Cardiovascular, Hematological-oncology, Immune

The community health nurse provides an education program about risk factors for prostate cancer. Which of the following statements by program attendees indicate the teaching has been effective? Select all that apply. 1. African American men have a much higher risk for prostate cancer than other men 2. Eating large amounts of red meat may increase my risk for prostate cancer 3. I should avoid taking NSAIDs to prevent prostate cancer 4. My father had prostate cancer, so I've an increased risk for it 5. My risk for prostate cancer increases as I become older

1. African American men have a much higher risk for prostate cancer than other men 2. Eating large amounts of red meat may increase my risk for prostate cancer 4. My father had prostate cancer, so I've an increased risk for it 5. My risk for prostate cancer increases as I become older: Nonmodifiable risk factors include: African-American ethnicity, having a first degree relative with prostate cancer and increasing age over 50. Clients can lower the risk of prostate cancer by avoiding modifiable risk factors which include: Diet high in red meat, low fiber intake, obesity

A client with throat cancer receives radiation therapy to the head and neck. Which strategies are appropriate to increase oral intake? Select all that apply. 1. Avoid irritants such as acidic, spicy foods 2. Discourage the use of topical analgesics 3. Encourage liquid nutritional supplements 4. Perform oral hygiene once a day 5. Use artificial saliva to control dryness

1. Avoid irritants such as acidic, spicy foods 3. Encourage liquid nutritional supplements 5. Use artificial saliva to control dryness: Relation therapy to the head and neck can decrease a client's oral intake due to the development of mucositis. These adverse side effects affect speech, taste, and ability to swallow and can have a significant impact on the client's nutritional status.

The nurses preparing to administer 40 mg of IV Lasix. Prior to administering the medication, the nurse assessed which parameters? Select all that apply 1. Blood pressure 2. BUN 3. Liver enzymes 4. Potassium 5. White blood cell count

1. Blood pressure 2. BUN 4. Potassium: When administering LasixIt is important to closely monitor the client's vital signs, serum electrolytes, and kidney function tests (blood urea nitrogen, creatinine) Prior to administration to prevent side effects such as hypokalemia, hypotension and kidney injury

A client is scheduled for a coronary arteriogram procedure. Which information should the nurse provide the client prior to the procedure? Select all that apply. 1. Client may be required to lie flat for several hours following the procedure 2. Client may feel warm or flushed when the contrast dye is injected during the procedure 3. Client should expect to stay in a hospital for 1 to 3 days following the procedure 4. Client should not drink or eat anything for 6 to 12 hours before the procedure 5. Client will receive general anesthesia and we'll not be awake during the procedure

1. Client may be required to lie flat for several hours following the procedure 2. Client may feel warm or flushed when the contrast dye is injected during the procedure 4. Client should not drink or eat anything for 6 to 12 hours before the procedure: The client should not drink/eat anything, the client may feel warmer flushed when the contrast dye is injected, Compression is applied to the puncture site and the client may have to lie flat for several hours to ensure hemostasis. Side note: Hospitalization is only required if they have an angioplasty or stent placements performed. General anesthesia is not used during coronary angiography, only sedation

A parent calls the nurse Tele health triage line with concerns about an allergic reaction to something a child ate. Which symptoms should the nurse instruct the parent to assess for to determine if the child is having an anaphylactic reaction? Select all that apply. 1. Dyspnea 2. Fever 3. Lightheadedness 4. Skin rash 5. Wheezing

1. Dyspnea 3. Lightheadedness 4. Skin rash 5. Wheezing: Anaphylaxis is a medical emergency requiring rapid assessment and intervention. Symptoms of an anaphylactic reaction includes signs of respiratory compromise (Oral and airway swelling, stridor, Wheezing, Chest tightness) and shock (Dizziness, Loss of consciousness)

The nurse has just completed discharge teaching for a client recently diagnosed with hypertension. Which of the following statements for the client indicate understanding of the dietary approaches to stop hypertension diet? Select all that apply. 1. I need to eat less red meat and more fresh vegetables 2. I'll limit drinking soda to only one at a time as an occasional treat 3. I'm going to replace potato chips with fruit during meals and snacks 4. I'm going to really miss drinking as much milk as I normally do 5. Taking a salt shaker off the table should be enough to reduce my sodium intake

1. I need to eat less red meat and more fresh vegetables 2. I'll limit drinking soda to only one at a time as an occasional treat 3. I'm going to replace potato chips with fruit during meals and snacks: The client is taught to limit intake of sugar, Sodium, Cholesterol and trans or saturated fats.

The nurse provides discharge teaching to a client who was hospitalized for deep venous thrombosis that has now resolved. Which of the following instructions should the nurse include to prevent the reoccurrence of DVT? Select all that apply. 1. Do not take car rides longer than four hours for at least 3-4 weeks 2. Drink plenty of fluids every day in and alcohol intake 3. Elevate legs on a footstool when sitting and Dorsiflex the feet often 4. Resume you're walking program as soon as possible after getting home 5. Sit in a crosslegged position for 5 to 10 minutes to improve circulation

2. Drink plenty of fluids every day in and alcohol intake 3. Elevate legs on a footstool when sitting and Dorsiflex the feet often 4. Resume you're walking program as soon as possible after getting home: Discharge teaching for a client with resolved DVT Includes interventions to prevent recurrence (Take in adequate fluids, elevate the extremities, exercise regularly, change positions frequently, stop smoking)

The nurse is teaching general skincare guidelines to a client receiving teletherapy. Which statement does the client make that indicates a proper understanding of teaching has been made? Select all that apply. 1. I may apply an ice pack to the treatment site if it begins to burn 2. I will rub baby oil after each treatment to prevent dry skin 3. I will use extra measures to protect my skin from sun exposure 4. I will wash the treatment site with lukewarm water and mild soap 5. I will wear soft, loose-fitting clothing

3. I will use extra measures to protect my skin from sun exposure 4. I will wash the treatment site with lukewarm water and mild soap 5. I will wear soft, loose-fitting clothing: Protect the skin from infection by not rubbing, scratching, or scrubbing. Cleanse the skin daily by a lukewarm shower. Use only creams and lotions approved by the healthcare provider. Shield of skin from the effects of the sun during and after therapy. Avoid extremes and skin temperature.

The nurses caring for several clients in a women's health clinic. Based on the data collected, which client's history is most concerning for an increased risk of endometrial cancer? 1. 40-year-old client who has been taking normal Birth control pills for the past 10 years 2. 45-year-old client who reports a history of ectopic pregnancy with a ruptured ovary and 2 preterm births 3. 47-year-old client with polycystic ovary syndrome, Obesity, And a history of unsuccessful infertility treatments 4. 60-year-old client who recently had a colposcopy after testing positive for a high-risk type of HPV

47-year-old client with polycystic ovary syndrome, Obesity, And a history of unsuccessful infertility treatments: Factors increasing estrogen exposure endometrial cancer risk include: Polycystic ovarian syndrome, infertility, Late menopause, Early Menarche, Obesity, Tamoxifen.

When admitting a client who has into your wall ST-elevation myocardial infarction to the cardiac step-down unit, Which intervention should the nurse perform first? 1. Assess for jugular venous distention 2. Attach the cardiac monitor to the client 3. Auscultate heart and breast sounds 4. Obtain the clients vital signs

Attach the cardiac monitor to the client: Just read me as of the most frequent complication following myocardial infarction. Ventricular fibrillation is the most common of these and frequently the cause of sudden cardiac death with MI. The nurse should attach the cardiac monitor to the client before performing any of these interventions.

Which clinical finding would the nurse anticipate in a client with chronic venous insufficiency? 1. Brownish hardened skin on lower extremities 2. Diminished peripheral pulses 3. Nonhealing ulcer on lateral surface of great toe 4. Shiny hairless lower extremities

Brownish hardened skin on lower extremities: Chronic venous insufficiency occurs when the valves in the veins of the lower extremities consistently fail to keep Venus blood moving forward which causes chronic increased venous pressure. The increased pressure pushes fluid out of the vascular space and into surrounding tissues where tissue enzymes break down red blood cells (brownish skin); This disease is characterized by brownish skin Discoloration, Chronic edema, Inflammation. Side note: Diminished pulses, nonhealing ulcers on a toe and shiny hairless extremities are associated with peripheral arterial disease

The nurse receives handoff of care report on for clients. Which client should the nurse see first? 1. Client with atrial fibrillation who reports feeling palpitations and has an irregular pulse of 122 per minute 2. Client with liver cirrhosis reports bleeding from an IV insertion site and has a platelet count of 48,000mm^3 3. Client with pericarditis whose blood pressure has decreased from 122/70 to 96/68 over the past hour. 4. Client with pneumonia who's white let's account has increased from 14,000mm^3 8 hours ago to 30,000mm^3

Client with pericarditis whose blood pressure has decreased from 122/70 to 96/68 over the past hour: Cardiac Tamponade Is a possible complication of acute. pericarditis that impairs cardiac output and is life-threatening without immediate intervention. Clinical features of cardiac Tamponade include hypotension, muffled heart sounds and neck vein distention.

Which client finding is most important for the nurse to follow-up? 1. Client with the distinct liver edge even with right coastal margin. 2. Client with pyelonephritis who has costovertebral angle tenderness. 3. Client with a rash that has purplish blotches that do not blanch. 4. Client with spinal injury whose toes pointed downward with the Babinski test

Client with rash that has purplish blotches that do not blanch: Purpera refers to purplish blotches indicating bleeding underneath the skin; it is a significant finding that requires further assessment Side note: The Babinski signs normal finding for adult is to have toes point downward

The nurses caring for a client with acute pericarditis. Which clinical finding would require immediate intervention by the nurse? 1. Client reports chest pain that is worse with deep Inspiration 2. Distant heart tones and jugular vein distention 3. ECG showing ST- segment elevations in all leads 4. Pericardial friction rub auscultated at the left sternal border

Distant heart tones in jugular vein distention: Acute pericarditis is inflammation of the membranous sac surrounding the exterior of the heart, which can cause an increase in the amount of fluid in the pericardium. It is critical for the nurse to observe first signs of cardiac Tamponade (Muffled or distant heart tones, Hypotension, jugular venous Distention)

The client is being discharged after receiving an implantable cardioverter defibrillator. Which statement by the client indicates that teaching has been effective? 1. I'm not worried about the device firing now because I know it won't hurt. 2. I will let my daughter fix my hair until by healthcare providers says I can do it 3. I will look into public transportation because I won't be able to drive again 4. I will notify my travel agent that I can no longer travel by plane.

I will let my daughter fix my hair until by healthcare providers says I can do it: Clients are instructed to refrain from lifting the affected arm above the shoulder to prevent dislodgment of the lead wire on the endocardium.

The nurse is admitting a client from the post anesthesia care unit who just received a permanent arterioventricular pacemaker for a complete heart block. Which action should the nurse implement first? 1. Assess incision for hematoma formation 2. Auscultate bilateral anterior and posterior lung sounds 3.Initiate continuous cardiac monitoring 4. Reestablish IV fluids and postoperative antibiotics

Initiate continuous cardiac monitoring: Assessing the a new permanent pacemaker is a priority after operative placement. The nurse should immediately attach the cardiac monitor before making other appropriate assessments.

A client with a permanent pacemaker with continuous telemetry calls the nurse and reports feeling lightheaded and dizzy. The clients blood pressure is 75/55. What is the nurses priority action? 1. Administer atropine .5 mg IV 2. Administered dopamine 5 mcg per kilogram per minute IV 3. Initiate transcutaneous pacing 4. Notify the healthcare provider

Initiate transcutaneous pacing: The client is symptomatic from insufficient perfusion. The nurses priority is to use transcutaneous pacemaker pads to normalize the heart rate, stabilize blood pressure and adequately perfuse organs until the permanent pacemaker is repaired or replaced. Administer analgesia and/or sedation as prescribed as transcutaneous pacing is very uncomfortable for the client.

An experienced nurse precepts a graduate nurse caring for a hospitalize client Who has a prescription for a transfusion of Packed red blood cells to be hung over three hours. Which statement by the graduate nurse indicates that the correct rationale for asking the client to avoid prior starting the transfusion? 1. A drop in blood pressure is expected during the transfusion and getting up to avoid may cause a false 2. Bed rest is required; therefore, voiding will prevent intermittent catheterization during the procedure 3. It's a transfusion reaction occurs, it will be important to collect a fresh urine specimen to check for hemolyzed red blood cells 4. That urine is collected and analyzed prior to starting The transfusion to assess the clients baseline results

It's a transfusion reaction occurs, it will be important to collect a fresh urine specimen to check for hemolyzed red blood cells: Asking the client to void prior to starting the transfusion helps ensure that any urine specimen collected after reaction is reflected of the bodies physiological process after the blood transfusion

The nurse cares for transgender client who is prescribed estrogen therapy. Which side effect is most important for the nurse to report to the healthcare provider? 1. Breast tenderness 2. Generalized weight gain 3. Leg swelling 4. Nausea and vomiting

Leg swelling: Estrogen clientsAre put at risk for developing blood clots due to hyper coagulability and therefore adverse thrombotic events. Signs and symptoms of deep venous thromosis are leg swelling, redness and pain. Side note: Breast tenderness and enlargement are common, Generalized weight gain during estrogen therapy is caused by fluid retention, Nausea and vomiting can occur with ushers in therapy.

A client with Polycythemia vera Comes to the clinic for a monthly treatment. The nurse knows that treatment for this condition will consist of which of the following? 1. Blood transfusion 2. fluid bolus 3. Phlebotomy 4. Steroid injection

Phlebotomy: Treatment of PV usually includes a periodic phlebotomy, the removal of 300 to 500 ML's of blood through venipuncture, to reduce the red blood cell count and achieve a hematocrit of <45%.

The nurse cures for a client with an exacerbation of IBD. The client tells the nurse about being infected with TB 10 years ago but never being medicated. Which prescription is of concern and prompts the nurse to notify the healthcare provider? 1. Lansoprazole 2. Metronidazole 3. Prednisone 4. Sulfasalazine

Prednisone: A client with LTBI who begins treatment with the corticosteroids is at increased risk for conversion to active TB disease.

A client with an implantable cardioverter defibrillator develops ventricular tachycardia with a pulse while admitted to the medical surgical unit. The ICD fires multiple times without successfully stopping the VT, causing the client to become confused and difficult to rouse. Which action by the nurse is appropriate? 1. Attempt to stimulate a bagel response by having the client cough 2. Deactivate the clients implantable cardioverter defibrillator with an external magnet 3. Obtain a stat 12 lead ECG to verify the cardiac rhythm 4. Prepare for synchronize cardioversion with the external defibrillator

Prepare for synchronize cardioversion with the external defibrillator: If the client experiences repeated ICD shocks without dysrhythmia resolution, the nurse should promptly obtain a manual external defibrillator and initiate measures to prevent hemodynamic instability and cardiac arrest.

The nurse is admitting a client who had mastectomy six months ago and is scheduled for elective surgery. During the physical assessment, the nurse notices a 0.5 cm mobile, firm, nontender lymph node, In the upper arm. What action should the nurse take? 1. Anticipate the scheduling of a biopsy 2. Apply ice to the node 3. Reassure the client that this is an expected finding 4. Requests and antibiotic

Reassure the client that this is an expected finding

The nurse on a medical surgical unit enters the room, find the client unresponsive with no pulse and starts two minutes of CPR. The nurse receives and an attaches an automated external defibrillator, but no shock is advised. What action should the nurse perform next? 1. Check for a carotid Pulse for at least 10 seconds 2. Provide rescue breaths at a rate of 10 to 12 per minute 3. Resume chest compressions at a rate of the hundred per minute 4. Use the jaw thrust maneuver to assess the airway

Resume chest compressions at a rate of the hundred per minute: Any unwitnessed collapse should be treated with two minutes of CPR Followed by activating the emergency response system and obtaining an automated external defibrillator. If no shock his advice, the nurse should resume high-quality chest compressions immediately at 100-120/min

The nurse on the step down cardiothoracic unit receives the change of shift hand off report. Which client should the nurse assessed first? 1. Two days post abdominal aortic aneurysm repair with the pedal pulls decreased from baseline 2. Two days post coronary bypass graft surgery with a white blood cell count of 18,000/mm^3 3. Cardiomyopathy with an EF of 25% and dyspnea on exertion 4. Pneumothorax with a chest tube to negative suction and subcutaneous emphysema

Two days post abdominal aortic aneurysm repair with pedal pulse decreased from baseline: The nurse should assess the pulses, skin color and temperature of the lower extremities in a client with an abdominal aortic aneurysm repair first. A pedal pulse decrease from the clients baseline can indicate the presence of an arterial or graft occlusion

A client is seen following a motor vehicle collision. An IV infusion of 1 L normal saline solution was administered before arrival at the hospital. The IV line is now infusing at 200 mL per hour. Which is such which assessment finding alerts the nurse to development of hypovolemic shock? 1. Jugular venous distension 2. Mean arterial blood pressure 65 3. Urine output less than 0.5 five mL per kilogram per hour 4. Warm, flushed skin

Urine output less than 0.5 five mL per kilogram per hour: Hypovolemic shock most commonly occurs from blood loss, clinical manifestations include: Change in mental status, tachycardia and thready pulse, cool, clammy skin, oliguria, tachypnea