Med Surg Final

A nurse who provides care in an ambulatory clinic integrates basic cancer screening into admission assessments. What client most likely faces the highest immediate risk of oral cancer?

A 65-year-old man with alcoholism who smokes

An 82-year-old client has come to the clinic for a scheduled follow-up appointment. The nurse learns from the client's child that the client is not following the instructions the client received upon discharge from the hospital last month. What is the most likely factor causing the client not to adhere to the therapeutic regimen?

Costs of the prescribed regimen

A client is scheduled for audiometry to evaluate hearing. When teaching the client about this test, which characteristic would the nurse include as being evaluated?

pitch frequency intensity

A nurse provides care on a bone marrow transplant unit and is preparing a client for a hematopoietic stem cell transplantation (HSCT) the following day. Which information should the nurse emphasize to the client's family and friends?

"Do not visit if you've had a recent infection"

The nurse is completing a client's health history with regard to potential risk factors for lung disease. What interview question addresses the most significant risk factor for respiratory diseases?

"Do you currently smoke, or have you ever smoked?"

While on spring break, a 22-year-old client was taken to the hospital for heat stroke and alcohol poisoning. The client is worried and states that a biopsy was taken and showed "some kind of benign condition." Which response by the nurse would best?

"I understand that you are worried. Benign conditions are noncancerous, but let's look at your chart to see your results"

While on spring break, a 22-year-old client was taken to the hospital for heat stroke and alcohol poisoning. The client is worried and states that a biopsy was taken and showed "some kind of benign condition." Which response by the nurse would be best?

"I understand that you are worried. Benign conditions are noncancerous, but let's look at your chart to see your results."

A client with systemic lupus erythematosus (SLE) is preparing for discharge. The nurse knows that the client has understood health education when the client makes what statement?

"I'll make sure to monitor my body temperature on a regular basis."

The community health nurse is performing a home visit to an 80-year-old client recovering from hip surgery. The nurse notes that the client seems uncharacteristically confused at times and has dry mucous membranes. When asked about fluid intake, the client states, "I stop drinking water early in the day because it is just too difficult to get up during the night to go to the bathroom." What would be the nurse's best response?

"Limiting your fluids can create imbalances that can result in confusion, so let's try adjusting the timing of your fluids."

The clinic nurse is caring for an adult oncology client who reports extreme fatigue and weakness after the first week of radiation therapy. Which response by the nurse would best reassure this client?

"These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory studies and test results"

A client has been hospitalized for a wedge resection of the left lower lung lobe after a routine chest x-ray showed carcinoma. The client reports feeling anxious and asks to smoke. Which statement by the nurse would be most therapeutic?

"You are anxious about the surgery. Do you see smoking as helping?"

An adult client with leukemia will soon begin chemotherapy. What would the nurse do to combat the most common adverse effects of chemotherapy?

Administer an antiemetic.

An adult client with leukemia will soon begin chemotherapy. What would the nurse to combat the most common adverse effects of chemotherapy?

Administer an antiemetic

A client who has been on long-term phenytoin therapy is admitted to the unit. In light of the adverse effects of this medication, the nurse should prioritize which of the following in the client's plan of care?

Administration of thorough oral hygiene

A client with rheumatoid arthritis comes into the clinic for a routine check-up. On assessment the nurse notes that the client appears to have lost some ability to function since the last office visit. What is the nurse's most appropriate action?

Arrange for the client to be assessed in the home environment

A nurse is assessing a client who has just been admitted to the postsurgical unit following surgical resection for the treatment of oropharyngeal cancer. What assessment should the nurse prioritize?

Assess for a patent airway.

A client with a diagnosis of primary immunodeficiency disease informs the nurse that the client has been experiencing a new onset of a dry cough and occasional shortness of breath. After determining that the client's vital signs are within reference ranges, what action should the nurse take?

Assess the client for signs and symptoms of infection.

The nurse determines that a client who has undergone skin, tissue, and muscle grafting following a modified radical neck dissection requires suctioning. What is the nurse's priority when suctioning this client?

Avoid applying suction on or near the suture line

The nurse manager is orienting a new nurse to the oncology unit. When reviewing the safe administration of antineoplastic agents, which action should the nurse manager emphasize?

Dispose of the antineoplastic wastes in the hazardous waste receptacle.

The nurse is conducting a health education about cancer prevention to a group of adults. What menu best demonstrates dietary choices for potentially reducing the risks of cancer?

Baked apricot chicken and steamed broccoli

A client has a diagnosis of rheumatoid arthritis, and the primary provider has now prescribed cyclophosphamide. The nurse's subsequent assessments should address which potential adverse effect?

Bone marrow suppression

The nurse is performing an initial assessment of a 75-year-old client who has just relocated to the long-term care facility. During the nurse's interview with the client, The client admits drinking around 600 mL (20 oz) of vodka every evening. What types of cancer does this put the client at risk for? Select all that apply

Breast cancer, Esophageal cancer, Liver cancer

The ED nurse is assessing a client who is reporting dyspnea. The nurse auscultates the client's chest and hears wheezing throughout the lung fields. What might this indicate about the client?

Bronchoconstriction

A client diagnosed with a cerebral aneurysm reports a severe headache to the nurse. What action is a priority for the nurse?

Call the health care provider immediately.

The hospice nurse has just admitted a new client to the program. What principle guides hospice care?

Care addresses the needs of the client as well as the needs of the family

The nurse on the medical-surgical unit is reviewing discharge instructions with a client who has a history of glaucoma. The nurse should anticipate the use of what medications?

Cholinergics

Which intervention should the nurse teach a client who is at risk for hypercalcemia?

Consume 2 to 4 L of fluid daily.

The nurse is completing a focused assessment addressing a client's immune function. What should the nurse prioritize in the physical assessment?

Palpation of the client's lymph nodes

A gerontologic nurse is teaching students about the high incidence and prevalence of dehydration in older adults. Which factors contribute to this phenomenon? Select all that apply.

Decreased kidney mass, Decreased renal blood flow, Decreased excretion of potassium

A public health nurse is teaching a health promotion workshop that focuses on vision and eye health. What should this nurse cite as the most common cause(s) of blindness and visual impairment among adults over the age of 40?

Diabetic retinopathy Macular degeneration Glaucoma

When discussing with a client factors that distinguish malignant cells from benign cells of the same tissue type, which characteristic should the nurse mention?

Different proteins in the cell membrane

A client with terminal small-cell lung cancer has been given a six-month prognosis and wants to die at home. The health care team believes the condition warrants inpatient care. The nurse might suggest which compromise?

Discuss a referral for hospice care

The nurse is caring for a client with a brain tumor and is aware that the normal compensation measures to keep ICP (intracranial pressure) within normal limits may no longer be effective. What are the normal compensation measures for the brain?

Displacing or shifting cerebral spinal fluid (CSF) Increasing the absorption of CSF Decreasing cerebral blood volume

A nurse is working with a client who has recently received a diagnosis of human immunodeficiency virus (HIV). When performing client education during discharge planning, what goal should the nurse prioritize?

Encourage the client to adhere to the client's therapeutic regimen.

A client on the oncology unit is receiving carmustine, a chemotherapy agent, and the nurse is aware that a significant side effect of this medication is thrombocytopenia. Which symptom should the nurse assess for in clients at risk for thrombocytopenia?

Epistaxis

The emergency room (ER) nurse is caring for a client who has been brought in by ambulance after sustaining a fall at home. What physical assessment finding(s) are suggestive of a basilar skull fracture?

Epistaxis Bruising over the mastoid

A nurse is performing the initial assessment of a client who has a recent diagnosis of systemic lupus erythematosus (SLE). Which skin manifestation would the nurse expect to observe on inspection?

Erythematous rash

The nurse is caring for a client with a secondary diagnosis of hypermagnesemia. What assessment finding would be most consistent with this diagnosis?

Shallow respirations

A clinic nurse is caring for a client newly diagnosed with fibromyalgia. When developing a care plan for this client, which nursing diagnosis should the nurse prioritize?

Fatigue related to pain

A client with a diagnosis of colon cancer is 2 days' postoperative following bowel resection and anastomosis. The nurse has planned the client's care in the knowledge of potential complications. What assessment should the nurse prioritize?

Frequent abdominal auscultation

The nurse is caring for a client who is to begin receiving external radiation for a malignant tumor of the neck. While providing client education, what potential adverse effects should the nurse discuss with the client?

Impaired nutritional status

The nurse is admitting an oncology client to the unit prior to surgery. The nurse reads in the electronic health record that the client has just finished radiation therapy. With knowledge of the consequent health risks, the nurse should prioritize assessments related to what health problem?

Impaired wound healing

A nurse is caring for a client who is acutely ill and has included vigilant oral care in the client's plan of care. What factor increases this client's risk for dental caries?

Inadequate nutrition and decreased saliva production can cause cavities

A client is hospitalized because a large abdominal tumor was seen on the computed tomography scan. A biopsy is ordered, and the client wants to know if "this will cause a big scar." Which type of biopsy will this client likely experience?

Incisional

A clinic nurse is caring for a client with suspected gout. While describing the pathophysiology of gout to the client, what should the nurse explain?

Increased uric acid levels

A nurse is planning the care of a client who has a long history of chronic pain, which has only recently been diagnosed as fibromyalgia. Which nursing diagnosis is most likely to apply to this client's care needs?

Ineffective role performance related to pain

A nurse is providing care for a client whose neck dissection surgery involved the use of a graft. When assessing the graft, the nurse should prioritize data related to what nursing diagnosis?

Ineffective tissue perfusion

A client has just been diagnosed with a primary immune deficiency disease (PIDD). The client has done some research online and believes this is an unlikely diagnosis due to the client's age. At which stage of life are people most commonly diagnosed with PIDD?

Infancy

The nurse is preparing to perform a client's abdominal assessment. What examination sequence should the nurse follow?

Inspection, auscultation, percussion, and palpation

The nurse is caring for a client who has undergone a mastoidectomy. In an effort to prevent postoperative infection, what intervention should the nurse implement?

Instruct the client to protect the ear from water for several weeks.

A nurse is performing the health history and physical assessment of a client who has a diagnosis of rheumatoid arthritis (RA). What assessment finding is most consistent with the clinical presentation of RA?

Joint stiffness lasting longer than 1 hour, especially in the morning

A client with a diagnosis of prostate cancer is scheduled to have an interstitial implant for high-dose radiation (HDR). What safety measure should the nurse include in this client's plan of care?

Limit the time that visitors spend at the client' bedside

A nurse who works in an oncology clinic is assessing a client who has arrived for a 2-month follow-up appointment following chemotherapy. The nurse notes that the client's skin appears yellow. Which blood tests should be done to further explore this clinical sign?

Liver function tests (LFTs)

During a routine mammogram, a client asks the nurse whether breast cancer causes the most deaths. Which type of cancer is the leading cause of death in the United States?

Lung

A client's most recent diagnostic imaging has revealed that lung cancer has metastasized to the bones and liver. What is the most likely mechanism by which the client's cancer cells spread?

Lymphatic circulation

A client has been diagnosed with a small bowel obstruction and has been admitted to the medical unit. The nurse's care should prioritize which of the following outcomes?

Maintaining fluid and electrolyte balance

An oncology nurse educator is providing health education to a client who has been diagnosed with skin cancer. The client's wife has asked about the differences between normal cells and cancer.

Malignant cells contain proteins called tumor-associated antigens

An oncology nurse educator is providing health education to a client who has been diagnosed with skin cancer. The client's wife has asked about the differences between normal cells and cancer cells. What characteristic of a cancer cell should the educator cite?

Malignant cells contain proteins called tumor-associated antigens.

A nurse is providing care for a client who has just been diagnosed with early-stage rheumatoid arthritis (RA). The nurse should anticipate the administration of which Medication?

Methotrexate

A nurse is providing care for a client who has just been diagnosed with early-stage rheumatoid arthritis (RA). The nurse should anticipate the administration of which medication?

Methotrexate

A client with systemic lupus erythematosus (SLE) asks the nurse why the client has to come to the office so often for "check-ups." Which rationale for frequent office visits would be best for the nurse to mention?

Monitoring the disease process and how well the prescribed treatment is working

A nurse is assessing a client with rheumatoid arthritis. The client expresses the intent to pursue complementary and alternative medicine (CAM) therapies. Which fact should underlie the nurse's response to the client?

Most CAM therapies lack sufficient evidence to support them

An ED nurse has just received a call from EMS that they are transporting a 17-year-old client who has just sustained a spinal cord injury (SCI). The nurse recognizes that the most common cause of this type of injury is what event?

Motor vehicle accidents

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?

Nausea and vomiting

The nurse is caring for a client who has just been told that the client's stage IV colon cancer has recurred and metastasized to the liver. The oncologist offers the client the option of surgery to treat the progression of this disease. What type of surgery does the oncologist offer?

Palliative

A client, diagnosed with cancer of the lung, has just been told the cancer has metastasized to the brain. What change in health status would the nurse attribute to the client's metastatic brain disease?

Personality changes

A nurse's plan of care for a client with rheumatoid arthritis includes several exercise-based interventions. What goal should the nurse prioritize?

Preserve or increase range of motion while limiting joint stress

Which nursing action best demonstrates primary cancer prevention?

Promoting and providing vaccines

A nurse is caring for a client who has undergone neck resection with a radial forearm free flap. The nurse's most recent assessment of the graft reveals that it has a bluish color and that mottling is visible. What is the nurse's most appropriate action?

Promptly report these indications of venous congestion.

A woman with a family history of breast cancer received a positive result on a breast tumor marking test and is requesting a bilateral mastectomy. This surgery is an example of which type of oncologic surgery?

Prophylactic surgery

The nurse is describing some of the major characteristics of cancer to a client who has recently received a diagnosis of malignant melanoma. When differentiating between benign and malignant cancer cells, the nurse should explain differences in which of the following aspects? Select all that apply

Rate of growth Ability to cause death Ability to spread

The nurse is describing some of the major characteristics of cancer to a client who has recently received a diagnosis of malignant melanoma. When differentiating between benign and malignant cancer cells, the nurse should explain differences in which of the following aspects? Select all that apply.

Rate of growth Ability to cause death Ability to spread

A client was diagnosed with cancer several weeks ago and family members describe the client as "utterly distraught." The client has fully withdrawn from social and family contact. What is the nurse's best action?

Refer the client to the appropriate mental health provider.

A 16-year-old female client has post-chemotherapy alopecia. This prompts the nursing diagnoses of Disturbed Body Image and Situational Low Self-Esteem. Which response by the client would best indicate improved coping related to these diagnoses?

Requests that her family bring her makeup and a wig

A client's decreased mobility has been attributed to an autoimmune reaction originating in the synovial tissue, which caused the formation of pannus. This client has been diagnosed with which health problem?

Rheumatoid arthritis (RA)

A client has been scheduled for a urea breath test in one month's time. What nursing diagnosis most likely prompted this diagnostic test?

Risk for impaired skin integrity related to peptic ulcers

The nurse on a bone marrow transplant unit is caring for a client with cancer who has just begun hematopoietic stem cell transplantation (HSCT). What is the priority nursing diagnosis for this client?

Risk for infection related to altered immunologic response

A public health nurse has formed an interdisciplinary team that is developing an educational program entitled Cancer: The Risks and What You Can Do About Them. Participants will receive information, but the major focus will be screening for relevant cancers. This program is an example of what type of health promotion activity?

Secondary prevention

A public health nurse has formed an interdisciplinary team that is developing an educational program entitled Cancer: The Risks and What You Can Do About Them. Participants will receive information, but the major focus will be screening for relevant cancers. This program is an example of what type of health promotion activity?

Secondary prevention

The nurse is educating a group of students about complications of an aneurysm. Which is a complication of aneurysm?

Seizure

A 62-year-old woman diagnosed with breast cancer is scheduled for a partial mastectomy. The oncology nurse explained that the surgeon will want to take tissue samples to ensure the disease has not spread to adjacent axillary lymph nodes. The client has asked if they will have her lymph nodes dissected, like her mother did several years ago. What alternative to lymph node dissection will this client most likely Undergo?

Sentinel node biopsy

The nurse is caring for a client with gastrointestinal symptoms who reports being under a significant amount of stress at home and at work. Which gastrointestinal effect of stress should the nurse anticipate is affecting this client?

Slowed peristalsis

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?

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?

Smoking cessation

While a client is receiving intravenous (IV) doxorubicin hydrochloride for the treatment of cancer, the nurse observes swelling and pain at the IV site. The nurse should prioritize which action?

Stopping the administration of the drug immediately

A client has returned to the medical unit after a barium enema. When assessing the client's subsequent bowel patterns and stools, what finding would warrant reporting to the health care provider?

Streaks of blood present in the stool

The nurse is caring for a client with an advanced stage of breast cancer and the client has recently learned that the cancer has metastasized. The nurse enters the room and finds the client struggling to breathe, and the nurse's rapid assessment reveals that the client's jugular veins are distended. The nurse should suspect the development of what oncologic emergency?

Superior vena cava syndrome (SVCS)

A nurse is providing care for a client who has a rheumatic disorder. The nurse's focused assessment includes the client's mood, behavior, level of consciousness, and neurologic status. Which diagnosis is most likely for this client?

Systemic lupus erythematosus (SLE)

A client has just been diagnosed with spondyloarthropathy. Which nursing intervention should the nurse prioritize?

Teaching about symptom management

A client's rheumatoid arthritis (RA) has failed to respond appreciably to first-line treatments and the primary provider has added prednisone to the client's drug regimen. What principle will guide this aspect of the client's treatment?

The drug should be used for as short a time as possible.

A nurse is providing a class on osteoporosis at the local center for older adults. Which statement related to osteoporosis is most accurate?

The use of corticosteroids increases the risk of osteoporosis

A client diagnosed with transient ischemic attacks (TIAs) is scheduled for a carotid endarterectomy. The nurse explains that this procedure will be done for which purpose?

To remove atherosclerotic plaques blocking cerebral flow

The home health nurse is performing a home visit for an oncology client discharged three days ago after completing chemotherapy treatment for non-Hodgkin lymphoma. The nurse's priority assessment should include examination for the signs and symptoms of which complication?

Tumor lysis syndrome (TLS)

The home health nurse is performing a home visit for an oncology client discharged three days ago after completing chemotherapy treatment for non-Hodgkin lymphoma. The nurse's priority assessment should include examination for the signs and symptoms of which complication?

Tumor lysis syndrome (TLS)

A nurse is planning client education for a client being discharged home with a diagnosis of rheumatoid arthritis. The client has been prescribed antimalarials for treatment, so the nurse knows to teach the client to self-monitor for what adverse effect?

Visual changes

A nurse working in a gerontology clinic as a member of a health care team recognizes that some older adults do not adhere to therapeutic regimens because of chronic illnesses that require long-term treatment by several health care providers. Which responsibility of the nurse is most important in this situation?

Working collaboratively with other team members to provide coordinated care