Exam #2

A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). The nurse informs the client that the physician will order diuretic therapy and restrict fluid and sodium intake to treat the disorder. If the client doesn't comply with the recommended treatment, which complication may arise? A. Cerebral edema B. Hypovolemic shock C. Severe hyperkalemia D. Tetany

A. Cerebral edema

Which electrolyte is a major anion in body fluid? A. Chloride B. Potassium C. Sodium D. Calcium

A. Chloride

The drug interleukin-2 is an example of which type of biologic response modifier? A. Cytokine B. Monoclonal antibodies C. Retinoids D. Antimetabolites

A. Cytokine

According to the tumor-node-metastasis (TNM) classification system, T0 means there is A. No evidence of primary tumor B. No regional lymph node metastasis C. No distant metastasis D. Distant metastasis

A. No evidence of primary tumor

Which type of surgery is used in an attempt to relieve complications of cancer? A. Palliative B. Prophylactic C. Reconstructive D. Salvage

A. Palliative

A client is being treated in the ICU 24 hours after having a radical neck dissection completed. The client's serum calcium concentration is 7.6 mg/dL (1.9 mmol/L). Which physical examination finding is consistent with this electrolyte imbalance? A. Presence of Trousseau sign B. Slurred speech C. Negative Chvostek sign D Muscle weakness

A. Presence of Trousseau sign

A client has a respiratory rate of 38 breaths/min. What effect does breathing faster have on arterial pH level? A. No effect B. Increases arterial pH C. Decreases arterial pH D. Provides long-term pH regulation

B. Increases arterial pH

For a client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the care plan? A. Administering aspirin if the temperature exceeds 102° F (38.8° C) B. Inspecting the skin for petechiae once every shift C. Providing for frequent rest periods D. Placing the client in strict isolation

B. Inspecting the skin for petechiae once every shift

A nurse in the Medical ICU has orders to infuse a hypertonic solution into a patient with low blood pressure. This solution will increase the number of dissolved particles in the patient's blood, creating pressure for fluids in the tissues to shift into the capillaries and increase the blood volume. What term or terms are associated with this process? A. Hydrostatic pressure B. Osmosis and osmolality C. Diffusion D. Active transport

B. Osmosis and osmolality

A client is receiving external radiation to the left thorax to treat lung cancer. Which intervention should be part of this client's care plan? A. Avoiding using soap on the irradiated areas B. Applying talcum powder to the irradiated areas daily after bathing C. Wearing a lead apron during direct contact with the client D. Removing thoracic skin markings after each radiation treatment

A. Avoiding using soap on the irradiated areas

The physician has prescribed 0.9% sodium chloride IV for a hospitalized client in metabolic alkalosis. Which nursing actions are required to manage this client? Select all that apply. A. Compare ABG findings with previous results. B. Maintain intake and output records. C. Document presenting signs and symptoms. D. Administer IV bicarbonate. E. Suction the client's airway.

A. Compare ABG findings with previous results. B. Maintain intake and output records. C. Document presenting signs and symptoms.

Which of the following is a clinical manifestation of fluid volume excess (FVE)? Select all that apply. A. Distended neck veins B. Crackles in the lung fields C. Shortness of breath D. Decreased blood pressure E. Bradycardia

A. Distended neck veins B. Crackles in the lung fields C. Shortness of breath

The client is receiving a vesicant antineoplastic for treatment of cancer. Which assessment finding would require the nurse to take immediate action? A. Extravasation B. Stomatitis C. Nausea and vomiting D. Bone pain

A. Extravasation

The nurse is assigned to care for a client with a serum phosphorus concentration of 5.0 mg/dL (1.61 mmol/L). The nurse anticipates that the client will also experience which electrolyte imbalance? A. Hypocalcemia B. Hyperchloremia C. Hypermagnesemia D. Hyponatremia

A. Hypocalcemia

A client with cancer is being evaluated for possible metastasis. What is one of the most common metastasis sites for cancer cells? A. Liver B. Colon C. Reproductive tract D. White blood cells (WBCs)

A. Liver

The nurse is caring for a client undergoing alcohol withdrawal. Which serum laboratory value should the nurse monitor most closely? A. Magnesium B. Calcium C. Phosphorus D. Potassium

A. Magnesium

A client is declared to have a terminal illness. What intervention will a nurse perform related to the final decision of a dying client? A. Respect the client's and family members' choices. B. Share emotional pain. C. Abide by the dying client's wishes. D. Ask the family members about spiritual care.

A. Respect the client's and family members' choices.

A client has a serum calcium level of 7.2 mg/dl (1.8 mmol/L). During the physical examination, the nurse expects to assess: A. Trousseau's sign. B. Homans' sign. C. Hegar's sign. D. Goodell's sign.

A. Trousseau's sign.

A client reports muscle cramps in the calves and feeling "tired a lot." The client is taking ethacrynic acid (Edecrin) for hypertension. Based on these symptoms, the client will be evaluated for which electrolyte imbalance? A. hypokalemia B. hyperkalemia C. hypocalcemia D. hypercalcemia

A. hypokalemia

Which arterial blood gas (ABG) result would the nurse anticipate for a client with a 3-day history of vomiting? A. pH: 7.55, PaCO2: 60 mm Hg, HCO3-: 28 B. pH: 7.45, PaCO2: 32 mm Hg, HCO3-: 21 C. pH: 7.28, PaCO2: 25 mm Hg, HCO3: 15 D. pH: 7.34, PaCO2: 60 mm Hg, HCO3: 34

A. pH: 7.55, PaCO2: 60 mm Hg, HCO3-: 28

While providing care to a terminally ill client, the client asks, "Am I dying?" Which response by the nurse would be most appropriate? A. "What makes you think that you might be dying?" B. "Tell me some more about what is on your mind." C. "You're just having a bit of a set-back. You'll be fine." D. "What has your physician told you about your condition?"

B. "Tell me some more about what is on your mind."

Following surgery for adenocarcinoma, the client learns the tumor stage is T3,N1,M0. What treatment mode should the nurse anticipate? A. No further treatment is indicated. B. Adjuvant therapy is likely. C. Palliative care is likely. D. Repeat biopsy is needed before treatment begins.

B. Adjuvant therapy is likely.

A client with chronic renal failure has a serum potassium level of 6.8 mEq/L. What should the nurse assess first? A. Blood pressure B. Respirations C. Temperature D. Pulse

D. Pulse

A nurse is providing an afternoon shift report and relates morning assessment findings to the oncoming nurse. Which daily assessment data is necessary to determine changes in the client's hypervolemia status? A. vital signs B. edema C. intake and output D. weight

D. Weight

A client has been diagnosed with an intestinal obstruction and has a nasogastric tube set to low continuous suction. Which acid-base disturbance is this client at risk for developing? A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis

D. Metabolic alkalosis

The nurse is caring for a client who has been diagnosed with chronic obstructive pulmonary disease (COPD) and is experiencing respiratory acidosis. The client asks what is making the acidotic state. What does the nurse identify as the result of the disease process that causes the fall in pH? The lungs are unable to breathe in sufficient oxygen. The lungs are unable to exchange oxygen and carbon dioxide. The lungs have ineffective cilia from years of smoking. The lungs are not able to regulate carbonic acid levels.

D. The lungs are not able to regulate carbonic acid levels.

The nurse is caring for a client who just learned of a terminal diagnosis. After the physician leaves, the nurse remains to answer further questions so that the client can make an informed decision about further treatment. By providing all available information, the nurse is promoting which ethical principle? A. The principle of justice B. The principle of nonmaleficence C. The principle of fidelity D. The principle of autonomy

D. The principle of autonomy

A terminally ill patient in pain asks the nurse to administer enough pain medication to end the suffering forever. What is the best response by the nurse? A. "I can't do that, I will go to jail." B. "I am surprised that you would ask me to do something like that." C. "I will see if the physician will order enough for that to occur." D. "I will notify the physician that the current dose of medication is not relieving your pain."

D. "I will notify the physician that the current dose of medication is not relieving your pain."

The nurse is working with a client who has had an allo-hematopoietic stem cell transplant (HSCT). The nurse notices a diffuse rash and diarrhea. The nurse contacts the physician to report that the client has symptoms of A. nadir. B. graft-versus-host disease. C. metastasis. D. acute leukopenia.

B. graft-versus-host disease.

The nurse performs a breast exam on a client and finds a firm, non-moveable lump in the upper outer quadrant of the right breast that the client reports was not there 3 weeks ago. What does this finding suggest? A. Normal finding B. Benign fibrocystic disease C. Malignant tumor D. Malignant tumor with metastasis to surrounding tissue

C. Malignant tumor

A nurse is performing a home visit for a client who received chemotherapy within the past 24 hours. The nurse observes a small child playing in the bathroom, where the toilet lid has been left up. Based on these observations, the nurse modifies the client's teaching plan to include: A. expected chemotherapy-related adverse effects. B. chemotherapy exposure and risk factors. C. signs and symptoms of infection. D. reinforcement of the client's medication regimen.

B. chemotherapy exposure and risk factors.

The nurse is evaluating the client's risk for cancer. The nurse should recommend the client change which lifestyle choice? A. uses the treadmill for 30 minutes on 5 days each week B. eats red meat such as steaks or hamburgers every day C. works as a secretary at a medical radiation treatment center D. drinks one glass of wine at dinner each night

B. eats red meat such as steaks or hamburgers every day

A nurse is caring for a client who is receiving chemotherapy and has a platelet count of 30,000/mm3. Which statement by the client indicates a need for additional teaching? A. "I floss my teeth every morning." B. "I use an electric razor to shave." C. "I take a stool softener every morning." D. "I removed all the throw rugs from the house."

A. "I floss my teeth every morning."

A client is recovering from a craniotomy with tumor debulking. Which comment by the client indicates to the nurse a correct understanding of what the surgery entailed? A. "I guess the doctor could not remove the entire tumor." B. "I am so glad the doctor was able to remove the entire tumor." C. "I will be glad to finally be done with treatments for this thing." D. "Thank goodness the tumor is contained and curable."

A. "I guess the doctor could not remove the entire tumor."

All nurses care for clients who are grieving. It is important for the nurse to understand the grieving process for which reason? A. Allows for the nurse to facilitate the grieving process B. Allows for the nurse to take the client through in the appropriate order C. Allows for the nurse to understand when the grieving process should be concluded D. Allows the nurse to express his or her feelings

A. Allows for the nurse to facilitate the grieving process

The nurse is caring for a client who has had a nuclear scan to aid in the diagnosis of possible cancer. The scan showed a "hot spot". What does this mean? A. An area of increased concentrations of the tracer used in the scan. B. Distinguishes areas of tissue that are normal. C. An area of decreased concentrations of the tracer used in the scan. D. Distinguishes abnormal areas of tumor

A. An area of increased concentrations of the tracer used in the scan.

The Emergency Department (ED) nurse is caring for a client with a possible acid-base imbalance. The physician has ordered an arterial blood gas (ABG). What is one of the most important indications of an acid-base imbalance that is shown in an ABG? A. PaO2 B. PO2 C. Carbonic acid D. Bicarbonate

D. Bicarbonate

A nurse is teaching a client with bone marrow suppression about the time frame when bone suppression will be noticeable after administration of floxuridine. What is the time frame the nurse should include with client teaching? A. 24 hours B. 2 to 4 days C. 7 to 14 days D. 21 to 28 days

C. 7 to 14 days

The nurse is providing client teaching for a client undergoing chemotherapy. What dietary modifications should the nurse advise? A. Eat wholesome meals. B. Avoid spicy and fatty foods. C. Avoid intake of fluids. D. Eat warm or hot foods.

B. Avoid spicy and fatty foods.

Which term is used to describe the personal feelings that accompany an anticipated or actual loss? A. Bereavement B. Grief C. Mourning D. Spirituality

B. Grief

The client is diagnosed with a benign brain tumor. Which of the following features of a benign tumor is of most concern to the nurse? A. Random, rapid growth of the tumor B. Cells colonizing to distant body parts C. Tumor pressure against normal tissues D. Emission of abnormal proteins

C. Tumor pressure against normal tissues

A nurse is monitoring a client being evaluated who has a potassium level of 7 mEq/L (mmol/L). Which electrocardiogram changes will the client display? A. prolonged T waves B. elevated ST segment C. peaked T waves D. shortened PR interval

C. peaked T waves

Which laboratory result does the nurse identify as a direct result of the client's hypovolemic status with hemoconcentration? A. Abnormal potassium level B. Elevated hematocrit level C. Low white blood count D. Low urine specific gravity

B. Elevated hematocrit level

The family of a client in hospice decides to place their loved one in a long-term care facility to establish an effective pain control regimen. Which aspects of hospice care is the family using? A. Inpatient respite care B. Palliative care C. Continuous care D. General inpatient care

B. Palliative care

When describing the term "grief" to a group of students, which of the following would the instructor include? A. A part of the life cycle in the form of change, growth, and transition B. The response experienced by anyone who has suffered a loss C. A feeling of connectedness with one's self and others D. Feelings of apprehension or worry in response to a situation

B. The response experienced by anyone who has suffered a loss

The physician is attending to a client with a malignant brain tumor. The physician recommends immediate radiation therapy. What is a reason for the physician's recommendation? A. To remove the tumor from the brain B. To prevent the formation of new cancer cells C. To analyze the lymph nodes involved D. To destroy marginal tissues

B. To prevent the formation of new cancer cells

A nurse is providing care to a client experiencing symptoms associated with terminal illness. Which of the following would be most appropriate to use as a means for managing the client's symptoms? A. Physician's orders B. Client's goals C. Length of required treatment D. Invasiveness of the treatment

B. Client's goals

Your patient has recently completed her first round of chemotherapy in the treatment of lung cancer. When reviewing this morning's blood work, what findings would be suggestive of myelosuppression? A. Decreased sodium levels and decreased potassium levels B. Increased creatinine and blood urea nitrogen (BUN) C. Decreased platelets and red blood cells D. Increased white blood cells and c-reactive protein (CRP)

C. Decreased platelets and red blood cells

A client diagnosed with a terminal illness appoints her oldest son as the authorized individual to make medical decisions on her behalf when she is no longer able to speak for herself. Which proxy directive is the patient using? A. Medical directive by proxy B. Living will declaration C. Durable power of attorney for health care D. End-of-life treatment directive

C. Durable power of attorney for health care

The nurse is caring for a pediatric client who is dying. The best way to provide care and comfort to clients who are dying and their families is to first do which of the following? A. A workshop on caring for the client who is dying B. Use evidence-based practice in daily care regimen. C. Explore own feelings on mortality and death and dying. D. Participate in a support group to learn clients' feeling on care.

C. Explore own feelings on mortality and death and dying.

A client received chemotherapy 24 hours ago. Which precautions are necessary when caring for the client? A. Wear sterile gloves. B. Place incontinence pads in the regular trash container. C. Wear personal protective equipment when handling blood, body fluids, and feces. D. Provide a urinal or bedpan to decrease the likelihood of soiling linens.

C. Wear personal protective equipment when handling blood, body fluids, and feces.

A nurse is evaluating a client with a terminal illness. What should the nurse report so that the health care team can consider alternative nutritional approaches and fluid administration routes for the client at the end of life? A. altered gastrointestinal function B. drop in blood pressure and rapid heart rate C. weight loss and inadequate food intake D. irregular eating habits

C. weight loss and inadequate food intake

A nurse is teaching a client about the rationale for administering allopurinol with chemotherapy. Which example would be the best teaching by the nurse? A. It stimulates the immune system against the tumor cells. B. It treats drug-related anemia. C. It prevents alopecia. D. It lowers serum and uric acid levels.

D. It lowers serum and uric acid levels.