Med Surg Exam I

A nurse is performing a physical assessment on a client who has systemic lupus erythematosus (SLE). Which of the following finds should the nurse expect?

-A dry, red rash across the bridge of the nose and on the cheeks.

A nurse is assessing a client who has a new skin lesion that has a wavy border. The nurse should document the lesion using which of the following descriptions?

-Serpiginous Seripiginous lesions have wavy borders that resemble a snake

During a routine physical examination, a nurse observes a 1-cm (0.4 in) lesion on a client's chest. The lesion is raised and flesh-colored with pearly white borders. The nurse should recognize that this finding is suggestive of which of the following types of skin cancer?

-Basal Cell Carcinoma A basal cell tumor usually begins as a small, waxy nodule with rolled, translucent, pearly borders. Telangiectatic vessels can also be present. As a basal cell tumor grows, it can undergo central ulceration.

A nurse is caring for a client who is receiving radiation therapy to treat lung cancer. Which of the following actions should the nurse take?

Observe for signs of infection Radiation therapy to sites containing bone marrow (such as the sternum) can lower the WBC count (leukopenia), thus increasing the client's risk for infection. Screening the client for signs of infection is essential at this time.

A nurse is instructing a client how to decrease the nausea associated with chemotherapy and radiation. Which of the following statements indicates an understanding of the teaching?

"I will eat foods that are served at room temperature."

A nurse providing teaching to a client who has breast cancer about the adverse effects of chemotherapy. Which of the following client statements indicates an understanding of the teaching?

"I'll call my doctor if I notice any unusual menstrual bleeding."

A nurse is teaching a client about the risk factors of skin cancer. Which of the following statements indicated the client understands the teaching? A) "Because I'm dark-complected, I won't have to worry about skin cancer". B) "I really need to use sunscreen - even in winter". C) "I used to lie in the sun all the time but now I just go to the tanning bed." D) My father was treated for melanoma, but skin cancer isn't related to genetics."

B) "I really need to use sunscreen - even in winter."

A nurse is admitting a client who is about to undergo surgery for benign prostatic hypertrophy. The client states, "I don't know what I will do if they find I have cancer." Which of the following responses should the nurse make? A) "Why do you think you might have cancer when your diagnosis is a benign condition?" B) "I'm looking at your chart here and I don't see any reason for you to worry about that." C) "I think that's something you need to discuss with your provider." D "I'm hearing that you are concerned that it might turn out you have cancer."

D) I'm hearing that you are concerned that i might turn out that you have cancer." This response illustrates the therapeutic communication techniques of seeking clarification and restating. It demonstrates the nurse's willingness to explore the client's fears and encourages communication.

A nurse is caring for a client with malignant melanoma, What should the nurse expect to see from the lesion?

Purplish in color

A nurse is teaching a client is receiving radiation therapy about skin care. Which of the following instructions should the nurse include?

Walk outside in the early mornings

Leukemia and low Platelet count

-monitor for ecchymoses

A nurse in the preoperative holding area is admitting a woman prior to reduction mammoplasty. What should the nurse include in the care given to this patient? Select all that apply. A) Establishing an IV line B) Verifying the surgical site with the patient C) Taking measures to ensure the patient's comfort D) Applying a grounding device to the patient E) Preparing the medications to be administered in the OR

A, B, C Feedback: In the holding area, the nurse reviews charts, identifies patients, verifies surgical site and marks site per institutional policy, establishes IV lines, administers medications, if prescribed, and takes measures to ensure each patient's comfort. A nurse in the preoperative holding area does not prepare medications to be administered by anyone else. A grounding device is applied in the OR.

A nurse is talking to a client about preventing skin cancer, which statement indicated a need for further teaching?

"Eating a high fiber diet will reduce my risk of developing skin cancer".

What group of men has a high level of risk for prostate cancer?

-African American Men

A nurse is caring for a client scheduled to receive external radiation to the neck for cancer of the larynx. During a pre-treatment exam, the nurse explains to the client that the most likely side effect would be

-Dysphagia Radiation therapy does not hurt while it is being given. But the side effects that people may get from radiation therapy can cause pain or discomfort. Only the area of treatment is affected by the radiation, so dysphagia (trouble swallowing) would be an expected side effect. Other possible side effects include hoarseness, xerostomia (dry mouth), loss of taste, and skin redness

A nurse is preparing a client for a radiation treatment who is postoperative following a mastectomy. The nurse should inform the client to expect which of the following adverse effects from the treatment?

-Fatigue

A nurse is caring for a client who received a diagnosis of systemic scleroderma 5 years ago. The nurse plans to assess the client to document the disease's progression. In addition to skin changes which of the following findings should the nurse expect?

-Finger Contractures

A client's lesion on their chest shows raised and flesh colored with pearly white borders.

basal cell carcinoma

A client with a positive for a mutant BRACA1 gene is at increased risk for what?

developing breast cancer

A nurse is assessing a 3-year-old child who has aortic stenosis. Which of the following findings should the nurse expect (Select all that apply)

-Hypotension -Weak Pulses -Murmur

Teaching early detection of colorectal cancer: american cancer society recommends at 50 years old men and women are at average risk and should get flexible sigmoidoscopy every

5 years

A nurse is caring for a client who is to start chemotherapy for advanced breast cancer. She tells the nurse she is worried about the adverse effects of the treatment. Which of the following responses should the nurse make?

"What is it about the adverse effects that concern you?"

A nurse is assessing a client who is to undergo a left lobectomy to treat lung cancer. The client tells the nurse that she scared and wishes she had never smoked. Which of the following responses should the nurse make?

-"It's okay to feel scared. Let's talk about what you are afraid of." It is the nurse's responsibility to acknowledge the client's statement, to encourage verbalization, and to explore the client's feelings

A nurse is teaching a client about the seven warning signs on cancer. Which of the following signs should the nurse include as manifestations of cancer? (Select all that apply)

-A nonhealing sore -Change in bowel pattern -Changes in moles -Nagging Cough

After radiation treatment, a client reports dryness, redness, and scaling of his skin occurring with the designated radiation treatment markings. The nurse should instruct the client to take which of the following actions?

-Apply hydrating lotions

A nurse is caring for an older adult client who has a terminal illness and is ventilator-dependent. The client is alert and oriented and he wants to discontinue the use of the ventilator. The nurse should be aware that continued treatment against the client's wishes is a violation of which of the following ethical principles?

-Autonomy

Palliative care to client whose partner asks why music therapy is recommended?

-Can help her verbally express her emotions -Works as a distraction and can help alleviate her pain -Can help facilitate movement in some clients who have mobility limitations

A nurse is planning care for a client who is being treated for chemotherapy and radiation for metastatic breast cancer, and who has neutropenia. The nurse should include which of the following restrictions in the client's plan of care?

-Fresh flowers and potted plants in the room

A nurse is caring for a client who has cancer and a new prescription for ondansetron to treat chemotherapy-induced nausea. Which of the following adverse effects should the nurse monitor?

-Headache

A nurse is assessing a client has a long history of smoking and is suspected of having laryngeal cancer. The nurse should anticipate that the client will report that her earliest manifestation was

-Hoarseness Laryngeal cancer, a malignant tumor of the larynx, is most often caused by long exposure to tobacco and alcohol. Hoarseness that does not resolve for several weeks is the earliest manifestation of cancer of the larynx because the tumor impedes the action of the vocal cords during speech. The voice may sound harsh and lower in pitch than normal.

Nervus that changes, has irregular borders, black/brown, elevated 2cm

-Malignant Melanoma

A nurse is caring for a client who is dying of metastatic breast cancer. She has a prescription for an opioid pain medication PRN. The nurse is concerned that administering a dose of pain medication might hasten the client's death. Which of the following ethical principles should the nurse use to support the decision not to administer the medication.

-Nonmaleficence

A nurse is caring for a client who is terminally ill and exhibiting signs of impending death. The client's medical record states that the client is a practicing Roman Catholic. Which of the following nursing actions is appropiate?

-Offer to make arrangements for the Sacrament of the Sicks

A nurse is in a dermatologist's office is planning an educational session about skin cancer. Which of the following should the nurse include as risk factors for skin cancer? (Select all that apply)

-Overexposure to ultraviolet light -Previous skin injury -Genetic Predisposition

a client is 1 day post-op left radical mastectomy what alerts the nurse that the patient is having difficulty adjusting to the loss of her breast?

-Refusing to look at the dressing or surgical incision

A hospice nurse is caring for a client who has terminal cancer and takes PO morphine for pain relief. The client reports that he had to increase the dose of morphine this week to obtain pain relief. Which of the following scenarios should the nurse document as the explanation for this situation.

-The client developed a tolerance to the medication

A nurse is caring for a client who is receiving cisaplatin for treatment of ovarian cancer. The client's most recent CBC is shown in the table below. It is important for the nurse to consider which of the following for the client? WBC 1400/mm3 RBC 4.3 X 10(^12)/L Hgb 12.1 g/dL HCT 36.5% Platelets 170,000/mm3 Albumin 4.5 g/dL

-The client has an increased risk for infection.

A nurse is providing teaching to a client who has a new diagnosis of testicular cancer. Which of the following information should the nurse include in the teaching? (Select all that apply) A) Close male relatives are at an increased risk of developing testicular cancer. B) Testicular cancer occurs between ages 15 and 35 C) Testicular cancers occurs in both testicles equally D)Sperm are no longer viable after diagnosis E) A early manifestation is a painful, scrotal lump

A) Close male relatives are at an increased risk of developing testicular cancer. B) Testicular cancer occurs between ages 15 and 35

A nurse is caring for a client who has metastatic bone cancer. The client states "I want to go home to die." The family is concerned about meeting the client's care needs at home. Which of the following actions should the nurse take? A) Discussing initiating hospice care with the client and family B) Write a referral to place the client in a nursing home C) Talk with the provider about extending the client's hospital stay D) Inform the client's family that they are responsible for providing pallatative care

A) Discussing initiating hospice care with the client and family

A nurse is providing an educational presentation addressing the topic of "protecting your skin". When discussing the anatomy of skin with this group, the nurse should state what cells are responsible for producing the pigmentation of the skin? A) Melanocytes B) Squamous Cells C) Islets of Langerhans D) T Cells

A) Melanocytes

Which diagnostic test would be used if a malignancy is suspected? A) Patch test B) Biopsy C) Skin scraping D) Tzanck Smear

Biopsy

A nurse is reviewing the CBC findings for a female client is receiving combination chemo for breast cancer, what finding should the nurse report?

WBC 2300/mm3

A nurse is reviewing the CBC findings for a female client who is receiving combination chemotherapy for breast cancer. Which of the following findings should the nurse report to the provider?

WBC 2300/mm3

A nurse is teaching a group of middle adult clients about early detecting of colorectal cancer. The nurse should include the American cancer society recommendation that men and women beginning at age 50 who are at average risk should have a fecal occult blood test and a colonoscopy at which of the following intervals?

ten years