Exam 4

The nurse plans a community education program related to prevention of the cancer with the highest death rates in both women and men, what should the nurse include in the teaching plan? Smoking cessation Screening colonoscopy Regular examination of reproductive organs Use of sunscreen as protection from ultraviolet light

Smoking cessation

The nurse is preparing to teach a group of women about breast cancer risk factors. Which risk factors should the nurse include in the teaching plan? Women older than 50 are at greatest risk for breast cancer BRCA1 and BRCA2 genetic mutations cause most breast cancers Early menopause (before age 50) increases the risk of breast cancer One to two alcoholic beverage per day decrease the risk of breast cancer

Women older than 50 are at greatest risk for breast cancer

While teaching a health promotion class to a group of women, the nurse identifies which patient as most at risk for cervical cancer? a. A 32 year old who has had about 10 sexual partners b. A 24 year old recently diagnosed with genital herpes c. A 40 year old who began menstruating at 9 years of age d. A 38 year old who has used oral contraceptives for 20 years

a. A 32 year old who has had about 10 sexual partners

When caring for a patient following a lumbar laminectomy, the nurse should: a.place a pillow between the patient's legs before turning to the side. b.elevate the head of the bed 30 degrees and then turn the patient to the side. c.ask the patient to flex the knees and push the heels into the bed during turning. d.have the patient grasp the side rail on the opposite side of the bed to help with turning.

a.place a pillow between the patient's legs before turning to the side.

A patient has a severely sprained ankle from a sports injury. What should the nurse teach the patient prior to discharge from the urgent care center? a. Alternate cold and heat for 30 minutes each until symptoms are relieved. b. Apply cold for 20 to 30 minutes with breaks of 10 to 15 minutes during the first 2 days. c. Use continuous cold for the first 24 hours and then continuous heat until the symptoms are relieved. d. Apply continuous heat to the ankle for the first 24 hours and then continuous cold until the symptoms are relieved.

b. Apply cold for 20 to 30 minutes with breaks of 10 to 15 minutes during the first 2 days.

A patient admitted to the emergency department after an auto crash is found to have a blood alcohol concentration of 210 mg/dL (0.21 %). The patient is alert, can relate information related to the crash, and does not appear intoxicated. Which action by the nurse is most appropriate? a. Request a repeat blood test be completed. b. Obtain an accurate history of alcohol intake. c. Administer the antidote for alcohol intoxication. d. Assess the patient for alcohol withdrawal delirium.

b. Obtain an accurate history of alcohol intake.

The nurse determines that teaching about management of osteoarthritis of the feet and hands has been effective when the patient says: a."I will be careful to avoid crowds and people with infections." b."I can use heat to relieve the stiffness when I wake up in the morning." c."I should exercise my hands every day, especially if they are painful and inflamed." d."I should avoid the use of glucosamine as it does not have any therapeutic value."

b."I can use heat to relieve the stiffness when I wake up in the morning."

Which patient would be at greatest risk for developing osteoporosis? a.A 73-year-old man who has 5 alcoholic drinks per week and limits sun exposure to prevent recurrence of skin cancer. b.An 84-year-old man who has recently been diagnosed with hypothyroidism and is prescribed levothyroxine (Synthroid). c.A 69-year-old woman who had a renal transplant 5 years ago and has been taking prednisone to prevent organ rejection. d.A 55-year-old woman who recently had a hysterectomy with bilateral salpingo-oophorectomy and refuses estrogen therapy.

c.A 69-year-old woman who had a renal transplant 5 years ago and has been taking prednisone to prevent organ rejection.

A patient who is admitted to a burn unit is hypovolemic. A new nurse asks an experienced nurse about the patient's condition. Which response by the experienced is the most appropriate? a. "Blood loss from burned tissue is the most likely cause of hypovolemia." b. "Third spacing of fluid into fluid-filled vesicles is usually the cause of hypovolemia." c. "The usual cause of hypovolemia is evaporation of fluid from denuded body surfaces." d. "Increased capillary permeability causes fluid shifts out of blood vessels and results in hypovolemia."

d. "Increased capillary permeability causes fluid shifts out of blood vessels and results in hypovolemia."

When monitoring initial fluid replacement for the patient with 40% TBSA deep partial-thickness and full-thickness burns, which finding would most concern the nurse? a. Serum K+ of 4.5 mEq/L b. Urine output of 35 mL/hr c. Decreased bowel sounds d. Blood pressure of 86/72 mm Hg

d. Blood pressure of 86/72 mm Hg

During the emergent phase of burn injury, the nurse assesses for the presence of hypovolemia. In burn patients, hypovolemia occurs primarily as a result of a. Blood loss from injured tissue. b. Third spacing of fluid into fluid-filled vesicles. c. Evaporation of fluid from denuded body surfaces. d. Capillary permeability with fluid shift to the interstitium.

d. Capillary permeability with fluid shift to the interstitium.

A patient is undergoing diagnostic testing for symptoms of polyarthralgia, fatigue, and hair loss. Laboratory results include the presence of anti-DNA, antinuclear antibodies, and anti-Smith in the blood. The nurse recognizes that these findings are most likely to be related to which diagnosis? a. Systemic sclerosis b. Rheumatoid arthritis c. Chronic fatigue syndrome d. Systemic lupus erythematosus

d. Systemic lupus erythematosus

A plaster splint is applied with an elastic bandage to the leg of a patient with a fractured tibia in preparation for open reduction and internal fixation. The patient reports increasing pain in the affected leg and foot that is not relieved by loosening of the elastic bandage. The first action by the nurse is to: a. elevate the leg on 2 pillows. b. notify the health care provider. c. apply an ice bag over the fracture site. d. perform neurovascular assessment of the foot.

d. perform neurovascular assessment of the foot.

At an outpatient clinic, K.L.'s 78-year-old grandma is found to have a Hgb of 8.7 g/dL (87 g/L) and a Hct of 35%. Based on the most common cause of these findings in the older adult, the nurse collects information about: history of jaundice and black tarry stools. 3-day diet recall of the foods the patient has eaten. any drugs that have depressed the function of the bone marrow. history of any chronic diseases, such as cancer or renal disease.

history of any chronic diseases, such as cancer or renal disease.

A pt who has been treated with morphine by pt controlled analgesia (PCA) is discharged from the hospital with instructions that all of the following medications may be used for pain. Which medication will the nurse instruct the pt to use first? Aspirin Ibuprofen Acetaminophen (tylenol) oxycodone/acetaminophen (percocet)

oxycodone/acetaminaphen (percocet)

During a routine health exam, a 32-year-old pt tells the nurse she does not perform breast self-examinations. What is the most appropriate statement for the nurse to make? "Breast self-examination has little or no value." "Breast self-examination is an option for all women." "It is important for you to do monthly breast examinations." "Yearly breast examinations are not frequent enough."

"Breast self-examination is an option for all women."

The nurse teaches a student nurse about managing chronic pain when caring for older pts. Which statement, if made by the student nurse, indicates an understanding of the teaching? "Chronic pain is not an inevitable part of aging." "Older pts who are confused do not experience pain." "Older pts tolerate pain better than younger pts." "Opioids should not be used for chronic pain in the older pts."

"Chronic pain is not an inevitable part of aging."

The nurse explains to a patient with advanced cancer about the differences between hospice and palliative care. Which statement, if made by the patient, indicates that teaching was effective? "Hospice care is not available if I am in the hospital." "Palliative care provides better methods of pain control." "Hospice care will help my family and I prepare for death." "Palliative care does not include any advance directives."

"Hospice care will help my family and I prepare for death."

The nurse is teaching a newly diagnosed 34-year-old male about his HIV infection. Which statement by the patient would indicate the patient needs additional education? "I will need to take my HIV medication daily for the rest of my life." "Although I only take one pill, it has multiple medications combined into a single tablet." "I should notify my HIV provider if I get fevers that do not go away with Tylenol or aspirin." "Once my viral load is undetectable I don't have to worry about taking my medication."

"Once my viral load is undetectable I don't have to worry about taking my medication."

A pressure dressing is applied to the face and neck of a patient following face-lift surgery. The patient tells the nurse that the dressing feels restrictive and asks if it can be loosened. Which response by the nurse is most appropriate? "This dressing is used to prevent bleeding into the skin." "The dressing will support and secure the incision edges." dressing is necessary to prevent infection after surgery." "Face dressings provide time to become adjusted to a change."

"This dressing is used to prevent bleeding into the skin."

The nurse provides postoperative instructions for an adult pt after cataract surgery. Which written statement, if provided by the nurse, would be most appropriate? "To avoid contamination of the eye, use aseptic technique when applying eye drops." "Conjunctivitis may result if the eye is contaminated with wet or dirty eye patches." "To prevent infection in the eye, wash your hands before changing the eye patch or using eye drops." "Coughing and bending and over can cause increased intraocular pressure, resulting in retinal damage or displacement of the intraocular lens."

"To prevent infection in the eye, wash your hands before changing the eye patch or using eye drops."

Which patient is at highest risk for skin cancer? 56-year-old Native American with colon polyps. 72-year-old retired high school chemistry teacher. 32 year old who uses a tanning booth twice a week. 44 year old who regularly bathes with perfumed soap.

32 year old who uses a tanning booth twice a week.

When caring for pts with sexually transmitted infection, it is important that the nurse teach them to: Advise all sexual partners for the need for treatment Use a condom for sexual intercourse during treatment Engage in monogamous relationshi[s to prevent reinfection Wash the genitalia before sexual intercourse to prevent disease transmission

Advise all sexual partners for the need for treatment

A patient tells the nurse that she is worried about her 17-year-old son who has been socializing with some friends she thinks are using drugs. The best response by the nurse to the patient's concern is: A. "You need to stop his association with these friends to prevent him from using drugs" B. "Most young people experiment with drugs, but very few become addicted to illegal substances." C. "You should learn about the early signs and symptoms of drug use and share your concerns with your son. D. "You need to make an appointment for your son with a drug counselor so he can be taught about the harmful effects of drugs.

C. "You should learn about the early signs and symptoms of drug use and share your concerns with your son.

The nurse is caring for a patient who is receiving antiretroviral therapy (ART) for treatment of HIV infection. Which assessment best indicates that the patient's condition is improving?Decreased viral load Increased drug resistance Decreased CD4+ T-cell count Increased aminotransferase levels

Decreased viral load

The nurse is caring for a pt after abdominal surgery. Which action by the nurse is most appropriate for analgesic titration of the prescribed pain medication? Teach the pt to increase the time between doses of pain medication Limit use of pain medication to avoid dependence on opioid analgesics Determined with the pt the analgesic dosage required for pain relief Assist pt to plan the distribution of a specific total dose of analgesic over a 24 hour period

Determined with the pt the analgesic dosage required for pain relief

The nurse is caring for a patient with anxiety related to a skin condition. Which intervention would be most appropriate at this time for the nurse to add to this patient's plan of care? Encourage the patient to express feelings of anxiety. Use touch to demonstrate acceptance of appearance. (not B bc there is potential that it can be infectious) Refer the patient for counseling and further evaluation. Teach the patient use of cosmetics and cover-up techniques.

Encourage the patient to express feelings of anxiety.

To prevent the debilitating cycle of fatigue-depression-fatigue that can occur in patients with cancer, an appropriate nursing intervention is to Have the patient rest after expending any major energy Encourage the patient to implement a daily walking program Teach the patient to ignore the fatigue to maintain normal daily activities Prevent depression by informing the patient to expect fatigue during cancer treatment

Encourage the patient to implement a daily walking program

Every visit you make to E.M., her house is filled with visitors. You need to ask her some questions, but she seems reluctant to let go of their hands. What should you do? Ask E.M.'s husband what to do. Tell everyone to leave—she needs rest. Ask your questions with everyone present. Explain to E.M. why you need privacy and then follow her wishes.

Explain to E.M. why you need privacy and then follow her wishes.

The hospice nurse visits with the wife of a dying patient. The nurse is most concerned if the patient's wife makes which statement? I don't think that I can live without my husband to take care of me." I wonder if expressing my sadness makes my husband feel worse." have shared so much that it is hard to realize that I will be alone." don't feel guilty about leaving him to go to lunch with my friends."

I don't think that I can live without my husband to take care of me."

The nurse is caring for a 74-year-old woman. What would be a normal age-related finding? Kyphosis Back pain Loss of height Spinal crepitation

Loss of height

The nurse notices that a pt has an altered gait. To further assess this problem, which action should the nurse take? Measure the length of both legs Perform deep palpation of the hip joints Perform muscle-strength testing of the legs Test range of motion of the lower extremities

Measure the length of both legs

A diagnosis of AIDS can be made for a patient with HIV with WBC counts less than 3000/µL. CD4+ T-cell count less than 500/µL. development of oral candidiasis (thrush). Onset of Pneumocystis jiroveci pneumonia.

Onset of Pneumocystis jiroveci pneumonia.

The nurse teaches a pt about drugs used to treat genital herpes. Which drug should the nurse include in the patient instructions? Acyclovir ointment Oral acyclovir (zovirax) Human papillomavirus vaccine Podofilox (condylox) typical gel

Oral acyclovir (zovirax)

The nurse practitioner orders blood work for B.C. While reviewing the results of her complete blood count (CBC), which finding would be of greatest concern to the nurse? Hemoglobin of 11.4 g/dL (normal: M 14-18, F 12-16) Platelet count of 80,000/μ White cell count of 4500/μL Red cell count of 4.5×106/μL

Platelet count of 80,000/μ

The nurse is providing discharge teaching to a pt who had a myelogram. What would the nurse include in the teaching plan? (injecting dye into a joint space) Take acetaminophen (tylenol) to prevent fever Remain flat in bed for 24 to 48 hours to prevent pain Decrease fluid intake for 4 to 8 hours to prevent nausea Report a headache that is worse when sitting or standing

Report a headache that is worse when sitting or standing