse offer when the client asks what the terminology means?Advancing age
"The brain tumor measures about 1 to 2 cm and shows no regional lymph nodes and no distant metastasis."
The family of an unconscious dying client realizes that their mother will die soon. The client's children are having a difficult time letting go. How does the nurse respond to the needs of this family?
"This must be difficult for you."
The nurse is performing a spiritual assessment on a dying client. Which question provides the most accurate data on this aspect of the client's life?
"What gives you purpose and meaning in your life?"
A nurse is caring for a client whose partner passed away four months ago. The client has a recent diagnosis of diabetes mellitus. The client is tearful and states, "how could you possibly understand what I am going through?" Which of the following responses should the nurse make?
"You are right. I cannot really understand. Perhaps you'd like to tell me more about what you're feeling."
A nurse is caring for a client who is concerned about discharge to home with a new colostomy because of being an avid swimmer. Which of the following statements should the nurse make? Select all that apply
"Your daily routines will be different when you get home." "Tell me about the support system you'll have after you leave the hospital." "It sounds like you are not sure how having a colostomy will affect swimming."
The daughter of a dying client says, "I don't want my father to be uncomfortable." How does the nurse respond?
"Your father will be closely monitored and cared for."
an older male is being evaluated for hydronephrosis. what priority health history question may provide info about a possible cause of this disorder?
"do you have difficulty starting and continuing urination?"
A client has continuous bladder irrigation after surgery yesterday. The amount of bladder irrigating solution that has infused over the past 12 hrs is 1050 mL. The amount of fluid in the urinary drainage bag is 1825 mL. The nurse records that the client had _____ mL urinary output in the past 12 hrs.
775 mL
The nurse working on an inpatient hospice unit has received the change-of-shift report. Which client does the nurse assess first?
A 26-year-old with metastatic breast cancer who is experiencing pain rated at 10 (0-to-10 scale) and anxiety
In which newly admitted client situations does the nurse initiate a conversation about advance directives?
A client with a non-life-threatening illness A person who currently has advance directives The client with end-stage kidney disease The laboring mother expecting her first child
A client with testicular cancer is worried about sterility and the ability to conceive children later. Which resource does the nurse refer the client to before surgery takes place?
A sperm bank facility
The nurse is caring for four male patients with testicular cancer. Which does the nurse recognize that is at highest risk to die from testicular cancer annually?
African American middle aged prostate Euro-American testicular (ans: 54-y.o. african american)
A dying client exhibits signs of agitation. The Foley catheter has drained 100 mL in the last 3 hours, and the client's last bowel movement was yesterday evening. What does the nurse do first?
Administer an analgesic.
A client has undergone transurethral resection of the prostate (TURP). Which interventions does the nurse incorporate in this client's postoperative care? Select all that apply.
Administer antispasmodic medications. Assist the client to mobilize as soon as permitted.
A client with terminal lung cancer is receiving hospice care at home. Which nursing action does the RN manager ask the LPN/LVN to do?
Administer prescribed medications to relieve the client's pain, shortness of breath, and nausea.
The RN working in the hospital emergency department is assigned to care for these four clients. Which client does the nurse attend to first?
Adolescent with an erection for "10 or 11 hours" who is reporting severe pain
A 72-year-old client recovering from lung cancer surgery asks the nurse to explain how she developed cancer when she has never smoked. Which factor may explain the possible cause?
Advancing age
A nurse is caring for a client awaiting transport to the surgical suite for a coronary artery bypass graft. Just as the transport team arrives, the nurse takes the client's vital signs and notes and elevation in blood pressure and heart rate. The nurse should recognize this response as which part of the general adaptation syndrome (GAS)?
Alarm stage
A nurse is caring for a client who has a new diagnosis of type 2 diabetes mellitus. Which of the following nursing interventions for stress, coping, and adherence to the treatment plan should the nurse initiate at this time? Select all that apply
Allow the client to provide input in the treatment plan. Assist the client with time management, and address the client's priorities. Encourage the client in expression of feelings and concerns.
A client with prostate cancer asks the nurse for more information and counseling. Which resources does the nurse suggest?
American Cancer Society's Man to Man program Us TOO International National Prostate Cancer Coalition Client's church, synagogue, or place of worship
The nurse will conduct prostate screening and provide education about prostate cancer with which male client?
An adult male who is older than 50 years
Which tumor features are most closely associated with malignant cells rather than begins cells? Select all that apply
Aneuploidy Large nuclear-to-cytoplasmic ratio Tight adhesion
After returning from transurethral resection of the prostate, the client's urine in the continuous bladder irrigation system is a burgundy color. Which client needs does the nurse anticipate after the surgeon sees the client?
Antispasmodic drugs Monitoring for anemia
A nurse is about to perform postmortem care of a client. The family wishes to view the body. Which of the following actions should the nurse take? Select all that apply
Apply fresh linens and place a clean gown on the body. Remove all equipment from the bedside. Dim the lights in the room.
A client has died after a long hospital stay. The family was present at the time of the client's death. Which postmortem action does the nurse implement?
Asks the family if they wish to help wash the client
A dying client is having difficulty swallowing oral medications. Which intervention does the nurse implement for this client?
Asks the provider if the medications can be discontinued or substituted
Six months later, the patient's symptoms have not significantly improved, and he is referred to a surgeon for a transurethral resection of the prostate TURP. Postoperatively, what are the priority nursing interventions for this patient? Select all that apply
Assess for signs of infection check urine output every two hours remind the patient that urine will be blood-tinged administer pain and antispasmodic drugs as needed
A client with benign prostatic hyperplasia is being discharged with alpha-adrenergic blockers. Which information is important for the nurse to include when teaching the client about this type of pharmacologic management? Select all that apply.
Avoid drugs used to treat erection problems. Be careful when changing positions. Keep all appointments for follow-up laboratory testing.
Which actions does the nurse teach a client as primary cancer prevention strategies? Select all that apply
Avoid sun exposure quitting cigarette smoking having a mole surgically removed
The nurse suspects metastasis from left breast cancer to the thoracic spine when the client has which symptom?
Back pain
A client has a glioblastoma. The nurse begins to plan care for this client with which type of cancer?
Brain
A client has a diagnosis of lung cancer. To which areas does the nurse anticipate that this client's tumor may metastasize?
Brain Bone Lymph nodes Kidneys
A hospitalized client of the Islamic (Muslim) religion is dying. What concept does the nurse share with the health care team about this client's beliefs about death?
Death is seen as the beginning of a new and better life, with Islam as the vehicle.
When assessing a patient with benign prosthetic hyperplasia BPH, what assessment finding does the nurse anticipate?
Distended bladder
The nurse presents a cancer prevention program to teens. Which instruction will have the greatest impact in cancer prevention?
Do not smoke cigarettes.
Bedrooms a client had a transurethral resection of the prostate TURP with continuous bladder irrigation yesterday. The staff nurse notes that the urinary drainage is pink tinged and clear. What is the nurses best action?
Document the assessment in the medical record
The nurse is assessing a client with lung cancer. Which symptom does the nurse anticipate finding?
Dyspnea
Which of the following strategies should a nurse used to establish a helping relationship with a client?
Encourage the client to communicate their thoughts and feelings.
A young adult with testicular cancer is admitted for unilateral orchiectomy and retroperitoneal lymph node dissection. Which nursing action is best for the nurse to delegate to unlicensed assistive personnel (UAP)?
Encourage the client to cough and deep-breathe after surgery.
A client diagnosed with lung cancer 6 months ago is now ventilator-dependent and unresponsive. The family wants to remove the ventilator and stop antibiotics and IV fluids. What does the nurse do next?
Facilitates a meeting between the family and health care team
The nurse is coordinating interdisciplinary palliative care interventions for the dying client. Which goal is the nurse seeking to meet?
Facilitating a peaceful death for the client
The home health nurse is caring for a client who has a history of a kidney transplant and takes cyclosporine (Sandimmune) and prednisone (Deltasone) to prevent rejection. Which assessment finding is most important to communicate to the transplant team?
Palpable lump in the client's axilla
A Christian client is struggling with a diagnosis of cancer and says, "Why is life so unfair?" What health care team member does the nurse ask to provide support?
Hospital chaplain
Which statement by client who has tested negative for a BRCA1 mutation (while her sister is positive) indicates to the nurse that the client has correct understanding of the results?
I will continue to perform monthly breast self examinations
A client receiving palliative care ask the nurse, why is this happening to me? What is the nurses best response?
I'm sorry. I know that this is a difficult time for you.
The nurse is teaching a client about taking sildenafil (Viagra) for erectile dysfunction. Which statement by the client indicates a need for further teaching?
If I have chest pain during sex, I should take a nitroglycerin tablet.
The nurse is conducting a community health education class on diet and cancer risk reduction. What should be included in the discussion?
Increase consumption of whole grains Avoid beef and processed meats. Eat "colorful fruits and vegetables," including greens.
A nurse who is skilled in complementary and alternative medicine (CAM) therapies works on a cancer unit with clients who are terminally ill. For which client symptom does the nurse use these therapies?
Increased pain
The nurse explains to a client that which risk factor of those listed most likely contributed to the client's primary liver carcinoma?
Infection with hepatitis B virus
Which activity performed by the community health nurse best reflects primary prevention of cancer?
Teaching a class on cancer prevention
A nurse is consulting the partner of a client who just died after a long battle with liver cancer. The grieving partner states, "I hate them for leaving me." Which of the following statements should the nurse make to facilitate morning for the partner? Select all that apply
Would you like me to contact the chaplain to come and speak with you? You know, it is quite normal to feel anger toward your loved one at this time. Tell me more about how you are feeling.
The patient has a prostate ultrasound and is diagnosed with BPH. The healthcare provider prescribes drug therapy with finasteride (Proscar).
It will decrease the level of dihydrotestosterone DHT and shrink the prostate.
Which type of cancer has been associated with Down syndrome?
Leukemia
What are the common cancers related to tobacco use?
Lung cancer Cancer of the tongue Cancer of the larynx
Which condition, when assessed in a dying client, requires that the nurse take action?
Moaning
A client with terminal pancreatic cancer is near death and reports increasing shortness of breath with associated anxiety. Which hospice protocol order does the nurse implement first?
Morphine sulfate (Roxanol) 5 to 10 mg sublingually as needed
Which statement about the process of malignant transformation is correct?
Nutrition of cancer cells is provided by tumor angiogenesis factor (TAF) in the promotion stage.
An older client with advanced dementia and severe osteoarthritis is unresponsive but grimaces and moans when reposition. Which intervention is the most appropriate for the nurse to implement for this client?
Obtain an order for trans dermal fentanyl
A dying client becomes increasingly withdrawn and begins to refuse to eat and drink. What intervention does the nurse implement?
Offers ice chips
Which assessment finding causes the nurse to suspect that a client may have testicular cancer?
Painless testicular lump
The nurse is caring for a client with erectile dysfunction who has not had success with common treatment modalities. The nurse anticipates that the primary health care provider will recommend which treatment for this client?
Penile implants
The nurse includes which factors in teaching regarding the typical warning signs of cancer?
Persistent constipation Scab present for 6 months Axillary swelling
A dying client cannot swallow and is accumulating audible mucus in the upper airway (death rattles). The nursing assistant reports that these noises are upsetting to family members. What does the nurse tell the assistant to do?
Place the client in a side-lying position so secretions can drain.
The client who received combination chemotherapy 7 days ago for breast cancer calls the oncology clinic to report a temperature of 100.5°F (38.6°C) and has no other symptoms of infection. What is the nurses best response?
Please go to the nearest emergency room for a full work up for infection
What will the nurse include in teaching to assist the client who has undergone open radical prostatectomy surgery to overcome urinary incontinence?
Practice Kegel exercises to improve muscle control
Why is prostate cancer screening often emphasized to the African-American population in the United States?
Prostate cancer occurs at an earlier age.
The potential problem of grief is most relevant to a client after which procedure?
Radical prostatectomy
A nurse is caring for a client who states, I have to check with my partner and see if they think I am ready to go home. The nurse replies, how do you feel about going home today? Which clarifying technique is the nurse using to enhance communication with the client?
Reflecting, it directs the focus of the conversation back to the client so that they can further explore their own feelings
A hospice client has just died. Which of these postmortem nursing tasks is most appropriate to delegate to a nursing assistant?
Removing all IV lines or tubes according to the hospice policy
Which method is a common integrative health therapy for benign prostatic hyperplasia (BPH)?
Serenoa repens
When discussing care and treatment of prostate cancer with clients, it is important for the nurse to remember that the most common issue among men who have been diagnosed with prostate cancer is the alteration of which factor?
Sexual function after treatment
A client dying of cancer is receiving high doses of opioids. In addition, which intervention is the most effective for this client?
Short, light massage
A nurse is caring for a school age child who is sitting in a chair. To facilitate effective communication, which of the following actions should the nurse take?
Sit at I level with the child.
In a dying client's hospital room, the nurse overhears family telling the client to "calm down," and observes the client being agitated and making repetitive motions. What action does the nurse take?
Suggests that the family tell the client that things are "all right"
Hormone treatment for prostate cancer works by which action?
Suppression of the growth of the tumor
A hospice client becomes too weak to swallow. What does the nurse do initially to increase the client's comfort?
Teaches the family how to provide oral care
The nurse manager in a long-term care facility is developing a plan for primary and secondary prevention of colorectal cancer. Which tasks associated with the screening plan will be delegated to nursing assistants within the facility
Testing of stool specimens for occult blood
Which statements regarding care of the client receiving radiotherapy in the form of unsealed radioactive isotopes guides the nurses care planning? Select all that apply
The client may have restrictions on who can visit in for how long the clients urine and stool must be handled as radioactive material the nurse must ensure that all personal entering the clients room use appropriate precautions.
A client had an orchiectomy and laparoscopic radical retroperitoneal lymph nodes dissection this morning. Which assessment finding will the nurse report to the primary health care provider?
The client's pain level is a 10 On a 0 to 10 pain scale after pain medication
A nurse is caring for a client who has terminal lung cancer. The nurse observes the clients family assisting with all ADLs. Which of the following rationales for self-care should the nurse communicate to the family?
The client's sense of loss can be lessened through retaining control of some areas of life.
A nurse is counseling a 60-year-old African-American male client about risk factors for lung cancer. Teaching should focus most on what risk factor?
Tobacco use
A nurse is caring for a client who has stage four lung cancer and is three days postoperative following a wedge resection. The client states, "I told myself that I would go through the surgery and quit smoking, if I could just live long enough to attend my child's wedding." Based on the Kubler Ross model, which stage of grief is the client experiencing?
bargaining
A nurse is caring for a family who is experiencing a crisis. Which of the following approaches should the nurse use when working with a family using an open structure for coping with crisis?
conveying a family meeting
A nurse is caring for a client who has a terminal illness. That is expected within 24 hours. The clients family is at the bedside and asked the nurse what to expect at this time. Which of the following findings should the nurse include?
decreased muscle tone
The nurse understands that The patient Who has undergone a transurethral resection of the prostate TURP is at risk for developing which priority concern?
hemorrhage
A nurse is caring for a client who has left sided him a pleasure resulting from a cerebrovascular accident. The client works as a carpenter and is now experiencing a situational role change based on physical limitations. The client is the primary wage earner in the family. Which of the following describes the clients role problem?
role conflict
Which of the following actions should the nurse take when demonstrating empathic presents to a client? Select all that apply
using open pasture establish and maintain eye contact sit facing the client