Chronic Final
Nausea and vomiting
A client newly diagnosed with cancer is scheduled to begin chemotherapy treatment and the nurse is providing anticipatory guidance about potential adverse effects. When addressing the most common adverse effect, what should the nurse describe?
The client's activity just prior to the onset of pain
A client presents with intense back pain, rating it an "11" on the 0-to-10 scale. He is hunched over and reports that the pain is running down his legs. What information will the nurse inquire about while obtaining the history of the present health concern?
A fasting blood sugar result of 126 mg/dL or more on two separate occasions is diagnostic of diabetes.
A client, being evaluated for diabetes, asks how a blood glucose test is used to diagnose this disease. What is the nurses best response?
Engraftment
A cluster of symptoms referred to as _____________ syndrome may occur during the neutrophil recovery phase in both allogeneic and autologous transplants.
The client reports that pain occurs during the night
A nurse is assessing a client who has duodenal ulcer. Which of the following findings should the nurse expect?
Kyphosis
A nurse is assessing an older adult client who has experienced some loss of bone density. The nurse observes a "hunchback" curvature of the client's spine. The nurse should expect the provider to document which of the following disorders?
Hiccups
A nurse is assigning a client who is postoperative following a gastrectomy. The nurse should identify which of the following findings as an indication of abdominal distention?
"I will walk daily and gradually decrease the distance and pace of walking."
A nurse is caring for a client who has acute low back pain. Which statement by the client indicates that he needs additional education?
"The CEA determines the efficacy of your chemotherapy"
A nurse is caring for a client who has colorectal cancer and is receiving chemotherapy. The client asks the nurse why his blood is being drawn for a carcinoembyonic antigen (CEA) level. Which of the following responses should the nurse make?
Renal stone
A nurse is caring for a client who has osteoporosis and takes a daily calcium supplement. Which of the following adverse effects of calcium should the nurse suspect when the client reports having flank pain?
Literacy. Dexterity. Motivation. Culture.
A nurse is caring for a client who has type 1 diabetes mellitus and is not following the guidelines for therapy. Which of the following should the nurse consider as contributing factors to the client's nonadherance? (Select all that apply)
Nonnutritive sugar substitute
A nurse is caring for a client who has type 1 diabetes mellitus. Which of the following recommendations should the nurse make to the client for a sweetener?
"I will eat beans to ensure I get enough fiber in my diet"
The nurse is providing dietary teaching for as client who has a new diagnosis of celiac disease. Which of the following statements by the client indicates an understanding of the teaching?
Hemoglobin A1C monitors effectiveness of diabetic therapy. Hemoglobin A1C reviews blood glucose control over a period of time. Hemoglobin A1C result is altered in the presence of anemia.
The nurse knows that education regarding hemoglobin A1C has been effective if the patient makes which of the following statements about hemoglobin A1C? Select all that apply.
False
The nurse should recommend short periods of bed rest, in a prone position, for patients experiencing back pain resulting from a compression fracture:
Help prevent cervical cancer
The physician recommends that parents have their daughter vaccinated with HPV vaccine. What is this vaccine for?
Blood pressure of 96/58 mmHg
The physician's order reads: Administer Metoprolol (Lopressor), which vital sign should the nurse recheck prior to calling the provider.
True
Factors that contribute to urinary tract infections (UTIs) include bacterial invasion of the urinary tract, urethrovesical reflux, and shorter urethra in women.
3 hours
A patient reports to the nurse that he is having urinary frequency. The nurse understands that the patient is voiding more frequently than every:
False
Abdominal pain and constipation are common clinical manifestations of Crohn's disease.
Secondary
According to the classification of hypertension diagnosed in the older adult, hypertension that can be attributed to an underlying cause is termed:
True
An advance directive applies only if a patient is incapacitated.
"Do you have any allergy to penicillin?"
Before giving any antibiotic to a client with a urinary tract infection, the appropriate question to ask would be:
True
Cancer of the bladder is more common after age 55 and smoking increases the risk by 50%
True
Celiac disease is a disorder of malabsorption caused by an autoimmune response to consumption of products that contain the protein gluten.
False
Disability is the loss or abnormality of psychological, physiologic, or anatomic structure or function at the organ level.
False
Diverticulosis is the sac-like herniation of the lining of the bowel that extends through a defect in the muscle layer.
True
Diverticulum is the sac-like herniation of the lining of the bowel that extends through a defect in the muscle layer
True
Due to the lack of insulin in Type 1 diabetes, the body uses fats and proteins for energy, leading to the acidosis associated with DKA.
False
Irritable bowel disease (IBD) is a functional disorder characterized by recurrent abdominal pain that affects frequency of defecation and consistency of stool; is associated with no specific structural or biomedical alterations.
3 months or longer
Medical or health problems are considered chronic that require long-term management of:
True
Older adult client patients often lack the typical symptoms of UTI and sepsis:
False
Prophylactic cancer vaccines have been proven to prevent prostate, breast, and lung cancers:
Are efforts made to direct all conversations/questions to the patient's family?
Questions to ask to ensure quality of care include all of the following except
Preferred treatment for incontinence
Reasons for urinary diversion include all of the following except:
06:45
The client is scheduled to get a breakfast tray at 07:00. At what time should the client receive a prescribed dose of insulin lispro?
Discontinue the intravenous medication
While administering cisplatin (Platinol-AQ) to a client, the nurse assesses swelling at the insertion site. The first action of the nurse is to:
Colorectal
The leading causes of cancer death in the United States, for men, are lung, prostate, and:
Treatment directives. Appointment directives.
Two types of advance directives are:
False
Upper urinary tract infections (UTIs) are very common and are classified as uncomplicated or complicated:
False
Urinary incontinence is inevitable and is not treatable:
Lift with the large leg muscles (quadriceps), not the back muscles
Using proper body mechanics to life objects is essential to prevent exacerbations of low back pain. Which of the following is the most important teaching point?
Fracture, dislocation, infection, osteoarthritis, or scoliosis
What findings can be identified with the use of radiography of the spine/
Deformity in which the great toe deviates laterally
What is Hallux valgus (Bunion)?
Polyethylene glycol and electrolytes (Colyte)
What is an example of a laxative osmotic agent?
Address the individual's physical, emotional and social needs.
Working with individuals who are diagnosed with a chronic illness requires healthcare providers to not only address the medical aspects of their disorder but also working with the person as a whole, thus plan a holistic approach. Which of the following is considered holistic in approach? Select the best answer.
3 oz canned salmon
A nurse is providing nutritional teaching to a client who has osteoporosis. Which of the following foods should the nurse recommend as being the highest in calcium?
Red, open sores on the oral mucosa
A client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis?
Metformin does not cause hypoglycemia
A client has refused a scheduled dose of metformin, stating that he is worried about inducing hypoglycemia because his blood glucose level is currently 66 mg/dL. The nurse should convey what teaching points to the client?
Maintaining a low-sodium diet
A client hospitalized for treatment of hypertension is being prepared for discharge. Which teaching topic should the nurse be sure to cover?
"I chose broiled chicken with a baked potato for dinner"
A client is placed on a low-sodium (500 mg/day) diet. Which client statement indicates that the nurse's nutrition teaching plan has been effective?
A developmental disability
A 19-year-old client with a diagnosis of Down syndrome is being admitted to the unit for the treatment of community-acquired pneumonia. When planning this client's care, the nurse recognizes that this client's disability is categorized as what?
Change positions (lying or sitting to standing) slowly.
A 77-year-old client has newly diagnosed stage 2 hypertension. The physician has prescribed the client a thiazide and an angio-converting enzyme inhibitor. The nurse is concerned about postural hypotension. Which of the following will the nurse be sure to include in education for this client?
Instruct the client to sit for several minutes before standing
A client experiences orthostatic hypotension while receiving furosemide (Lasix) to treat hypertension. How should the nurse intervene?
"There are things you can do to minimize the effects of this disease on your health"
A client from a low socioeconomic background was diagnosed with a chronic health problem. The client states, "Everyone has to die of something." The most appropriate response by this nurse is:
Sexual health
A community health nurse has drafted a program that will address the health promotion needs of members of the community who live with one or more disabilities. Which of the following areas of health promotion education is known to be neglected among adults with disabilities?
Observing for safety hazards that could be a fall risk
A family member is caring for an older adult client with osteomalacia in the home. When the home health nurse comes to evaluate the client, what should be a focus point of the visit?
"A single elevated blood pressure does not confirm hypertension. You will need to have your blood pressure measured several times before a diagnosis can be made".
A group of student nurses are practicing taking blood pressure. A 56-year-old male student has a blood pressure reading of 146/96 mm Hg. Upon hearing the reading, he exclaims, "My pressure has never been this high. Do you think my doctor will prescribe medication to reduce it?" Which of the following responses by the nursing instructor would be best?
"Who will care for our son once we're unable?"
A man and a woman are in their early 80s and have provided constant care for their 44-year-old son who has Down Syndrome. When planning this family's care, the nurse should be aware that the parents most likely have what concerns around what question?
Osteomalacia
A metabolic bone disease characterized by inadequate bone mineralization, and softening and weakening of the long bones that cause pain, tenderness, and deformities caused by the bowing of bones and pathologic fractures is known as:
True
A nurse assessing a patient for urinary retention knows that the patient could also report these signs and symptoms of UTI: hematuria, urgency, frequency, and nocturia.
WBC 15,000/mm3
A nurse in an emergency department is caring for a client who reports costovertebral angle (CVA) tenderness, nausea, and vomiting. Which of the following laboratory values should the nurse report to the provider?
Fatty diarrheal stools
A nurse is assessing a client who has Chron's disease. Which of the following findings should the nurse expect?
Arrange activities to allow for daily rest periods. Use progressive relaxation techniques. Restrict intake of carbonated beverages.
A nurse is caring for a client who has ulcerative colitis. The client has several exacerbation's over the past 3 years. Which of the following instructions should the nurse include in the plan of care to minimize the risk of further exacerbation's? (Select all that apply.)
Teach the client to use the call light. Keep the client's bed in the lowest position. Place a fall-risk identification band on the client's wrist.
A nurse is caring for a client who is at risk for falls. Which of the following actions should the nurse take? (Select all that apply.)
Review serum electrolyte values
A nurse is caring for a client who was admitted for treatment of left-sided heart failure with intravenous loop diuretics and digitalis the therapy. The client is experiencing weakness and irregular heart rate. Which of the following actions should the nurse take first?
Alendronate
A nurse is caring for a client with a new diagnosis of Paget's disease. The nurse anticipates the provider will prescribe which of the following medications for this client?
Interstitial nephritis
A nurse is caring for a patient who was admitted for lower urinary tract infections (UTIs). The nurse knows that the following are causes of lower urinary tract infections except:
Aledndronate
A nurse is caring for four clients for whom she has to administer oral medications in the morning. The nurse should administer which of the following medications before breakfast?
Listen carefully to the patient's responses
A nurse is conducting a health assessment and interviewing a patient. Which of the following would be MOST appropriate for the nurse to do?
Auscultation
A nurse is conducting a physical assessment of a patient with a cardiac murmur. Which technique would the nurse most likely use to assess the murmur?
Determine what the client knows about managing diabetes
A nurse is developing a teaching plan for a client who has a new diagnosis of type 2 diabetes mellitus. Which of the following actions should the nurse plan to take first?
Wash and inspect the feet daily.
A nurse is developing a teaching plan for a client with diabetes mellitus. A client with diabetes mellitus should:
Hypotension
A nurse is expecting a client who has upper gastrointestinal bleeding. Which of the following findings should the nurse expect?
Instruct the client to start urinating then pass the container into the stream (midstream urine)
A nurse is obtaining a urine specimen for culture and sensitivity from a client who has manifestations of a urinary tract infection. Which of the following actions should the nurse take?
Client's report of pain on a pain scale.
A nurse is performing a pain assessment for a client who is postoperative. Which of the following findings should the nurse use to determine the severity of client's pain?
Family history of hypertension
A nurse is performing blood pressure screenings at a local health fair. While obtaining subjective assessment data from a patient with hypertension, the nurse learns that the patient has a family history of hypertension and she herself has high cholesterol and lipid levels. The patient says she smokes one pack of cigarettes daily and drinks "about a pack of beer" every day. The nurse notes what non-modifiable risk factor for hypertension:
Eggs
A nurse is providing dietary teaching for a client who is postoperative following a gastrectomy. Which of the following foods should the nurse encourage the client to include in her diet to prevent dumping syndrome?
Dark purple stoma
A nurse is providing discharge teaching for a client following an ileostomy. The nurse should instruct the client to report which of the following findings to the provider?
"I will decrease the amount of carbonated beverages I drink"
A nurse is providing discharge teaching for a client who has GERD. Which of the following statements by the client indicates an understanding of the teaching?
"I should eat foods that are low in fiber"
A nurse is providing discharge teaching for an older adult client who has mild diverticulitis. Which of the following statements by the client indicates an understanding of the teaching?
Moist, clammy skin. Tachycardia. Blurred vision.
A nurse is providing teaching to a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize that the client understands the teaching when he identifies which of the following as manifestattions of hypoglycemia? (Select all that apply).
Thyroid hormones
A nurse is reviewing risk factors for osteoporosis with a group of nursing students. The nurse should include that which of the following types of medication therapy is a risk factor for osteoporosis?
Drink clear liquids for 24 hr prior to the procedure, and then take nothing by mouth for 6 hr before the procedure
A nurse is teaching a client how to prepare for a colonscopy. Which of the following instructions should the nurse include in the teaching?
Avoid the use of NSAIDS for pain
A nurse is teaching a client who has a new diagnosis of acute pyelonephritis. Which of the following instructions should the nurse include in the teaching?
Expect the NPH if it appears cloudy
A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH every morning if her blood glucose level is above 200 mg/dL. Which of the following information should the nurse include?
Do not exercise if ketones are present in your urine.
A nurse is teaching a client who has type 1 diabetes mellitus about exercise. Which of the following instructions should the nurse teach the client?
Persistent cough
A nurse is teaching a client who is starting to take an ACE inhibitor to treat hypertension. The nurse should instruct the client to notify the provider if he experiences which of the following adverse effects of this medication?
"Take the medication with a meal."
A nurse is teaching a client who takes metformin XR for type II diabetes mellitus. Which of the following instructions should the nurse include in the teaching?
"Maintain stable blood glucose level."
A nurse is teaching an older adult client who has diabetes mellitus about preventing the long term complications of retinopathy and nephropathy. Which of the following instructions should the nurse include?
"Do not visit if you've had a recent infection"
A nurse provides care on a bone marrow transplant unit and is preparing a female client for a hematopoietic stem cell transplantation (HSCT) the following day. What information should the nurse emphasize to the client's family and friends?
Managing chronic conditions must be a collaborative process.
A nursing instructor is discussing characteristics of chronic illness with a class. The instructor asks the students to name one characteristic. Which of the following answers is correct:
True
A patient's history of present health concern or illness is the single most important factor in helping the health care team arrive at a diagnosis or determine the patient's current needs.
8:00 pm
A total of 1000 mL of an IV solution is to infuse at 100 mL/hour. If it is 10:00 AM when the infusion starts, at what time will it be completed?
Administer an antiemetic
An adult client with leukemia will soon begin chemotherapy. What would the nurse do to combat the most common adverse effects on chemotherapy?
With age, biologic changes reduce the efficiency of body systems
An elderly client has presented to the clinic with new diagnosis of osteoarthritis. The client's daughter is accompanying him and the nurse has explained why the incidence of chronic diseases tends to increase with age. What rationale for this phenomenon should the nurse describe?
Hearing loss
During a health history, the nurse notices that a client is watching the nurse's face intently and leaning in closer with each question asked. As the nurse becomes aware of such behaviors, she will inquire about which possible client impairment?
Have you discussed your end-of-life choices with your family and/or designated surrogate and healthcare team? Do you have basic information about advance medical directives? Do you wish to initiate an advance medical directive. Do you think that your condition is terminal?
During patient assessment, a holistic nurse may ask the following questions: Select all that apply.
False
Functional incontinence is the involuntary loss of urine through an intact urethra as a result of sneezing, coughing, or changing position.
Slows down the transport of amino acids into cells
Functions of insulin include all of the following except:
60 minutes. 30 minutes.
How long does a patient taking biophosphonates need to stay upright after administration? Choose all that apply.
True
Irritable bowel syndrome (IBS) is a functional disorder characterized by recurrent abdominal pain that affects frequency of defecation and consistency of stool; is associated with no specific structural or biomedical alterations.
Application of cold compress to the perineum
Nursing care of patient with urinary tract infections include all of the following except:
True
Nursing interventions for a patient undergoing foot surgery include a neurovascular assessment every 1 to 2 hours for the first 24 hours.
True
Osteoporosis frequently results in compression fractures of the spine, fractures of the neck or intertrochanteric region of the femur, and Colles fractures of the wrist:
True
Osteoporosis frequently results in compression fractures of the spine, fractures of the neck or intertrochanteric region of the femur, and Colles' fractures of the wrist:
False
Pain and fatigue are the most common side effects of chemotherapy:
Relief of symptoms of disease and promotion of comfort and quality of life.
Palliation refers to
True
Passive smoke (i.e. secondhand smoke) has been linked to lung cancer, nonsmokers who live with a smoker have about a 20% to 30% greater risk of developing lung cancer.
"Benign tumors don't usually cause death."
The clinic nurse is caring for a client who has just been diagnosed with a tumor. The client says to the nurse "The doctor says my tumor is benign. What does that mean?" What is the nurse's best response?
Relieve pain and discomfort while promoting quality of life
The hospice nurse is assigned to care for a patient with metastatic bone cancer who wants to remain at home. What is the therapeutic goal in the care of this patient?
True
The most common site for peptic ulcer formation is the duodenum:
Discontinue the infusion
The nurse assesses that extravasation of a chemotherapy agent has occurred. What should the initial action of the nurse be?
Nausea and vomiting. Right lower quadrant pain. Oral temperature 38.4 C (101.1 F).
The nurse is assessing a client who has appendicitis. Which of the following findings should the nurse expect? (Select all that apply).
Weak peripheral pulses
The nurse is assessing a client who has left-sided failure. Which of the following manifestations should the nurse expect to find?
Absence of adventitious breath sounds
The nurse is assessing a client who has pulmonary edema related to heart failure. Which of the following findings indicates effective treatment of the client's condition?
"My cancer has now spread to my liver".
The nurse is caring for a client with the diagnosis of colon cancer with metastasis to the liver. Which statement made by the client indicates an understanding of the diagnosis?
Provide a sign language interpreter
The nurse is caring for a patient who communicates via sign language. To promote communication, the nurse should do which of the following?
Smoking cessation
The public health nurse is presenting a health promotion class to a group at a local community center. Which intervention most directly addresses the leading cause of cancer deaths in North America?
Tell the RN you will wait until he returns to the room prior to the administration of these medications
The registered nurse watched you verify the client's identity. You completed all the scanning of the medications and the correct 8 checks for medication administration. You opened each single dose pill packet and placed them all in one cup. Suddenly, the RN is called out of the room what should you do?
Increase in exercise and reduction in calorie intake
The school nurse is working with a female high school junior whose BMI is 31. When planning this girl's care, the nurse should identify what goal?
Hypertensive emergencies are associated with evidence of target organ damage.
The staff educator is teaching ED nurses about hypertensive crisis. The nurse educator should explain that hypertensive urgency differs from hypertensive emergency in what way?
Bisacodyl (Dulcolax)
What is an example of a stimulant laxative agent?
Foot with an abnormally high arch and a fixed equinus deformity of the forefoot
What is pev cavus?
Administer 10 units of regular insulin subcutaneously (sub-Q). Perform a blood sugar analysis.
What should be the nurse's initial response when a client diagnosed with type 1 diabetes suddenly reports feeling weak, shaky, and dizzy?
Regular
When considering the management of diabetic ketoacidosis (DKA), what type of insulin can be administered intravenously?
Carpal tunnel syndrome
Which common problem of the upper extremity results from entrapment of the median nerve at the wrist?
lispro (Humalog)
Which of the following categories of insulin is rapid-acting?
regular (Humalin R)
Which of the following categories of insulin is short-acting?
Tobacco
Which of the following in the single largest preventable cause of cancer?
Angiogenesis
Which of the following is a term used to describe the growth of new blood vessels that allow cancer cells to grow?
Right patient
Which of the following medication right is missing in this order? "Ibuprofen 400 mg by mouth every 6 hours as needed for pain."
Dietary and genetic factor. Hormonal and chemical agents. Viruses. (all of the above)
Which specific agents or factors are associated with the etiology of cancer?
"Regular exercise makes your body better able to use the insulin it produces."
Which statement would be appropriately included in the teaching concerning type 2 diabetes?
Autologous
Which type of vaccine uses the client's own cancer cells, which are killed and prepared for injection back into the client?
Inherited gene mutation
While competing an admission assessment, the client reports a family history of ovarian cancer among a maternal grandmother, aunt, and sister. The nurse knows that these cancers are most likely associated with what etiology?
Prophylactic surgery
You are a clinic nurse. One of your clients has found she is at high risk for breast cancer. She asks you what can be done to reduce her risk. What is a means of reducing the risk for breast cancer?
Sciatica
_______________ is an inflammation of the sciatic nerve, resulting in pain and tenderness along the nerve through the thigh and leg.
Latent Autoimmune Diabetes of Adult (LADA)
_______________ is the subtype of diabetes in which progression of autoimmune beta cell destruction in the pancreas is slow and not insulin dependent in the first 6 months of disease onset.
Mixed
___________________________ urinary incontinence encompasses several types of urinary incontinence, it is involuntary leakage associated with urgency and also with excertion, efforts, sneezing, or coughing.
