Elevate module 4

A client with a severe cough is suspected of having lung cancer. When preparing the client for testing to confirm a diagnosis of cancer, which tests should a nurse anticipate? 1. Chest x-ray 2. Arterial blood gas 3. Bronchoscopy 4. Computed tomography (CT) 5. Pulmonary function test

1. Chest x-ray 3. Bronchoscopy 4. Computed tomography (CT)

A client has been receiving 5-fluorouracil treatments for colon cancer and is admitted with weakness, fatigue, thrombocytopenia and low grade fever. Which actions would be appropriate for this client? 1. Dedicated supplies in room 2. Semi-private room 3. Liquid diet 4. Limit visitors 5. Nasogastric tube placement

1. Dedicated supplies in room 4. Limit visitors (risk for infection and bleeding, needs a private room due to being immunocompromised, high calorie/protein diet)

What signs/symptoms would the nurse expect to find in a client admitted to the unit with a diagnosis of Addison's disease? 1. Moon face 2. Buffalo hump 3. Hirsutism 4. Acne 5. Hyperpigmentation 6. Hypotension

5. Hyperpigmentation 6. Hypotension

A client diagnosed with cancer has been losing weight. What should the nurse teach the client regarding methods for improving nutritional needs to maintain weight? 1. Add butter to foods 2. Spread peanut butter on toast 3. Use biscuits to make sandwiches 4. Put honey on top of hot cereal 5. Eat Caesar salads once per day

1. Add butter to foods 2. Spread peanut butter on toast 3. Use biscuits to make sandwiches 4. Put honey on top of hot cereal

A client diagnosed with cancer has been losing weight. What should the nurse teach the client regarding methods for improving nutritional needs to maintain weight? 1. Add butter to foods. 2. Cup of cubed beef broth. 3. Add powdered creamer to milkshake. 4. Use biscuits to make sandwiches. 5. Fish sauted in olive oil. 6. Put honey on top of hot cereal.

1. Add butter to foods. 3. Add powdered creamer to milkshake. 4. Use biscuits to make sandwiches. 6. Put honey on top of hot cereal.

Which client instruction is important when the client is scheduled for a vanillylmandelic acid (VMA) test? 1. Avoid caffeine for 72 hours. 2. A 24 hour urine specimen requires starting with an empty bladder. 3. Physical exercise should be avoided throughout the test. 4. Avoid all commercially prepared foods for 24 hours prior to testing. 5. A preservative will be added to the collection container.

1. Avoid caffeine for 72 hours. 2. A 24 hour urine specimen requires starting with an empty bladder. 3. Physical exercise should be avoided throughout the test. 5. A preservative will be added to the collection container. (avoid vanilla, caffine, citrus fruits, & bananas)

What is the nursing priority for the client experiencing hyperparathyroidism? 1. Continuous cardiac monitoring. 2. Initiate fall precautions. 3. Administer IV normal saline. 4. Begin preparations for emergency parathyroidectomy.

1. Continuous cardiac monitoring. (worried about calcium, too much calcium=sedation)

The nurse recognizes which manifestation as a sign/symptom of Hodgkin's lymphoma? 1. Drenching night sweats 2. Small, red, itchy bumps 3. Painful lymph nodes in the neck 4. Weight loss of 2 kg in 1 week 5. Flushed skin 6. Enlarged spleen

1. Drenching night sweats 2. Small, red, itchy bumps 6. Enlarged spleen (swollen lymph nodes are usually painless, large weight loss, pale skin)

What signs and symptoms of ovarian cancer should a nurse include when educating women? 1. GI disturbances 2. Menstrual changes 3. Malnutrition 4. Increasing abdominal girth 5. Pain radiating down the legs

1. GI disturbances 2. Menstrual changes 4. Increasing abdominal girth

The nurse is providing foot care to the client who has diabetes. What should the nurse include in the teaching? 1. Inspect the feet daily for abrasions or pressure areas. 2. Check water temperature with the hands before getting into tub. 3. Do not use heating pads on the feet or lower legs. 4. Thoroughly dry the feet, especially between the toes. 5. Cut toenails rather than file them. 6. Cut nails in a rounded fashion.

1. Inspect the feet daily for abrasions or pressure areas. 2. Check water temperature with the hands before getting into tub. 3. Do not use heating pads on the feet or lower legs. 4. Thoroughly dry the feet, especially between the toes. (filing toenails is safer than cutting, straight across)

A client diagnosed with hypothyroidism has been taking levothyroxine in increasing doses over the past week. Which findings, if present, would indicate to the nurse that the drug dosage is too high? 1. Irritability 2. Weight gain 3. Tachycardia 4. Tremors 5. Headache 6. Bradycardia

1. Irritability 3. Tachycardia 4. Tremors 5. Headache (s/s of hyperthyroidism)

A nurse is assigned a client who is one day post thyroidectomy. While taking the blood pressure, the client's hand starts to tremble. On auscultation of the heart, the nurse notes an arrhythmia. What actions should the nurse take? 1. Pad the side rails 2. Monitor potassium level 3. Take blood pressure in opposite arm 4. Place trach set at bedside 5. Check for airway patency

1. Pad the side rails 4. Place trach set at bedside 5. Check for airway patency (decreased calcium)

What is priority for the client experiencing hyperparathyroid crisis? 1. Support for airway and breathing. 2. Continuous cardiac monitoring for arrhythmias. 3. Provide safety precautions. 4. Prepare for emergency tracheostomy.

1. Support for airway and breathing.

Which statements made by a client diagnosed with Addison's disease indicates to the nurse that the client understands fludrocortisone therapy? 1. "Taking my medicine at night will help me sleep." 2. "It is important to wear a medical alert bracelet all of the time." 3. "I will limit my sodium intake to 200 mg per day." 4. "My medication dose will change based on my daily weight." 5. "I may need more medication if I feel weak or dizzy."

2. "It is important to wear a medical alert bracelet all of the time." 4. "My medication dose will change based on my daily weight." 5. "I may need more medication if I feel weak or dizzy." (need HIGH sodium diet, patient is losing sodium and retaining potassium)

An elderly client diagnosed with Stage 4 cancer is anxiously awaiting the primary healthcare provider to discuss possible care options. What is the appropriate way for the nurse to assist the client? 1. Assure the client that the healthcare provider will present all the best options. 2. Assist client to make list of questions to ask prior to the discussion. 3. Offer to remain with the client during healthcare provider's visit. 4. Suggest the presence of a family member could be helpful to client. 5. Provide written information to client about cancer treatments.

2. Assist client to make list of questions to ask prior to the discussion. 3. Offer to remain with the client during healthcare provider's visit. 4. Suggest the presence of a family member could be helpful to client.

A 13 year old found unresponsive in the park is brought into the emergency department (ED). The nurse sees a medical alert bracelet stating "Diabetic", and notes a fruity smell to the breath. There are no family members available to obtain consent for treatment and attempts to call them have been unsuccessful. What action should the nurse take? 1. Obtain consent from the social worker on duty in the emergency department. 2. Begin treatment by inserting two large bore IVs for administration of normal saline. 3. Give Glucagon IM and then wait for the arrival of a parent to consent to further treatment. 4. Notify the pirmary healthcare provider.

2. Begin treatment by inserting two large bore IVs for administration of normal saline. (emergency, consent is not needed)

What signs/symptoms would the nurse expect to find in a client admitted to the unit with a diagnosis of Cushing's disease? 1. Hyperpigmentation 2. Buffalo hump 3. Hirsutism 4. Acne 5. Moon face 6. Hypertension

2. Buffalo hump 3. Hirsutism 4. Acne 5. Moon face 6. Hypertension (hyperpigmentation= Addison's)

A client's absolute neutrophil count (ANC) is 750/mm3. Which measures should the nurse take to protect the client? 1. Prohibit the client from shaving. 2. Instruct the client to wear a mask when leaving the hospital room. 3. Remove fresh flowers and plants from the client's room. 4. Ask visitors to perform hand hygiene before entering the client's room. 5. Instruct client to avoid flossing of teeth.

2. Instruct the client to wear a mask when leaving the hospital room. 3. Remove fresh flowers and plants from the client's room. 4. Ask visitors to perform hand hygiene before entering the client's room. (ANC < 1,000= neutropenic precautions)

What medications would the nurse anticipate for the treatment of hyperthyroidism? 1. Levothyroxine 2. Methimazole 3. Propranolol 4. Iodine compounds 5. Calcitonin

2. Methimazole 3. Propranolol 4. Iodine compounds

A client has been prescribed levothyroxine sodium. What should the nurse teach the client about this medication? 1. Treatment will last for one year. 2. Notify the primary healthcare provider of chest pain. 3. Take medication ½ hour before breakfast. 4. Take calcium supplements 4 hours after taking levothyroxine. 5. Improvement of symptoms will occur within 2 days.

2. Notify the primary healthcare provider of chest pain. 3. Take medication ½ hour before breakfast. 4. Take calcium supplements 4 hours after taking levothyroxine. (life long treatment, may take several weeks for symptoms to improve)

A client, who is receiving an IV vesicant agent, reports pain at the intravenous site. What is the priority nursing action? 1. Apply a cold compress to the IV site 2. Stop the infusion 3. Check the IV for a blood return 4. Notify the primary healthcare provider

2. Stop the infusion

A nurse is caring for a client who is diagnosed with diabetic ketoacidosis (DKA). Which primary healthcare provider prescription is appropriate during the first 24 hours of treatment for this client? 1. 0.45% saline solution (NaCl) at 50 mL/hr 2. 3% saline solution (NaCl) at 125 mL/hr 3. 0.9% saline solution (NaCl) at 1,000 mL/hr times 2 4. Dextrose 5% in lactated Ringer's solution at 150 mL/hr

3. 0.9% saline solution (NaCl) at 1,000 mL/hr times 2

Which client diagnosis would a prescription for an intravenous infusion of 1000 mL normal saline with 20 mEq (20 mmol) potassium chloride be appropriate? 1. Major burn injury 2. Kidney disease 3. Abdominal cramping with diarrhea 4. Diabetic Ketoacidosis (DKA) 5. Hypokalemia

3. Abdominal cramping with diarrhea 4. Diabetic Ketoacidosis (DKA) 5. Hypokalemia (DKA- will receive IV insulin which pulls glucose and potassium out of the blood stream and into the cell)

Which risk factor should the nurse include when planning to educate a group of women about breast cancer? 1. Menopause before the age of 50 2. Drinking one glass of wine daily 3. Multiparity 4. Early menarche

4. Early menarche (menopause after age 50, no pregnancy)

s/s of ovarian cancer

irregular menses increasing premenstrual tension menorrhagia with breast tenderness early menopause abdominal discomfort dyspepsia pelvic pressure urinary frequency (indigestion, flatulence, fullness after a light meal, and increasing abdominal girth are significant symptoms)