module 2 cellular regulation

Exemplar 2.7 Prostate Cancer 1) A nurse is screening a client for prostate cancer. The nurse knows that a client with prostate cancer will exhibit which clinical symptoms? Select all that apply. A) Fatigue B) Upper extremity weakness C) Back pain D) Hematuria E) Scrotal edema

A) Fatigue C) Back pain D) Hematuria

An oncology nurse is treating a client with prostate cancer. The client displays symptoms of an enlarged prostate, including: Select all that apply. A) Hematuria. B) Dysuria. C) Nerve pain. D) Bone pain. E) Bowel or bladder dysfunction.

A) Hematuria. B) Dysuria.

Exemplar 2.1 Cancer The nurse instructs a group of community members on the difference between benign and malignant neoplasms. Which participant statements indicate that teaching has been effective? Select all that apply. A) "Benign tumors grow slowly." B) "Malignant tumors are easy to remove." C) "Benign tumors stay in one area." D) "Malignant tumors push other tissue out of the way." E) "Malignant tumors can grow back."

A) "Benign tumors grow slowly." C) "Benign tumors stay in one area." E) "Malignant tumors can grow back."

The nurse instructs a client recovering from a mastectomy on ways to prevent lymphedema. Which client statement indicates that teaching has been successful? A) "I should do the exercises on my affected arm every day." B) "I have to take no special precautions." C) "I should avoid cleansing my skin with soap." D) "Eating fresh fruits and vegetables will prevent my arm from swelling."

A) "I should do the exercises on my affected arm every day."

Exemplar 2.1 Cancer The nurse has completed a seminar teaching a group in the community about ways to reduce cancer risks. The nurse returns a month later to evaluate the effectiveness of the seminar. Which statements made by members of the group indicate retention and application of the material presented by the nurse to reduce the risk of developing cancer? Select all that apply. A) "I stopped using tanning booths." B) "I began drinking two glasses of red wine a day with dinner." C) "I have reduced my intake of fiber." D) "I have increased the amount of lean red meat in my diet." E) "I now limit my alcohol intake to three drinks per week."

A) "I stopped using tanning booths." E) "I now limit my alcohol intake to three drinks per week."

Exemplar 2.6 Lung Cancer 1) The student nurse is questioning the instructor about the different types of chemotherapeutic agents used to treat cancer. Which statement by the instructor best explains why lung cancers are less sensitive to antineoplastic agents than other types of cancers? A) "Lung cancer cells have a low growth fraction, so they are less sensitive to antineoplastic agents." B) "Lung cancer cells grow in a high-oxygen environment, so they are not very sensitive to antineoplastic agents." C) "Lung cancer cells have been growing for a long time before detection, so they are less sensitive to antineoplastic agents." D) "Lung cancer cells have a very erratic cell cycle, so they are not very sensitive to antineoplastic agents."

A) "Lung cancer cells have a low growth fraction, so they are less sensitive to antineoplastic agents."

A client recovering from surgery to place a permanent colostomy as treatment for colon cancer is concerned that her spouse will no longer find her sexually attractive. Which response by the nurse is the most appropriate? A) "Tell me more about the concerns you are having." B) "Would you like me to speak with your husband for you?" C) "Do not worry about sex right now. It is more important to focus on recovery." D) "I will refer you to a counselor to talk about your concerns."

A) "Tell me more about the concerns you are having."

A nursing instructor is explaining the term hyperplasia to the class. Which statement, made by a nursing student, indicates an understanding of why hyperplasia occurs with myocardial infarction? A) "The cells of the muscle experience hyperplasia with the prolonged need for oxygen." B) "The cells of the heart are metaplastic in response to muscle damage." C) "The cells of the heart muscle have lost fluid." D) "The cells of the heart muscle are responding to metabolic needs."

A) "The cells of the muscle experience hyperplasia with the prolonged need for oxygen."

A nurse is caring for a client with cancer. The nurse teaches the client about which potentially undesirable cellular alterations that can occur during the cell cycle? Select all that apply. A) Hyperplasia B) Differentiation C) Anaplasia D) Dysphagia E) Adaptation

A) Hyperplasia C) Anaplasia

The nurse is planning care for a client scheduled for a prostatectomy. The client's spouse wants to know if the client will have any limitations after the surgery. Which diagnoses should the nurse use to plan this client's care? Select all that apply. A) Constipation B) Pain C) Impaired Urinary Elimination D) Risk for Falls E) Sexual Dysfunction

B) Pain C) Impaired Urinary Elimination E) Sexual Dysfunction

The nurse provides an educational session for community members about the risk factors for colorectal cancer. Which participant statement indicates that teaching has been effective? Select all that apply. A) "There is a genetic link in the development of colorectal cancer." B) "People with other bowel disease are at increased risk for developing this cancer." C) "Eating a diet high in red meat reduces the risk for developing this type of cancer." D) "Eating cereal fiber reduces the risk of developing colorectal cancer." E) "Taking aspirin and a multivitamin each day reduces the risk of colorectal cancer."

A) "There is a genetic link in the development of colorectal cancer." B) "People with other bowel disease are at increased risk for developing this cancer." E) "Taking aspirin and a multivitamin each day reduces the risk of colorectal cancer."

Exemplar 2.3 Breast Cancer The nurse is caring for a client with metastatic breast cancer receiving chemotherapy. Even though the prognosis is poor, the client tells the nurse that the plan is to do everything to survive. How should the nurse respond to this client? A) "You have a great attitude and I am here to support you through education to help you survive." B) "It is important to plan for your death, even though there is a chance you will survive." C) "You should face the reality of the situation. You do not have a good chance of survival." D) "I am going to speak with your family regarding your unrealistic expectations."

A) "You have a great attitude and I am here to support you through education to help you survive."

The nurse is caring for a client who has a continuous bladder irrigation running following a prostatectomy. During the shift, a total of 1500 mL of irrigant is infused. The Foley bag is emptied twice for the shift with totals of 850 mL and 950 mL. What is the client's actual urine output for the shift? A) 300 mL B) 250 mL C) 100 mL D) 950 mL

A) 300 mL

The nurse is caring for a client with colorectal cancer who is post-operative from a transverse colostomy placement. What area of the bowel is involved? A) A B) B C) C D) D E) E

A) A

Exemplar 2.1 Cancer The nurse is preparing a seminar that discusses the risk and incidence of cancer and culture. What information is considered culturally correct when teaching about the risk of developing cancer? Select all that apply. A) African-American men are more likely to develop prostate cancer than men of other ethnic and racial groups. B) Hispanics have an increased risk of cervical, stomach, and liver cancer. C) The incidence and mortality rate of all type of cancers are lowest in the Caucasian population. D) African-Americans are less likely to develop cancer than any other ethnic or racial group in the United States. E) The Asian/Pacific islander population has the lowest mortality rate of any racial or ethnic group.

A) African-American men are more likely to develop prostate cancer than men of other ethnic and racial groups. E) The Asian/Pacific islander population has the lowest mortality rate of any racial or ethnic group.

Exemplar 2.3 Breast Cancer 1) The nurse is reviewing data collected during a health history and physical assessment and determines that a client is at risk for developing breast cancer. What did the nurse most likely assess in this client? Select all that apply. A) Age 60 B) Breastfed both children C) Sister had breast cancer D) Body mass index 22 E) Menopause at age 58

A) Age 60 C) Sister had breast cancer E) Menopause at age 58

The nurse is teaching a class at a local community center about decreasing risk factors for cancer. Which risk factors should the nurse include in the teaching regarding leukemia? Select all that apply. A) Alkylating agents B) Diets low in fat C) Exposure to infectious agents D) Bloom syndrome E) Decreased exercise

A) Alkylating agents C) Exposure to infectious agents E) Decreased exercise

A client is admitted to the Emergency Department in a sickle cell crisis. The nurse assesses the client and documents the following clinical findings: temperature 102°F, O2 saturation of 89%, and complaints of severe abdominal pain. Based on the assessment findings, which intervention is the greatest priority? A) Apply oxygen per nasal cannula at 3 L/minute. B) Assess and document peripheral pulses. C) Administer morphine sulfate 10 mg IM. D) Administer Tylenol 650 mg by mouth.

A) Apply oxygen per nasal cannula at 3 L/minute.

A client with breast cancer is receiving 5-fluorouracil (5-FU). Based on knowledge of this medication and its anticipated adverse effects or side effects, which actions should the nurse perform? Select all that apply. A) Assess CBC results. B) Encourage daily fluid intake of 2-3 liters. C) Monitor ECG. D) Test stool for occult blood. E) Assess lung sounds.

A) Assess CBC results. D) Test stool for occult blood.

Exemplar 2.2 Anemia A nursing student is preparing an educational program on hemolytic anemia for the residents of an assisted-living center. Which extrinsic causes of hemolytic anemia should the student include in the program? Select all that apply. A) Bacterial infection B) Thalassemia C) Ibuprofen use D) Prosthetic heart valves E) Acetaminophen use

A) Bacterial infection C) Ibuprofen use D) Prosthetic heart valves

Exemplar 2.1 Cancer The nurse is providing discharge instructions to a client being treated for cancer. For which symptoms should the client be instructed to call for help at home? Select all that apply. A) Difficulty breathing B) Significant increase in vomiting C) Desire to end life D) Improved sense of well-being E) New onset of bleeding

A) Difficulty breathing B) Significant increase in vomiting C) Desire to end life E) New onset of bleeding

A nurse is planning care for a client with leukemia. The nurse chooses "Risk for Bleeding" as the nursing diagnosis. What interventions support this nursing diagnosis? Select all that apply. A) Educate client in use of soft toothbrush for oral care. B) Use non-electric razor when providing grooming for client. C) Limit parenteral injections. D) Apply pressure to arterial puncture sites for 5 minutes. E) Encourage client to deep breathe and huff cough frequently.

A) Educate client in use of soft toothbrush for oral care. C) Limit parenteral injections.

The nurse is caring for an 18-year-old Asian client with a strong family history of breast cancer. What should the nurse instruct the client regarding cancer prevention? Select all that apply. A) Encourage the client to learn more about the disease. B) Talk to family members who have the disease. C) Perform monthly breast self-examination. D) Teach the side effects of cancer treatment. E) Discuss cancer fears with the healthcare provider.

A) Encourage the client to learn more about the disease. C) Perform monthly breast self-examination.

A pediatric nurse is educating the client with sickle cell disease and the client's family regarding the genetic implications of the disease. The nurse will include all information except: A) If both parents have the trait, then with each pregnancy, the risk of having a child with the disease is 50%. B) The disorder is transmitted as an autosomal recessive genetic defect. C) The sickle cell gene may have originated to protect against lethal forms of malaria. D) In African-Americans, sickle cell disease occurs in 1 out of every 500 births.

A) If both parents have the trait, then with each pregnancy, the risk of having a child with the disease is 50%.

The nurse is planning care to address ineffective airway clearance for a client with lung cancer. Which interventions should the nurse include in the client's plan of care? Select all that apply. A) Increase fluid intake to 3000 mL per day. B) Turn, cough, and deep breathe every 2 hours. C) Chest percussion every 8 hours D) Smoking cessation education E) Administer pneumococcal vaccine.

A) Increase fluid intake to 3000 mL per day. B) Turn, cough, and deep breathe every 2 hours. C) Chest percussion every 8 hours

Exemplar 2.2 Anemia A client with a history of anemia has started a vegan diet. Which addition to meals should the nurse recommend to help ensure that this client has adequate amounts of iron in the diet? Select all that apply. A) Legumes B) Orange juice C) Brewer's yeast D) Okra E) Peas

A) Legumes B) Orange juice E) Peas

Exemplar 2.2 Anemia An older client with renal failure is diagnosed with anemia. What does the nurse realize was the cause of this client's anemia? A) Loss of the kidney hormone erythropoietin B) A loss of appetite related to elevated blood urea nitrogen (BUN) and creatinine levels C) The renal dialysis used to treat the chronic renal failure D) Loss of blood through the urine because the failing kidney does not function properly

A) Loss of the kidney hormone erythropoietin

A nurse is caring for a client recovering from a wedge resection of the left lung for a tumor. What would be appropriate goals for the nursing diagnosis of ineffective airway clearance? Select all that apply. A) Minimize accumulation of fluid. B) Participation in care by the client C) Maintain a patent airway. D) Maintain current weight. E) Express feelings and concerns.

A) Minimize accumulation of fluid. C) Maintain a patent airway.

Exemplar 2.2 Anemia A nurse is providing discharge instructions to a client with iron deficiency who is experiencing glossitis. The nurse includes which statements to provide information to the client? Select all that apply. A) Monitor the condition of the lips and tongue daily. B) Use an alcohol-based mouthwash every 2-4 hours. C) Provide frequent oral hygiene. D) Apply a non-petroleum-based lubricating jelly or ointment to the lips after oral care. E) Use a soft toothbrush or sponge to provide oral care.

A) Monitor the condition of the lips and tongue daily. C) Provide frequent oral hygiene. E) Use a soft toothbrush or sponge to provide oral care.

A nurse is caring for a client with chronic myeloid leukemia (CML) who is neutropenic. To ensure safety for the client, the nurse will: Select all that apply. A) Place client in reverse isolation. B) Place patient in standard precaution isolation. C) Administer granulocyte colony-stimulating factor (G-CSF) as ordered. D) Administer neutrophil colony-stimulating factor (N-CSF) as ordered. E) Administer a prophylactic gram-negative antibiotic.

A) Place client in reverse isolation. C) Administer granulocyte colony-stimulating factor (G-CSF) as ordered.

The nurse is assigned to care for a child with sickle cell disease who is being admitted with splenic sequestration crisis. Which room would be the most appropriate for this child? A) Private room B) Semi-private room C) Contact-isolation room D) Airborne-isolation room

A) Private room

A client with prostate cancer is being discharged from the hospital. The client's nurse will include all education regarding prostate cancer except: A) Provide information on doses of complementary herbs. B) Teach the client and his family noninvasive methods of pain control. C) Stress the importance of keeping client appointments with healthcare providers. D) Provide the client and the client's family information on support groups.

A) Provide information on doses of complementary herbs.

The nurse is planning care for a client with acute myeloid leukemia (AML). Which diagnoses are priorities for this client to minimize the risk of complications associated with AML? Select all that apply. A) Risk for Infection B) Ineffective Thermoregulation C) Imbalanced Nutrition D) Fluid Volume Excess E) Risk for Ineffective Protection (Bleeding)

A) Risk for Infection E) Risk for Ineffective Protection (Bleeding)

Exemplar 2.3 Breast Cancer The nurse is teaching a 34-year-old client with client who has a sister and mother with a history of breast cancer about early screening for the health problem. Which should the nurse include in this teaching? Select all that apply. A) Routine monthly breast self-examination B) Annual screening mammography C) Routine breast exams to begin after age 35 D) Clinical breast examination every 3 years E) Reporting of any changes in breast tissue to the health provider at the next routine visit

A) Routine monthly breast self-examination B) Annual screening mammography D) Clinical breast examination every 3 years

The nurse is reviewing the plan of care for a client being treated with brachytherapy for breast cancer. Which assessment finding indicates that the client's skin integrity has been maintained? A) Skin intact B) Skin dry and excoriated C) Skin stretched D) Skin damp and sweaty

A) Skin intact

The nurse is planning care for a young child who is admitted with sickle cell crisis. The parents are with the child, and neither has much information about the disease. When planning care for this family, the nurse will set which goal with this family? A) The child will drink adequate amounts of fluid each day. B) The child will play outside in the sun. C) The family will not have the child vaccinated. D) The family will plan vacations in high-altitude areas.

A) The child will drink adequate amounts of fluid each day.

The nurse is preparing an educational program on risk factors for the development of prostate cancer. What information will the nurse include as being the greatest risk factor for developing prostate cancer? A) The client's age B) A family history C) A history of a vasectomy D) A diet high in fat

A) The client's age

The nurse is caring for a client who has been diagnosed with cancer. Which diagnostic tests may be helpful to assist with treatment options? Select all that apply. A) Tumor markers B) Urinalysis C) Physical assessment D) MRI E) Stool analysis

A) Tumor markers B) Urinalysis D) MRI

A client in sickle cell crisis reports taking a recent skiing trip that caused a respiratory infection from the cold weather. The client reports a pain level of 8 on a pain scale from 0 to 10. Which nursing diagnosis is a priority for this client? A) Fluid Volume Excess B) Risk for Self-Mutilation C) Knowledge Deficit D) Acute Pain

D) Acute Pain

Exemplar 2.2 Anemia A client experiencing fatigue, pallor, and dyspnea on exertion has a complete blood count drawn. Which red blood cell disorder should the nurse anticipate the client is experiencing? A) Polycythemia B) Erythropoiesis C) Herpes simplex D) Anemia

D) Anemia

A nurse working in the Pediatric Intensive Care Unit (PICU) is caring for a child with leukemia. What is the most common type of leukemia in children? A) Chronic lymphocytic leukemia B) Acute lymphocytic (lymphoblastic) leukemia C) Acute myeloid (myeloblastic) leukemia D) Chronic myeloid (myelogenous) leukemia.

B) Acute lymphocytic (lymphoblastic) leukemia

The nurse is teaching a class to prospective parents about the roles that ribonucleic acid (RNA) and deoxyribonucleic acid (DNA) play in the development of the human fetus. The nurse concludes that the parents understand teaching when what is stated by the parents? Select all that apply. A) "RNA will determine what color eyes my baby has." B) "DNA molecules form the genetic material." C) "RNA is the messenger that carries DNA to the ribosomes." D) "DNA is outside the nucleus of the cell." E) "DNA plays a role in protein synthesis in our bodies."

B) "DNA molecules form the genetic material." C) "RNA is the messenger that carries DNA to the ribosomes."

Exemplar 2.2 Anemia A nurse is providing discharge teaching for a client with iron deficiency anemia. The client has been prescribed ferrous sulfate and has been told to increase the intake of foods that are naturally high in iron. Which client statements indicate a need for further education? Select all that apply. A) "I will take my ferrous sulfate tablet with my morning oatmeal." B) "I will decrease my intake of green leafy vegetables while taking my ferrous sulfate tablet." C) "I will increase my fluid intake while I am taking my ferrous sulfate." D) "I will take my ferrous sulfate tablet on an empty stomach." E) "I will decrease milk intake while taking my ferrous sulfate tablet."

B) "I will decrease my intake of green leafy vegetables while taking my ferrous sulfate tablet." D) "I will take my ferrous sulfate tablet on an empty stomach." E) "I will decrease milk intake while taking my ferrous sulfate tablet."

The nurse is teaching a client scheduled for a colonoscopy on pre- and post-procedure care. Which statement by the client indicates the need for further teaching? A) "I will likely have medications that will make me drowsy during the test." B) "It might be quite painful." C) "The physician might take tissue samples for further analysis." D) "The procedure will only take about 1 hour."

B) "It might be quite painful."

The nurse instructs a group of community members about ways to reduce the development of cancer. Which participant statements indicate that teaching has been effective? Select all that apply. A) "I should eat at least 2 servings of fruits or vegetables each day." B) "Sunscreen should be applied before spending time outdoors." C) "I need to cut down on my smoking." D) "I need to get my home tested for radon." E) "I need to keep my children away from smokers."

B) "Sunscreen should be applied before spending time outdoors." D) "I need to get my home tested for radon." E) "I need to keep my children away from smokers."

A client prescribed tamoxifen (Nolvadex) for breast cancer treatment asks the nurse how the medication works. What is the best response by the nurse? A) "Tamoxifen works by inhibiting the cellular mitosis of breast cancer." B) "Tamoxifen works by blocking estrogen receptors on breast tissue." C) "Tamoxifen works by binding to the DNA of breast cancer cells." D) "Tamoxifen works by inhibiting the metabolism of breast cancer cells."

B) "Tamoxifen works by blocking estrogen receptors on breast tissue."

The nurse is caring for a school-aged child who had a bone marrow transplant for the treatment of leukemia several weeks ago. The child requires protective isolation. Which statement by the child's family indicates understanding of this type of isolation? A) "We will encourage oral hygiene twice a day. B) "We will encourage meticulous hand washing among all people in contact with our child." C) "You will have to administer all medications by IM injection." D) "It will be important to restrict all visitors."

B) "We will encourage meticulous hand washing among all people in contact with our child."

Exemplar 2.2 Anemia The home healthcare nurse is preparing a care plan for a client with severe anemia. The client currently lives alone and states, "I can't even walk to the kitchen without getting winded." What would be the priority nursing diagnosis for this client? A) Hopelessness B) Activity Intolerance C) Altered Nutrition, Less than Body Requirements D) Anxiety

B) Activity Intolerance

Exemplar 2.5 Leukemia 1) A pediatric client is receiving chemotherapy for acute lymphocytic leukemia. The nurse recognizes that a potential oncological emergency for this client would be tumor lysis syndrome. For which manifestations should the nurse monitor this client? Select all that apply. A) Thrombocytopenia B) Altered levels of consciousness C) Respiratory distress D) Oliguria E) Upper-extremity edema

B) Altered levels of consciousness D) Oliguria

A nurse educator is teaching a group of parents how to prevent a sickle cell crisis in the child with sickle cell disease. What should the nurse instruct about the precipitating factors that could contribute to a sickle cell crisis? Select all that apply. A) Increased fluid intake B) Altitude C) Fever D) Vomiting E) Regular exercise

B) Altitude C) Fever D) Vomiting

The nurse is preparing care for a client recovering from surgery for colorectal cancer. Which interventions should the nurse use when creating a pain management plan for this client? Select all that apply. A) Provide pain medication upon request. B) Assess surgical site for inflammation. C) Assess bowel sounds. D) Administer pain medication after painful procedures. E) Instruct to use a pillow to splint when deep breathing and coughing.

B) Assess surgical site for inflammation. C) Assess bowel sounds. E) Instruct to use a pillow to splint when deep breathing and coughing.

The nurse is caring for a client with leukemia. Which treatment should the nurse expect to be prescribed for this client? A) Diuretic therapy B) Chemotherapy C) Electrolyte replacement therapy D) IV fluid therapy

B) Chemotherapy

The nurse is evaluating care provided to a client recovering from surgery for colorectal cancer. Which outcomes indicate that care has been successful? Select all that apply. A) Client reports pain level as an 8 on a rating scale of 0-10. B) Client has an hourly urine output of 45 mL. C) Client performs morning care with assistance. D) Client states family members will care for the ostomy at home. E) Client tolerates full liquid diet and is requesting solid food.

B) Client has an hourly urine output of 45 mL. C) Client performs morning care with assistance. E) Client tolerates full liquid diet and is requesting solid food.

The nurse is providing care to a client who has received multiple transfusions of packed red blood cells for treatment of sickle cell disease. Recent lab values for this client indicate high levels of iron. Which medication should the nurse expect to administer to the client experiencing an overload of iron? A) Acetaminophen B) Deferoxamine C) Morphine sulfate D) Tamoxifen

B) Deferoxamine

A client receiving radiation therapy as treatment for colorectal cancer is experiencing nausea and vomiting. What should the nurse encourage the client to do? A) Avoid all food and liquid until nausea and vomiting stop. B) Delay the intake of a meal until 3-4 hours after treatment. C) Eat spicy or well-seasoned foods instead of bland foods. D) Use a commercial mouthwash before eating a meal.

B) Delay the intake of a meal until 3-4 hours after treatment.

A nurse is caring for a client who has had a double-barrel colostomy. The nurse understands that the proximal stoma: Select all that apply. A) Is also called the mucus fistula. B) Diverts feces to the abdominal wall. C) Expels mucus from the distal colon. D) Is a functional stoma. E) Expels mucus from the proximal colon.

B) Diverts feces to the abdominal wall. D) Is a functional stoma.

Exemplar 2.1 Cancer The nurse is caring for a thin, older client who was diagnosed with cancer and is receiving aggressive chemotherapy. The client is experiencing severe side effects from the therapy and has lost 10 pounds in the past week. What should the nurse teach the client to do? Select all that apply. A) Purchase fast foods and prepared foods. B) Eat cold foods rather than hot foods, because they are better tolerated. C) Keep a food diary and record intake. D) Eat large frequent meals high in calories. E) Drink liquid supplements to increase intake of nutrients.

B) Eat cold foods rather than hot foods, because they are better tolerated. C) Keep a food diary and record intake. E) Drink liquid supplements to increase intake of nutrients.

A nurse is caring for a client who has been diagnosed with skin cancer. Which nursing interventions will reduce the growth of cancer cells and support normal cell function? Select all that apply. A) Encouraging mobility and exercise B) Encouraging increased rest and sleep C) Assessing normal functioning of organ systems D) Reducing oxygen supply to retard growth of cancer cells E) Increasing calorie intake

B) Encouraging increased rest and sleep C) Assessing normal functioning of organ systems E) Increasing calorie intake

A nursing instructor is teaching student nurses about methods of cellular transport. When instructing on passive transportation, which information will the nurse include in the teaching plan? A) Endocytosis B) Facilitated diffusion C) Exocytosis D) Phagocytosis

B) Facilitated diffusion B) Passive cellular transportation does not require energy and includes facilitated diffusion, diffusion, osmosis, and filtration. Active cellular transportation requires energy and includes active transport pumps, endocytosis, phagocytosis, pinocytosis, and exocytosis.

The nurse is caring for a client with sickle cell anemia. The nurse teaches the client that the inherited alteration of which type of hemoglobin causes the abnormal shape to the red blood cell? A) Hgb A B) Hgb S C) Hgb B D) Hgb E

B) Hgb S B) The inherited alteration of Hgb S causes the abnormal sickle-shaped red blood cell in sickle cell anemia.

A client with anemia is prescribed synthetic erythropoietin. What should the nurse expect the therapeutic effect of this treatment to be? A) Increase in platelets B) Increase in red blood cells C) Decrease in white blood cells D) Decrease in lymph fluid

B) Increase in red blood cells

Exemplar 2.2 Anemia The nurse is caring for an older client with hemolytic anemia. What should the nurse recall about this diagnosis? Select all that apply. A) It causes the red blood cells to be microcytic. B) It is associated with an increase in the reticulocyte count. C) It is the result of blood loss. D) It is a result of the premature destruction of red blood cells. E) It always requires treatment with folic acid.

B) It is associated with an increase in the reticulocyte count. D) It is a result of the premature destruction of red blood cells. E) It always requires treatment with folic acid.

A 51-year-old client reports to the nurse an inability to tolerate usual exercise and the feeling of fatigue. The client states that these symptoms have been gradual over time. Which physical assessment findings, along with the client's verbal complaints, would indicate chronic lymphocytic leukemia (CML)? Select all that apply. A) Joint pain B) Pallor C) Splenomegaly D) Abnormal bleeding E) Edema

B) Pallor C) Splenomegaly E) Edema

Exemplar 2.1 Cancer The nurse accompanies the physician into the client's room and listens as the diagnosis of cancer is shared with the client and family. Once the physician leaves the room, the nurse notes that the client and family are teary-eyed regarding the diagnosis. What is the nurse's most appropriate intervention at this time? A) Arrange for the client to complete a medical power of attorney form. B) Provide emotional support in coping with the diagnosis. C) Provide teaching about the treatment options for this form of cancer. D) Help the client and family remain realistic about prognosis.

B) Provide emotional support in coping with the diagnosis.

The nurse is caring for a client with leukemia who is experiencing neutropenia as a result of chemotherapy. Which action should the nurse include in the plan of care for this client? A) Replace hand hygiene with gloves. B) Restrict visitors with communicable illnesses. C) Restrict fluid intake. D) Insert an indwelling urinary catheter to prevent skin breakdown.

B) Restrict visitors with communicable illnesses.

Exemplar 2.1 Cancer During a treatment meeting on an oncology unit, the nurse learns that a client is scheduled for chemotherapy before and after surgery. What are the purposes for this client to receive chemotherapy at these specific times? Select all that apply. A) Eradicate all cancer cells. B) Shrink the tumor. C) Kill remaining cancer cells. D) Allow the immune system to kill cancer cells. E) Improve wound healing.

B) Shrink the tumor. C) Kill remaining cancer cells.

While completing a physical examination, the nurse suspects a client has breast cancer. What did the nurse assess in this client? Select all that apply. A) Rash along the inside of the right arm B) Skin retraction near the left nipple C) Palpable lump in the right axillae D) Flaking skin over the right nipple E) Pain when extending the left arm

B) Skin retraction near the left nipple C) Palpable lump in the right axillae D) Flaking skin over the right nipple

An Emergency Department nurse is caring for a child in a sickle cell crisis. The nurse suspects the etiology of the crisis as being thrombotic in nature due to which clinical manifestations? Select all that apply. A) The client has profound pallor and fatigue. B) The client is in extreme pain. C) The client has profound hypotension and shock. D) The client has a fever. E) The client's chest CT reveals a pulmonary infarct.

B) The client is in extreme pain. D) The client has a fever.

A pediatric nurse is caring for a child with acute lymphoblastic leukemia (ALL). When providing education to the child's parents regarding this disease, the nurse should include: Select all that apply. A) ALL is characterized by abnormal proliferation of all bone marrow elements. B) This form of leukemia is the most common type among children and adolescents. C) Most cases of ALL result from the malignant transformation of B cells. D) This form of leukemia is very rarely seen in children. E) The onset of ALL is usually gradual.

B) This form of leukemia is the most common type among children and adolescents. C) Most cases of ALL result from the malignant transformation of B cells.

Exemplar 2.2 Anemia A client complaining of mouth soreness had gastric bypass surgery 1 year ago. During the assessment, the nurse notes the client's tongue is beefy, red, and smooth and the client's skin appears yellowish. Which additional information is most likely needed before diagnosing this client? A) Vitamin B6 levels B) Vitamin B12 levels C) Potassium levels D) Iron levels

B) Vitamin B12 levels

A nursing instructor is teaching a group of student nurses about the cultural implications of prostate cancer. Which statement will the nursing instructor include? A) "African-American men are at lowest risk for prostate cancer." B) "Asian- and Native American men have the highest risk for developing prostate cancer." C) "Approximately one in eight men ages 70 and older will be diagnosed with prostate cancer." D) "A diet low in dairy increases a man's risk for developing prostate cancer."

C) "Approximately one in eight men ages 70 and older will be diagnosed with prostate cancer."

Exemplar 2.8 Sickle Cell Disease 1) Parents of a newborn infant are concerned that their baby may have sickle cell disease. The nurse reviews the medical record and finds that both parents have the sickle cell trait. Which is the best response for the nurse to give the parents? A) "Since neither of you actually has sickle cell disease, your baby is not at risk." B) "Your baby has the disease, as you both carry the trait." C) "As you both have the sickle cell trait, your baby will be tested for the disease." D) "Have you talked to a genetic counselor about your concerns?"

C) "As you both have the sickle cell trait, your baby will be tested for the disease."

The nurse is preparing to perform a health assessment on a 32-year-old client who has a family history of cancer. Which questions should the nurse ask the client to assess for the early warning signs of cancer? Select all that apply. A) "Do you have a cough that is associated with seasonal allergies?" B) "Have you noticed a change in your appetite?" C) "Have you noticed any cuts that have not healed?" D) "Have you had any changes in bowel or bladder habits?" E) "Have you experienced any problems swallowing?"

C) "Have you noticed any cuts that have not healed?" D) "Have you had any changes in bowel or bladder habits?" E) "Have you experienced any problems swallowing?"

Exemplar 2.2 Anemia The nurse is evaluating a client's understanding of dietary needs to treat dietary deficiency anemia. Which client statement indicates a need for additional teaching? A) "I will eat more fruits and vegetables, especially green leafy ones, to get more iron in my diet." B) "I will need to include more protein foods in my diet such as meats, dried beans, and whole-grain breads." C) "I will decrease foods high in vitamin C, as they decrease my absorption of iron." D) "I will take vitamins with extra iron in addition to eating a balanced diet with meat to correct my anemia."

C) "I will decrease foods high in vitamin C, as they decrease my absorption of iron."

The nurse is caring for a client who is undergoing diagnostic tests to rule out lung cancer. The client asks the nurse why a computed tomography (CT) scan was ordered. What is the best response by the nurse? A) "The doctor prefers this test." B) "To rule out the possibility that your problems are caused by pneumonia." C) "It is more specific in diagnosing your condition." D) "Why are you concerned about this test?"

C) "It is more specific in diagnosing your condition."

The nursing is preparing to discharge a client recovering from prostate surgery for cancer. What should the nurse emphasize when teaching this client? A) "You may drive yourself home." B) "Avoid strenuous activity and heavy lifting for 2 weeks." C) "It is quite common to notice blood in your urine following this type of surgery." D) "Reduce your fluid intake so you won't need to void as often."

C) "It is quite common to notice blood in your urine following this type of surgery."

Exemplar 2.3 Breast Cancer A client recovering from a hysterectomy does not want to take the prescribed estrogen replacement therapy because of the fear of developing breast cancer. What should the nurse respond to this client? A) "The risk of breast cancer is slightly increased for women who opt to take estrogen replacement therapy." B) "Perhaps you should consider an estrogen-progestin combination therapy." C) "The risk of breast cancer is not increased for women who have had a hysterectomy and take estrogen replacement medications." D) "Taking estrogen replacement is required after a hysterectomy."

C) "The risk of breast cancer is not increased for women who have had a hysterectomy and take estrogen replacement medications."

A child from a culture other than the nurse's has recently been diagnosed with leukemia. The client's sibling is 6 years old and expressing feelings of anger and guilt. This reaction by the sibling is very upsetting to the parents. How should the nurse explain the sibling's behavior? A) "This behavior is abnormal. I will have the physician refer you to a psychologist." B) "This behavior is just the sibling's way to get attention." C) "This is a normal response. Your other child is also affected by the diagnosis and anger and guilt are expected feelings for a 6-year-old." D) "Your other child should not be so upset. The cancer is easily treated."

C) "This is a normal response. Your other child is also affected by the diagnosis and anger and guilt are expected feelings for a 6-year-old."

A 6-year-old male child is being admitted with newly diagnosed acute lymphocytic leukemia. The multidisciplinary team is meeting to plan care for this child and family. Which statement by the parents should receive priority in the nursing planning process? A) "His brother is upset about the amount of time we are away from home." B) "Can we plan a trip out of town sometime this summer?" C) "We are afraid that he will dislodge his central line at school." D) "How do we get our parking validated?"

C) "We are afraid that he will dislodge his central line at school."

A client is scheduled to undergo a prostate biopsy. The client has asked the nurse what he can expect immediately following the procedure. The nurse responds to the client by stating: A) "You will need to avoid strenuous activity for 24 hours." B) "Your sexual partners will need to be notified." C) "You will likely experience discomfort for 24-48 hours after the procedure." D) "You will not have any restrictions following the biopsy."

C) "You will likely experience discomfort for 24-48 hours after the procedure."

The nurse is caring for a client in a community clinic who wishes to quit smoking. The client asks the nurse, "If I quit smoking, will my risk of lung cancer be the same as a nonsmoker?" Which is the best response by the nurse? A) "No one knows for sure what the risk is for someone who quits smoking." B) "Your risk of lung cancer will be equal to that of a non-smoker." C) "Your risk of lung cancer will decline if you quit, but it will remain higher than a non-smoker's." D) "Your risk of lung cancer will never drop because the damage has already been done."

C) "Your risk of lung cancer will decline if you quit, but it will remain higher than a non-smoker's."

Exemplar 2.1 Cancer A client being treated with chemotherapy for cancer complains of fatigue, pallor, progressive weakness, exertional dyspnea, headache, and tachycardia. Which diagnosis should the nurse use as the priority when planning this client's care? A) Powerlessness B) Imbalanced Nutrition, Less than Body Requirements C) Activity Intolerance D) Ineffective Coping

C) Activity Intolerance

A client has just been told that a colectomy and ileostomy are needed to treat a new diagnosis of colon cancer. Which diagnosis should the nurse use to plan this client's preoperative nursing care? A) Knowledge Deficit B) Risk for Disuse Syndrome C) Risk for Perioperative-Positioning Injury D) Anticipatory Grieving

D) Anticipatory Grieving

Exemplar 2.4 Colorectal Cancer The nurse is speaking with a client who wants information regarding colorectal cancer. Which statement indicates the client understood the information presented by the nurse? A) The risk of colorectal cancer decreases with age. B) Colorectal cancer can be detected in early stages by measuring the level of the carcinogenic embryonic antigen (CEA). C) Colorectal cancer occurs more frequently in clients who have a history of ulcerative colitis. D) Colorectal cancer has no symptoms in the early stage and there are no definitive diagnostic tests.

C) Colorectal cancer occurs more frequently in clients who have a history of ulcerative colitis.

Exemplar 2.2 Anemia A nurse is educating a client with anemia about the pathophysiological mechanisms of anemia. The nurse's teaching should include all except: A) Altered hemoglobin synthesis. B) Altered DNA synthesis. C) Decreased hemolysis. D) Bone marrow failure.

C) Decreased hemolysis.

Exemplar 2.3 Breast Cancer The nurse is instructing a group of women between the ages of 40 and 50 about early detection of breast cancer. What should the nurse include in this teaching? A) Perform monthly breast self-exams. B) See a healthcare provider if there is a strong family history of breast cancer. C) Have a yearly mammogram. D) Have a clinical breast exam performed by a healthcare provider every 5 years.

C) Have a yearly mammogram.

Exemplar 2.2 Anemia The nurse suspects that a client with severe shortness of breath in the absence of cyanosis is experiencing anemia. Which laboratory tests should the nurse review to confirm anemia? Select all that apply. A) Serum electrolytes B) Cardiac enzymes C) Hemoglobin D) Blood sugar E) Hematocrit

C) Hemoglobin E) Hematocrit

The nurse is assisting the physician with a bone marrow aspiration and biopsy on a client who has leukemia. The client also has thrombocytopenia. When the physician has completed this test, which intervention is a priority for the nurse? A) Dispose of the equipment used, and clean the area properly. B) Label and refrigerate the specimen obtained by the physician. C) Hold pressure on the wound for approximately 5 minutes. D) Make certain the client understands the purpose of the test.

C) Hold pressure on the wound for approximately 5 minutes.

A client with terminal colon cancer is refusing all food and fluids. The client has a living will that states no artificial nutrition is to be provided; however, the family is asking for a gastrostomy tube. What should the nurse do? A) Take the case to the hospital's ethics committee. B) Talk to the physician so he or she can move forward with the family's wishes. C) Honor the client's refusal and help the family come to terms with the situation. D) Honor the family's wishes and have them sign a consent form.

C) Honor the client's refusal and help the family come to terms with the situation.

A male Hispanic client has had a lung biopsy. The results indicate a poor prognosis for the client. The family is at the client's bedside and begins to moan and cry loudly. The doctor has told the nurse that he needs to have the consent form signed for surgery. The client has asked the nurse to allow the family private time. What should the nurse do at this time? A) Ask the family to come back later. B) Have the doctor get the consent with the family present. C) Provide the client and family privacy. D) Take the client to another room.

C) Provide the client and family privacy.

Exemplar 2.3 Breast Cancer During an assessment, the nurse notes that a client receiving radiation treatments for breast cancer has excoriated skin. What is the priority nursing diagnosis for this client? A) Excess Fluid Volume B) Ineffective Breathing Pattern C) Risk for Infection D) Activity Intolerance

C) Risk for Infection

A pediatric client being treated for acute lymphocytic leukemia (ALL) has a white blood cell count of 1,000/mm3. Which nursing diagnosis would be a priority for this client? A) Readiness for Enhanced Immunization Status B) Impaired Gas Exchange C) Risk for Infection D) Activity Intolerance

C) Risk for Infection C) In leukemia, the WBCs that are present are immature and incapable of fighting infection. The client with a WBC count of 500-1,000/mm3 is considered a moderate risk for infection. The client may or may not have activity intolerance, but it is not the priority nursing diagnosis. Impaired gas exchange is not evident in this client. Children with cancer would not be receiving immunizations during treatment.

Exemplar 2.1 Cancer A client being treated for cancer has a tumor designation of Stage IV, T4, N3, M1. What does this staging indicate to the nurse? A) The tumor will respond to chemotherapy. B) The tumor is small in size. C) The tumor has metastasized with lymph node involvement. D) There is one single tumor to treat.

C) The tumor has metastasized with lymph node involvement.

Exemplar 2.1 Cancer A preschool-age child is being seen in a pediatric oncology clinic. The nurse assigned to care for the client anticipates a diagnosis of cancer. Which reaction is considered common for the preschool-age child to experience with illnesses and hospitalizations? Select all that apply. A) Unawareness of the illness and its severity B) Understanding of what cancer is and how it is treated C) Thoughts that they caused their illness and are being punished D) Confusion as to why a parent is unable to make the illness go away E) Acceptance, especially if able to discuss the disease with children their own age

C) Thoughts that they caused their illness and are being punished D) Confusion as to why a parent is unable to make the illness go away

The nurse is caring for a client who returns to the unit following transurethral resection of the prostate due to prostate cancer with a three-way Foley catheter in place. The client states that he has the urge to urinate and wants the catheter removed. The nurse knows that this feeling is caused by spasms. What should the nurse respond to the client? A) "This must be a complication, because the Foley catheter is supposed to evacuate clots that cause the sensation you are describing." B) "The spasm is an unexpected finding because the procedure does not invade the urethra." C) "The sensation is caused by the silicone used in the catheter. I will speak to the doctor about switching to a different catheter." D) "This is an expected sensation, but the Foley catheter must remain in place."

D) "This is an expected sensation, but the Foley catheter must remain in place."

The nurse is caring for an 86-year-old client who is very thin and emaciated. The client reports new onset of shortness of breath. A chest x-ray reveals a spot on the lungs that the physician believes is an inoperable lung cancer. Due to the client's poor nutritional status, chemotherapy is not an option. The physician also believes that the location of the cancer would make radiation therapy unsuccessful. In advocating for this client, what should the nurse encourage the healthcare team to do? A) Provide palliative care to keep the client comfortable without diagnostic testing. B) Perform any procedure necessary to diagnose the client properly. C) Promote the use of blood tests to diagnose the suspected cancer. D) Determine the client's and family's wishes regarding diagnostic testing.

D) Determine the client's and family's wishes regarding diagnostic testing.

The nurse is caring for a client who has just been diagnosed with chronic myeloid leukemia (CML). The client and the nurse are discussing the anticipatory grieving process. Which action by the nurse would be inappropriate at this time? A) Make referrals for support or bereavement groups. B) Identify family stress management strategies. C) Encourage the client to see an attorney now to get affairs "in order" before it is too late. D) Encourage the client to share feelings and discuss grieving.

D) Encourage the client to share feelings and discuss grieving.

The nurse is caring for a client who was admitted to a medical-surgical unit in a sickle cell crisis. Which medication should the nurse expect to administer to this client? A) Acetaminophen (Tylenol) B) Ibuprofen (Advil) C) Meperidine (Demerol) D) Hydroxyurea

D) Hydroxyurea

While receiving discharge teaching, a 60-year-old client recovering from a prostatectomy is distressed to learn that episodes of incontinence may occur. What should the nurse teach the client to help minimize incontinence? A) Proper administration of incontinence medication B) Steps to change the Foley catheter bag every day C) Fluid restriction D) Kegel exercises

D) Kegel exercises

Exemplar 2.2 Anemia The nurse is instructing a client with iron deficiency anemia about appropriate menu choices. Which diet choice indicates that teaching has been effective? A) Tofu with mixed vegetables in curry, milk, whole-wheat bun B) Broiled fish, lettuce salad, grapefruit half, carrot sticks C) Pork chop, mashed potatoes and gravy, cauliflower, tea D) Roast beef, steamed spinach, tomato soup, orange juice

D) Roast beef, steamed spinach, tomato soup, orange juice