Test Taking
The nurse is providing care to a patient with a family history of breast cancer. Which assessment question to determine the patient's genetic risk is most appropriate? Multiple choice question "Do you conduct self-breast examinations?" "Do you know your breast cancer gene (BRAC) status?" "Have you ever had a suspicious mammogram of your breast?" "Have you ever noted dimpling when conducting a breast exam?"
"Do you know your breast cancer gene (BRAC) status?" Genetic markers for breast cancer (BRAC 1 and BRAC 2) indicate whether a patient has a genetic predisposition to breast cancer; therefore, this question is most appropriate for determining the patient's genetic risk for breast cancer. Although asking about self-breast examinations, previous mammogram results and dimpling are appropriate assessment questions, these queries will not determine the patent's genetic risk for breast cancer.
A patient has been advised to undergo an autologous bone marrow transplant. A nurse explains the procedure to the patient. Which patient statement indicates that the teaching has been understood? Multiple choice question "It involves transfusing stem cells from an identical twin." "It involves transfusing stem cells from a family member." "It involves transfusing stem cells harvested from myself." "It involves transfusing stem cells from a donor from a bone marrow registry."
"It involves transfusing stem cells harvested from myself." Bone marrow transplants are very effective in treating malignancies of the bone marrow. There are three types of bone marrow transplantation. An autologous stem cell transplant requires harvesting the stem cells from the patient and transfusing it back to the patient after myeloablative therapy. Syngeneic transplantation involves obtaining stem cells from one identical twin and infusing them into the other. An allogeneic transplantation involves obtaining stem cells from a donor who is human leukocyte antigen (HLA) matched to the patient. It can be a family member or a donor from a bone marrow registry.
A patient experiences anemia secondary to acute blood loss following trauma. The patient asks the nurse about treatment that will be needed following discharge. How should the nurse respond? Multiple choice question "You will need to take an iron supplement for the rest of your life to make sure the anemia does not return." "You will need to make dietary changes to help support the production of red blood cells for the next one to two years." "It would be best to take several supplements to prevent the anemia from recurring, including folic acid, niacin, and riboflavin." "Once the blood loss is controlled and blood volume is replaced, the anemia generally corrects itself, so no long-term treatment is needed."
"Once the blood loss is controlled and blood volume is replaced, the anemia generally corrects itself, so no long-term treatment is needed." Anemia caused by acute blood loss generally resolves itself once the source of the bleeding is identified and controlled and blood/fluid volume is replaced. It is incorrect to tell the patient he or she will need supplements for the rest of his or her life, that several supplements are necessary to prevent recurrence, or that dietary changes will be necessary for the next year or two.
During the admission assessment, the nurse discovers that the patient has used illicit drugs. Related to the hematologic system, what question should the nurse next ask the patient? Multiple choice question "Do you have any blood in your stools?" "What agent and when did you last use it?" "Have you had any surgeries causing pain?" "Do you have shortness of breath with activity?"
"What agent and when did you last use it?" Although asking about blood in the stools, painful surgeries, or shortness of breath with activity are appropriate questions related to the hematologic system, the only one related specifically to illicit drug use is asking about what agent and when it was last used. The route and frequency also should be assessed.
The nurse is assigned to care for a patient with osteosarcoma of the right leg. The unlicensed assistive personnel (UAP) reports that the patient's vital signs are normal, but the patient says there is still pain in the leg and it is getting worse. What assessment question should the nurse ask the patient to determine treatment measures for this patient's pain? Multiple choice question "Where is the pain?" "Is the pain getting worse?" "What does the pain feel like?" "Do you use medications to relieve the pain?"
"What does the pain feel like?" The UAP told the nurse the location of the patient's pain and the worsening of pain (pattern). Asking about quality of the pain will help in planning further treatment. The nurse should already know if the patient is using medication to relieve the pain or can check the patient's medication administration record to see if analgesics have been administered. The intensity of pain using a pain scale also should be assessed.
The nurse is assessing laboratory reports that include the red blood cell indices of four patients in a clinical care setting. Which patient's red blood cell indices reflect microcytosis? 1) MCH 27 pg, MCV 85 fL 2) MCH 30 pg, MCV 80 fL 3) MCH 30 pg, MCV 80fL 4) MCH 40 pg, MCV 105 fL
3) MCH 30 pg, MCV 80fL The normal value for MCV is 80 to 100 fL and the normal value for MCH is 27 to 34 pg. Microcytosis is a condition in which red blood cells are unusually small. Low MCV or low MCH values indicate microcytosis or hypochromia. Therefore the red blood cell indices of patient 3 with an MCH value of 25 pg and MCV value of 76 fL indicate microcytosis. Patient 1 has an MCH of 27 pg and MCV of 85 fL, which are within the normal range and do not indicate microcytosis. Patient 2 has an MCH of 30 pg and MCV of 80 fL, which are within the normal range. Patient 4 has an MCH of 40 pg and MCV of 105 fL, higher than the normal range. Therefore this indicates macrocytosis.
A patient is scheduled for pelvic radiation therapy. The patient asks why the instructions state to go for radiation therapy with a full bladder. What explanation should the nurse give? Multiple choice question A full bladder indicates adequate fluid intake. A full bladder improves effectiveness of the treatment. A full bladder moves the bowels out of the treatment field. A full bladder prevents harmful effects of radiation therapy on the bladder.
A full bladder moves the bowels out of the treatment field. Radiation therapy may compromise the gastrointestinal function, leading to diarrhea. The small bowel is highly sensitive to radiation therapy and may not tolerate significant doses. A full bladder helps to move the bowels out of the treatment field and minimizes the radiation effects on it. An adequate urine output indicates an adequate fluid intake. A full bladder does not improve the effectiveness of the therapy and does not prevent harmful effects of radiation therapy on the bladder.
A patient with multiple myeloma presents with sudden onset of depression, fatigue, muscle weakness, polyuria, nocturia, and vomiting. The serum calcium level is in excess of 12 mg/dL. The nurse recognizes that which treatments could be helpful for the patient? Select all that apply. Multiple selection question Adequate hydration Administration of mesna Administration of allopurinol Administration of demeclocycline Infusion of bisphosphonate zoledronate
Adequate hydration Infusion of bisphosphonate zoledronate The clinical features of depression, fatigue, muscle weakness, polyuria, nocturia, and vomiting in a patient suffering from multiple myeloma are suggestive of hypercalcemia. Interventions for this condition involve adequate hydration and using bisphosphonate zoledronate to prevent formation of calcium stones in the kidney. Mesna is used for the treatment of hemorrhagic cystitis. Allopurinol is useful for managing tumor lysis syndrome and not hypercalcemia. Demeclocycline is used for treating syndrome of inappropriate antidiuretic hormone.
The nurse expects to observe which manifestations in a patient who experienced an acute blood loss of 2000 mL? Select all that apply. Multiple selection question Air hunger Clammy skin Lactic acidosis Vasovagal syncope Decreased central venous pressure
Air hunger Clammy skin Decreased central venous pressure Air hunger, clammy skin, and a decreased central venous pressure are the clinical manifestations seen in a patient who has sustained 2000 mL of acute blood loss. Lactic acidosis may occur in cases of 2500 mL of acute blood loss. Rare vasovagal syncope may occur if 500 mL of acute blood loss occurs.
A patient with anemia experiences fatigue when performing activities of daily living. Which nursing intervention is appropriate to include in the patient's plan of care? Multiple choice question Encourage frequent visitors. Assist the patient in prioritizing activities. Assist the patient in walking immediately after meals. Ensure that all physical activities are completed in the morning.
Assist the patient in prioritizing activities. The nurse should teach and assist the patient and caregiver to assign priority to activities to accommodate energy levels and promote tolerance for important activities. The patient should be asked to avoid activity immediately after meals to reduce competition for oxygen supply to vital functions. Activities should be alternated with rest periods throughout the day rather than completed in the morning. The caregiver should limit the number of visitors so that the patient receives adequate rest.
A nurse is caring for a patient with a benign breast tumor. What are the characteristics that differentiate a benign tumor from a malignant tumor? Select all that apply. Multiple selection question Benign tumors are metastatic. Benign tumors are encapsulated. Benign tumors are well differentiated. Benign tumors have a low rate of recurrence. Benign tumors infiltrate the neighboring areas.
Benign tumors are encapsulated. Benign tumors are well differentiated. Benign tumors have a low rate of recurrence. Benign tumors of the breast are encapsulated and have a well-defined border. They have well-differentiated cells. Once treated, benign tumors have a low rate of recurrence. Unlike malignant tumors, benign tumors are not metastatic and do not infiltrate the neighboring areas.
The nurse is conducting a community seminar regarding cancer prevention and detection. Which diagnostic tool should the nurse include as one that decreases cancer mortality rate through early detection? Multiple choice question Colonoscopy Polyp excision Fecal occult blood test Culture and sensitivity test
Colonoscopy A colonoscopy is a diagnostic tool that increases early detection and decreases the mortality rate for colon cancer. Polyp excisions are considered preventative and not diagnostic. Fecal occult blood testing may indicate a problem with the colon that requires further testing; however, this test is a laboratory test and not a diagnostic tool. A culture and sensitivity test will determine if there is a bacterial, fungal, or viral infection; however, this test is laboratory test and not a diagnostic tool.
A patient with thalassemia major that is receiving a blood transfusion shows signs of hemochromatosis. The nurse anticipates a prescription for what medication? Multiple choice question Methotrexate Deferoxamine Ferrous gluconate Iron dextran complex
Deferoxamine A patient with thalassemia major requires frequent blood transfusions and is at risk of iron toxicity. Deferoxamine chelates with the iron and reduces iron overload or hemochromatosis. Methotrexate is an anticancer drug, and it does not reduce iron overload. Iron supplements such as ferrous gluconate and iron dextran complex should not be administered to the patient because they further increase the risk of iron overload.
A nurse is teaching a group of patients who are at high risk of developing cancer due to family history. Which agents should the nurse discuss as being known to be cancer-promoting? Select all that apply. Multiple selection question Radiation Dietary fats Chemical agents Cigarette smoking Alcohol consumption
Dietary fats Cigarette smoking Alcohol consumption Dietary fats, cigarette smoking, and alcohol consumption are cancer-promoting agents and need to be excluded from the patient's lifestyle. Promotion is the second stage of cancer development in which the altered cells undergo reversible proliferation. This proliferation is promoted by promoting agents, such as single alteration of the genetic structure of the dietary fat, obesity, cigarette smoking, and alcohol consumption. Changing a person's lifestyle to modify these risk factors can reduce the chance of cancer development. Radiation and chemical agents are cancer-initiating agents rather than promoting agents.
The nurse reviews the laboratory test results for a patient with upper gastrointestinal bleeding and notes that the hemoglobin level is 8.7 g/dL and the hematocrit is 26%. The nurse should place highest priority on initiating interventions that will reduce which symptom? Multiple choice question Nausea Dizziness Headache Constipation
Dizziness The patient with a low hemoglobin and hematocrit (normal values 13.5% to 17% and 40% to 54%, respectively, for males) is anemic and would be most likely to experience fatigue and dizziness. This symptom develops because of the lowered oxygen-carrying capacity that leads to reduced tissue oxygenation to carry out cellular functions. Constipation, nausea, and headache are not associated with decreased hemoglobin and hematocrit levels.
A patient with cancer who is receiving methotrexate therapy has developed anemia. The nurse recognizes that which therapies may benefit this patient? Select all that apply. Multiple selection question Oral iron Epoetin alfa Oral folic acid Blood transfusion Parenteral vitamin B 12
Epoetin alfa Oral folic acid Epoetin alfa is used to treat anemia related to cancer and its therapies. Methotrexate leads to folic acid deficiency resulting in megaloblastic anemia. Therefore folic acid therapy is given to treat the patient. Oral iron is administered to patients with iron deficiency anemia, which is seen mostly in premenopausal and pregnant women. Blood transfusions are required to keep the approximate hemoglobin level to at least 10 g/dL in the case of thalassemia and severe anemia. Parenteral vitamin B 12 is administered to treat cobalamin deficiency caused by pernicious anemia.
A patient has been diagnosed with Burkitt's lymphoma. What does the nurse inform the patient that they most likely have had exposure to? Multiple choice question Bacteria Sun exposure Most chemicals Epstein-Barr virus
Epstein-Barr virus Epstein-Barr virus Burkitt's lymphoma consistently shows evidence of the presence of Epstein-Barr virus in vitro. Bacteria do not initiate cancer. Sun exposure causes cell alterations leading to melanoma and squamous and basal cell skin carcinoma. Long-term exposure to certain chemicals (e.g., ethylene oxide, chloroform, benzene) is known to initiate cancer.
A patient has peripheral neuropathy since taking chemotherapy. What medication does the nurse anticipate educating the patient regarding? Multiple choice question Furosemide Gabapentin Metoclopramide Morphine sulfate
Gabapentin Other adjuvant therapies, such as antidepressant and antiseizure drugs such as gabapentin, may be beneficial in the treatment of neuropathic pain, which is often resistant to opiods. Furosemide is a diuretic and therefore is not a treatment option for neuropathic pain. Metoclopramide is an antiemetic and would not be used to treat neuropathic pain. Morphine sulfate is an analgesic and would not be used to treat neuropathic pain.
The nurse creates patient teaching information related to heparin therapy. The nurse recalls that heparin should never be given to a patient with a history of what? Multiple choice question Splenomegaly Thromboembolism Hepatic encephalopathy Heparin-induced thrombocytopenia (HIT)
Heparin-induced thrombocytopenia (HIT) With HIT, heparin causes decreased platelet counts and increases the risk for hemorrhage. Patients who have had HIT should never be given heparin or low-molecular heparin (LMWH). This should be clearly marked in the patient's medical record. Splenomegaly is an enlarged spleen; this often occurs with anemia and autoimmune disorders. Hepatic encephalopathy occurs in alcoholic clients when brain tissue is destroyed due to decreased thiamine. Thromboembolism is another term for blood clot; heparin is used to treat clots and would not cause them.
A patient with cancer is receiving massive doses of chemotherapeutic agents. The nurse reviews the patient's laboratory results to assess for which findings that suggest the development of tumor lysis syndrome (TLS)? Select all that apply. Multiple selection question Hypokalemia Hyponatremia Hypercalcemia Hyperuricemia Hyperphosphatemia
Hyperuricemia Hyperphosphatemia Tumor lysis syndrome is a metabolic change that occurs whenever a tumor sensitive to chemotherapy is subjected to chemotherapeutic agents. It is characterized by hyperuricemia and hyperphosphatemia. Hyperkalemia is associated with tumor lysis syndrome, but not hypokalemia. Tumor lysis syndrome is not associated with hyponatremia. In tumor lysis syndrome there is hypocalcemia, but not hypercalcemia.
After reviewing the medical records of a patient with a bleeding disorder, the nurse finds that the patient underwent an ileal resection. Which reason does the nurse suspect behind this finding? Multiple choice question Impaired iron absorption Impaired cobalamin absorption Decrease of intrinsic factor levels Decrease of parietal cell surface area
Impaired cobalamin absorption The ileum is the site of cobalamin absorption, essential for proper functioning of the red blood cells. Therefore the patient with an ileal resection will have a bleeding disorder due to impaired cobalamin absorption. The duodenum is the site for iron absorption. Therefore the patient with a duodenal excision will have impaired iron absorption that results in a bleeding disorder. The patient with a partial or total gastrectomy will have a loss of parietal cells, which reduces the intrinsic factor levels. A patient who underwent a gastric bypass will have reduced parietal surface area, because the duodenum is bypassed.
The nurse suspects that a patient has polycythemia vera based on which findings in the patient's laboratory reports? Select all that apply. Multiple selection question Increased cobalamin levels Decreased histamine levels Increased hemoglobin levels Increased red blood cell levels Decreased blood platelet levels Increased white blood cell levels
Increased cobalamin levels Increased hemoglobin levels Increased red blood cell levels Increased white blood cell levels Polycythemia vera has increased cobalamin and hemoglobin levels, as well as the presence of increased white blood cell and red blood cell levels. Elevated levels of histamine and blood platelet count are seen in patients with polycythemia vera.
Which of the following are characteristics of a malignant neoplasm? Select all that apply Multiple selection question Infiltrative growth Rare reoccurrence Metastasis is absent Moderate vascularity Usually encapsulated Abnormal cell characteristics
Infiltrative growth Moderate vascularity Abnormal cell characteristics A malignant neoplasm has abnormal cell characteristics, moderate vascularity, and infiltrative growth. A benign tumor is usually encapsulated, does not metastasize, and rarely recurs.
A patient with cancer is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) and is now experiencing a seizure. Which treatment is most beneficial for the patient to correct the electrolyte imbalance that precipitated the seizure? Multiple choice question Furosemide Oral salt tablets Isotonic (0.9%) saline Intravenous 3% sodium chloride
Intravenous 3% sodium chloride SIADH is a complication of cancer associated with severe water retention by tumor cells. Intravenous administration of 3% sodium chloride will help treat hyponatremia immediately. Furosemide, oral salt tablets, and isotonic (0.9%) saline will help to reduce hyponatremia and to treat SIADH. However, these medications are not highly effective for severe cases.
A patient who has undergone bone marrow aspiration is being monitored by the nurse. The nurse observes that bleeding is present at the needle aspiration site. Which action should the nurse advise the patient to perform? Multiple choice question Sitting for 30 to 40 minutes Walking for 10 to 15 minutes Standing for 30 to 40 minutes Lying on the side for 30 to 60 minutes
Lying on the side for 30 to 60 minutes After bone marrow aspiration, if bleeding is present at the site, the patient should be advised to lie on the affected side for 30 to 60 minutes to maintain pressure on the site. If the bed is too soft, the patient can lie on a rolled towel to provide additional pressure. Walking, sitting, and standing do not help to maintain pressure on the site.
The nurse suspects that a patient is experiencing microcytic, hypochromic anemia after noting which blood test results? Multiple choice question Mean corpuscular volume of 90 fL and mean corpuscular hemoglobin of 30 pg Mean corpuscular volume of 70 fL and mean corpuscular hemoglobin of 20 pg Mean corpuscular volume of 100 fL and mean corpuscular hemoglobin of 34 pg Mean corpuscular volume of 120 fL and mean corpuscular hemoglobin of 40 pg
Mean corpuscular volume of 70 fL and mean corpuscular hemoglobin of 20 pg Microcytic, hypochromic anemia is characterized by the presence of a mean corpuscular volume of less than 80 fL and a mean corpuscular hemoglobin of less than 27 pg. Normocytic and normochromic anemia are characterized by the presence of mean corpuscular volume between 80 and 100 fL and mean corpuscular hemoglobin between 27 and 34 pg. Macrocytic and normochromic anemia are characterized by the presence of mean corpuscular volume of greater than 100 fL and mean corpuscular hemoglobin of greater than 34 pg.
A patient with ovarian cancer is receiving radiation therapy. A nurse finds that the patient has developed anemia as a side effect of radiation therapy. What interventions are appropriate for this patient? Select all that apply. Multiple selection question Monitor hemoglobin and hematocrit levels. Monitor WBC count, especially neutrophils. Administer iron supplements and erythropoietin. Promote foods that increase hemoglobin levels. Teach the patient to avoid large crowds and people with infections.
Monitor hemoglobin and hematocrit levels. Administer iron supplements and erythropoietin. Promote foods that increase hemoglobin levels. The hemoglobin and hematocrit levels should be monitored to determine the severity of anemia and the effectiveness of the treatment. Iron supplements and erythropoietin are administered to increase hemoglobin levels. Promoting foods that increase hemoglobin levels help to treat anemia. Monitoring WBC counts and teaching the patient to stay away from crowds are management techniques done in cases of leukopenia.
A patient with lung cancer has been treated with an anticancer drug that has a high propensity to cause myelosuppression. What nursing interventions would be helpful to this patient? Select all that apply. Multiple selection question Monitoring the platelet count Monitoring the basophil count Monitoring the neutrophil count Monitoring the eosinophil count Monitoring the red blood cell (RBC) count
Monitoring the platelet count Monitoring the neutrophil count Monitoring the red blood cell (RBC) count Monitoring the RBC count helps the nurse to detect the severity of anemia and assess the need for administering RBC growth factors or an RBC transfusion. Monitoring the platelet count helps to detect the risk of bleeding in the patient and the need for using platelet growth factors or a platelet transfusion. Monitoring the neutrophil count helps to detect the risk of infection and the need for using white blood cell (WBC) growth factors and measures to prevent infection. Eosinophil and basophil counts should be assessed only in patients who have an allergic predisposition or if the drug is known to produce allergic reactions.
A patient with peptic ulcer disease reports presence of blood in stools. The laboratory results reveal a hemoglobin level of 10 g/dL and a total iron level of 40 mcg/dL. The nurse expects what clinical manifestations? Select all that apply. Multiple selection question Pallor Cheilitis Jaundice Paresthesias Hepatomegaly
Pallor Cheilitis Paresthesias The normal range of total serum iron level is 50 to 175 mcg/dL. The normal range of hemoglobin is 13.2 to 17.3 g/dL in males and 11.7 to 15.5 g/dL in females. Therefore a hemoglobin value of 10 g/dL and total iron of 40 mcg/dL are indicative of iron deficiency anemia, which may be due to blood loss from peptic ulcer disease. The clinical manifestations of iron deficiency anemia are pallor, cheilitis (inflammation of the lips), and paresthesias. Hepatomegaly may occur in patients with thalassemia due to iron deposition. Jaundice occurs due to prominent hemolysis of red blood cells in patients with thalassemia.
When discussing cancer diagnoses with a patient, which should the nurse identify as the only definitive method? Multiple choice question Genetic markers Radiographic studies Pathologic evaluation Endoscopic examination
Pathologic evaluation Pathologic examinations are the only definitive method for cancer diagnosis. Genetic markers, radiographic studies, and endoscopic examinations may all be used in the diagnostic process, but these methods are not definitive for the diagnosis of cancer on their own.
The nurse is interacting with the caregivers of different patients who are diagnosed with cancer. Which patient does the nurse expect to take less time to cope with cancer? Patient A - "My friend lost her job a few months ago, but she was determiend to do well at her next job." Pt B - My friend used to say that he does not want a painful death like his father had due to cancer." Pt C - My friend thinks she is going to lose her good looks after the treatment Pt D - My friend is very tired and fed up because of the constant nausea and diarrhea
Patient A's statement about losing a job a few months ago but still trying to strive hard at the next job indicates that he or she has a positive attitude and may take less time to cope with the situation. Patient B had a negative experience with cancer; this patient may take a lot of time to cope with cancer. Patient C is worried about the disruption of body image with treatment; he or she may take excessive time to cope with the condition. Patient D is disturbed due to continuous nausea and diarrhea; he or she may take a lot of time to cope with cancer.
The nurse recalls that the role of folic acid in erythropoiesis is what? Multiple choice question Aids in absorption of iron Promotes RBC maturation Promotes hemoglobin synthesis Aids in mobilization of iron from tissue to plasma
Promotes RBC maturation Folic acid promotes maturation of red blood cells (RBC). Ascorbic acid aids in the absorption of iron. Iron and pyridoxine promote hemoglobin synthesis. Copper helps in the mobilization of iron from tissue to plasma.
Which item would be most beneficial when providing oral care to a patient with cancer who is at risk for oral-tissue injury? Multiple choice question Use of oral swabs only Soft-bristled toothbrush Hydrogen peroxide rinses Alcohol-based mouthwash
Soft-bristled toothbrush Soft-bristled toothbrushes will prevent further irritation to oral tissue that is fragile. Alcohol-based mouthwash and hydrogen peroxide may further damage fragile oral tissue. Oral swabs may be used; however, these are not as effective in cleaning the oral cavity and teeth and reducing bacteria accumulation in the mouth.
A nurse is performing the skin assessment of a patient. How would the nurse examine the entire body in a systematic manner? Multiple choice question Start at the neck. Perform light palpation. Use the pads of the fingers. Start from the face and move downward.
Start from the face and move downward. While performing skin assessment, the nurse should examine the skin over the entire body in a systematic manner. Starting with the face and oral cavity and moving downward over the body helps to avoid missing any area. Light palpation is used for superficial lymph nodes evaluation. The lymph nodes evaluation is started at the head and neck. Pads of the fingers are used for light palpation of superficial lymph nodes.
A patient on chemotherapy for eight weeks started at a weight of 130 lb. The patient now weighs 125 lb and complains that he or she cannot taste food anymore. Which nursing interventions would be a priority? Multiple choice question Advise the patient to try foods that are fatty, fried, or high in calories. Suggest that the patient try foods with various spices and seasonings that are not spicy. Advise the patient to drink a nutritional supplement beverage at least five times a day. Confer with the primary health care provider about the need for parenteral or enteral feedings.
Suggest that the patient try foods with various spices and seasonings that are not spicy. Tell the patient to experiment with spices and other seasoning agents in an attempt to mask the taste alterations. Lemon juice, onion, mint, basil, and fruit juice marinades may improve the taste of certain meats and fish. Bacon bits, onion, and ham may enhance the taste of vegetables. It is not recommended for a patient to eat foods high in fat and fried. It is not necessary for the patient to drink nutritional supplements five times daily. The patient does not need parenteral or enteral feedings at this point.
A patient's laboratory reports show a low mean corpuscular volume (MCV) and a high reticulocyte count. The nurse suspects which condition? Multiple choice question Thalassemia Hemolytic anemia Sickle cell anemia Folic acid deficiency
Thalassemia In thalassemia, a low mean corpuscular volume and a high reticulocyte count are observed. In sickle cell anemia, a normal MCV and low reticulocyte count are seen. In hemolytic anemia, a normal MCV and increased reticulocytes are found. An increased MCV and normal or low reticulocyte count occur due to a folic acid deficiency.
A patient is brought to an emergency department in an unconscious condition. The hemoglobin level of the patient is 20 g/dL. How should the nurse interpret the lab result? Multiple choice question The patient has anemia. The patient is dehydrated. The patient has fluid volume excess. The patient has internal hemorrhage.
The patient is dehydrated. The hemoglobin level in a normal healthy adult is 11 to 17 g/dL. The hemoglobin level may increase as a result of hemoconcentration as found in dehydration. A patient with anemia would have a low hemoglobin level due to decreased production of RBCs. A patient with internal hemorrhage would not have a high hemoglobin level of 20 g/dL; the patient would have a low hemoglobin level due to loss of intravascular volume. A patient with fluid volume excess would have a low hemoglobin level due to hemodilution.
The nurse provides instructions regarding markings on the skin to a patient who is undergoing radiation therapy. What explanation should the nurse provide regarding the markings? Multiple choice question They are permanent effects of radiation therapy. They indicate that previous treatments have been unsuccessful. They are a warning of potentially serious side effects of radiation. They should be protected because they are landmarks for the radiation therapy.
They should be protected because they are landmarks for the radiation therapy. Markings should be protected from being washed or removed because they are landmarks for the radiation therapy treatment field. They are not permanent; nor are they an indication that previous treatment has been unsuccessful or a warning about the side effects of radiation
The nurse is reviewing the laboratory test results for a patient with cancer. The total serum protein level is 6.4 mg/dL. What does the nurse interpret this finding to mean for the patient? Multiple choice question The protein level is reduced, which is consistent with malnutrition. The protein level is normal, and therefore the patient does not have malnutrition. The protein level is increased, which is a common finding in patients with cancer. The total protein level is increased; the patient would benefit from albumin infusion.
Total serum protein level should be between 6.0 and 8.0 g/dL. A protein level of 6.4 is normal.
The laboratory reports of a patient reveal a hemoglobin level of 9 mg/dL, a serum iron level of 40 mcg/dL, an indirect bilirubin level of 1 mg/dL, a vitamin B 12 level of 250 pg/mL, and a folic acid level of 14 ng/mL. Which other finding will the nurse observe in the patient's report? Multiple choice question Positive Coombs test Homocysteine 15 µmol/L Transferrin saturation of 10% Methylmalonic acid 0.3 µmol/L
Transferrin saturation of 10% The normal range for hemoglobin is 11 to 16 g/dL in females and 13.2 to 17.3 mg/dL in males. Hemoglobin of 9 g/dL indicates anemia. The normal range of serum iron is 50 to 175 mcg/dL. The patient has 40 mcg/dL of serum iron, which indicates iron-deficiency anemia. The values of indirect bilirubin, folic acid, and vitamin B 12 are within the normal range. The transferrin saturation is decreased in iron-deficiency anemia. The normal range of transferrin saturation is 15% to 50% but the patient has low transferrin saturation of 10% because of iron-deficiency anemia. A positive Coombs test can be observed in the patient with hemolytic anemia. The normal range for homocysteine is 3.7 to 10.4 µmol/L in females and 5.2 to 12.9 µmol/L in males. High homocysteine of 15 µmol/L is observed in patients with folic acid and cobalamin deficiency. A normal range for methylmalonic acid is 0.2 µmol/L. An increased methylmalonic acid level of 0.3 µmol/L is observed in patients with cobalamin deficiency.
The patient is receiving an intravenous (IV) vesicant chemotherapy drug. The nurse notices swelling and redness at the site. What should the nurse do first? Multiple choice question Ask the patient if the site hurts Turn off the chemotherapy infusion Call the prescribing health care provider Administer sterile saline to the reddened area
Turn off the chemotherapy infusion Because extravasation of vesicants may cause severe local tissue breakdown and necrosis, with any sign of extravasation the infusion first should be stopped, then the protocol for the drug-specific extravasation procedures should be followed to minimize further tissue damage. The site of extravasation usually hurts, but it may not. It is more important to stop the infusion immediately. The health care provider may be notified by another nurse while the patient's nurse starts the drug-specific extravasation procedures, which may or may not include sterile saline.
Melanomas, squamous cell carcinomas, and basal cell carcinomas are associated with which type of carcinogen? Multiple choice question Viral Chemical Ultraviolet radiation Inherited genetic mutation
Ultraviolet radiation Melanomas, squamous cell carcinomas, and basal cell carcinoma are types of skin cancer, which are associated with ultraviolet radiation. Viral carcinomas are associated with oncogenic viruses. Inherited genetic mutations are passed on from a parent. Chemical carcinogens are cancer-causing agents capable of producing cell alterations.
Which type of chemotherapy drug will cause severe local tissue breakdown and necrosis if inadvertently infiltrated into the skin? Multiple choice question Irritant Vesicant Extravasation Intraarterial chemotherapy
Vesicant A vesicant will cause severe local tissue breakdown and necrosis if it is inadvertently infiltrated into the skin. An irritant will damage the intima of the vein and cause phlebitis and sclerosis; however, it will not damage the skin. Extravasation is the process by which drugs are infiltrated into the tissues surrounding the infusion site. Intraarterial chemotherapy is a route used to deliver drugs to the tumor via the arteries that supply it.
