NU473 Week 1: Evolve Elsevier EAQ Cellular Regulation - 20 Questions

The nurse instructs a postpartum client on the administration of an iron supplement. Which drink selected by the client indicates the teaching was effective? o Milk o Water o Cream soda o Cranberry juice

o Cranberry juice · Iron is absorbed best when given in an acidic medium. One cup of cranberry juice contains 90 mg of vitamin C (ascorbic acid). Milk, water, and cream soda will all decrease the acidity of the stomach.

Medicines that cause Hemolysis Drugs that cause Hemolysis

o Acetohydroxamic acid o Amoxicillin o Chlorpropamide o Doxapram o Glyburide o Mefenamic acid o Menadiol diphosphate o Methyldopa o Nitrofurantoin o Penicillin G benzathine o Penicillin V o Primaquine o Procainamide hydrochloride o Quinidine polygalacturonate o Quinine o Sulfonamides o Tolbutamide o Vitamin K

Medicines that cause Bone Marrow Suppression Drugs that cause Bone Marrow Suppression

o Altretamine o Amphotericin B o Azathioprine o Chemotherapeutic agents o Chloramphenicol o Chromic phosphate o Colchicine o Didanosine o Eflornithine o Foscarnet sodium o Ganciclovir o Interferon alfa o Pentamidine o Sodium iodide o Zalcitabine o Zidovudine

When caring for a client who has pancytopenia after treatment for Hodgkin disease, which assessment finding is most important to report to the health care provider? o Fatigue o Hematocrit 32% o Occult blood in stool o Temperature 99.8°F (37.7°C)

o Temperature 99.8°F (37.7°C) · Bone marrow depression lowers levels of white blood cells, red blood cells, and platelets. Because infection is the most common cause of morbidity and death in clients with cancer, the elevated temperature needs to be reported quickly so that diagnosis and treatment of infection can be initiated. Fatigue may occur with anemia but does not need rapid intervention. A low hematocrit will be reported, but 32% is not dangerously low and no immediate action is needed. Occult blood in stools may occur because of low platelet levels but is not life threatening.

Medicines that cause Platelet Disruption Drugs that cause Platelet Disruption

o Aspirin o Carbenicillin o Carindacillin o Dipyridamole o Ibuprofen o Meloxicam o Naproxen o Oxaprozin o Pentoxifylline o Sulfinpyrazone o Ticarcillin o Ticlopidine o Valproic acid

The nurse reviews the serum laboratory values of a client. The nurse suspects hypofunctioning of the adrenal gland based on which results? Select all that apply. o Increased calcium o Decreased cortisol o Decreased sodium o Decreased potassium o Increased glucose

o Increased calcium o Decreased cortisol o Decreased sodium · Hypofunctioning of the adrenal gland is manifested by increased serum calcium, decreased serum cortisol, and decreased serum sodium levels. Decreased serum potassium and decreased serum bicarbonate levels are associated with hyperfunctioning of the adrenal gland. Normal to increased serum glucose is associated with hyperfunctioning of the adrenal gland.

Medicines Impairing Hematologic System

o Bone Marrow Suppression o Hemolysis o Platelet Disruption

Which information would the nurse include when teaching a client with coronary artery disease about aspirin therapy? Select all that apply. o Take aspirin with food. o Report ringing in the ears. o Monitor and report excessive bleeding and bruising. o Do not mix aspirin with medications for erectile dysfunction. o Avoid over-the-counter pain medications that contain aspirin

o Take aspirin with food. o Report ringing in the ears. o Monitor and report excessive bleeding and bruising. o Avoid over-the-counter pain medications that contain aspirin · Aspirin is taken with food to avoid gastrointestinal upset. Ringing in the ears should be reported, because it is a sign of aspirin toxicity. Excessive bruising and bleeding should be reported, because these may be caused by decreased platelet aggregation caused by aspirin. Over-the-counter medications must be checked for aspirin. Nitrates, not aspirin, must be avoided by those taking erectile dysfunction medications because of the risk of a dangerous drop in blood pressure.

The primary health care provider suspects pituitary gland dysfunction in a female client. The nurse anticipates that which diagnostic test will be prescribed? o Estradiol test o Prolactin test o Sims-Huhner test o Papanicolaou (Pap) test

o Prolactin test · A prolactin test is used to detect pituitary gland dysfunction that causes amenorrhea. The primary health care provider would suggest that the client have a prolactin test to determine if the client does or does not have any pituitary gland dysfunction. Estradiol is tested to determine functioning of the ovaries. In men the estradiol test is used to detect testicular tumors. The Sims-Huhner test is used to evaluate the hostility of the cervix for passage of sperm from the vagina into the uterus. The Pap test detects malignancies, particularly cervical cancer.

Which mechanism of action explains the ability of nitrogen mustard to interfere with growth of cancer cells? o Interference of the cellular protein synthesis o Inhibition of the synthesis of purine and pyrimidine o Binding with DNA to interfere with RNA production o Combining with DNA strands and interfering with cell replication

o Combining with DNA strands and interfering with cell replication · Alkylating agents such as nitrogen mustard combine with DNA strands and interfere with cell replication. Some chemotherapeutic medications are believed to act by interfering with cellular protein synthesis, but nitrogen mustard does not. Inhibiting the synthesis of purine and pyrimidine is the mechanism of action of antimetabolites. Antibiotics, not nitrogen mustard, used in cancer chemotherapy are believed to act by binding with DNA to interfere with RNA production.

The client undergoing therapy with an antiproliferative immunosuppressant medication has developed thrombocytopenia. Which medication may have caused the client's condition? o Citalopram o Daclizumab o Methyldopa o Azathioprine

o Azathioprine · Azathioprine is an antiproliferative medication that may cause bone marrow suppression and thrombocytopenia (a decrease in the number of thrombocytes). Citalopram is a selective serotonin reuptake inhibitor used as an antidepressant. Daclizumab may cause anaphylaxis. Methyldopa is used to treat gestational hypertension or pregnancy-induced hypertension.

The nurse is teaching a student about sexual assault in teenagers. Which statement made by the student indicates a need for further education? Select all that apply. o "Sexual intercourse that occurs by physical force is referred to as rape." o "A sexual assault committed on a person above the age of consent is called statutory rape." o "A medical examination of rape victims provides evidence of penetration and ejaculation." o "A rape that occurs when the assailant is 18 years of age or older is referred to as acquaintance rape." o "Inappropriate sexual activity, such as inappropriate touching and psychological coercion in sexual acts, is referred to as sexual assault."

o "A sexual assault committed on a person above the age of consent is called statutory rape." o "A rape that occurs when the assailant is 18 years of age or older is referred to as acquaintance rape." · A rape that occurs when the assailant is above 18 years of age and the victim is under 18 years of age is referred to as statutory rape. A rape that occurs when the assailant and victim know each other is referred to as acquaintance rape. Forced sexual intercourse that occurs by physical force or psychological coercion is referred to as rape. Penetration, ejaculation, and the use of force are clinical manifestations of rape. Inappropriate touching and inappropriate sexual activity is referred to as sexual assault.

The nurse is providing care to an infant who is diagnosed with cystic fibrosis (CF). Which parental statement indicates the need for further education related to the potential for poor growth? o "My child's diagnosis is associated delayed bone growth." o "My child will have a poor appetite, which will lead to poor growth." o "My child will have increased oxygen demands, which will lead to poor growth." o "My child will have a decreased ability to absorb nutrients, which will cause poor growth."

o "My child will have a poor appetite, which will lead to poor growth." · Pediatric clients who are diagnosed with CF experience poor growth despite a healthy appetite and diet; therefore, the parental statement indicates that the infant's poor appetite will lead to poor growth indicates the need for further education. Pediatric clients diagnosed with CF experience poor growth due to delayed bone growth, increased oxygen demands, and a decreased ability to absorb nutrients.

A client with invasive carcinoma of the bladder is scheduled for a cystectomy and an ileal conduit. The client expresses worries about the possibility of offensive odors associated with the urinary diversion. How would the nurse respond? o "Tell me more about your concerns." o "Products are available to limit this problem." o "This is a problem, but the surgery is necessary." o "Most people who have this surgery share this same concern."

o "Tell me more about your concerns." · The response "Tell me more about what you are thinking" is an open-ended statement that focuses on the client's concerns and allows further verbalization of feelings. Although true, the response "This is a problem, but the surgery is necessary" may increase anxiety and cut off communication. The responses "Products are available to limit this problem" and "Most people who have this surgery share this same concern" move the focus away from the client and minimize the client's concerns.

The nurse is teaching an adolescent female client with irregular menstruation about contraception. Which statements made by the client indicate the need for further education? Select all that apply. o "The calendar method of oral contraception is most suitable for me." o "The withdrawal method of contraception has high incidences of failure." o "Condoms do not offer protection against sexually transmitted infections." o "Oral contraceptive pills offer protection from sexually transmitted infections." o "Three-month injectable contraceptive medications may cause weight gain and decreased bone density."

o "The calendar method of oral contraception is most suitable for me." o "Condoms do not offer protection against sexually transmitted infections." o "Oral contraceptive pills offer protection from sexually transmitted infections." · The calendar method of oral contraception is not effective in clients with irregular menstruation. Condoms are the best contraceptive method to offer protection against sexually transmitted infections. Oral contraceptive pills do not offer protection from sexually transmitted infections. The withdrawal method of contraception has a high failure rate. Administered once in every 12 weeks, medroxyprogesterone injections are an ideal choice of contraception. Side effects such as weight gain and decreased bone mineralization are associated with this method.

The nurse suspects metastasis in a client with stage I seminoma who has just undergone biopsy. Which test is most appropriate for detecting the spread of cells in this client? o Ultrasonography o Alpha fetoprotein o Computed tomography o Lactase dehydrogenase

o Computed tomography · Stage I seminoma is a common type of testicular cancer. Testicular biopsy is not recommended because it may cause the spread of malignant cells (i.e., metastasis). Computed tomography (CT) is the most appropriate means of detecting metastases. Ultrasonography is beneficial in determining whether a mass is intratesticular. Alpha fetoprotein and lactase dehydrogenase are the serum tumor markers that should be assayed when a testicular mass is found to be intratesticular.

Which medical condition could most probably result in clients developing primary diabetes insipidus (DI)? o Meningitis o Brain tumor o Lithium therapy o Defect in hypothalamus

o Defect in hypothalamus · A defect in the hypothalamus (thirst center) could be the most probable cause of primary DI. Meningitis or a brain tumor could interfere with the synthesis, transport, or release of antidiuretic hormone (ADH) and cause central DI. Lithium therapy affects the renal response to ADH and results in nephrogenic DI or medication-related DI.

When assessing a client with Graves disease, which clinical complaint would the nurse expect to find in the client's history? o Diaphoresis o Menorrhagia o Dry, brittle hair o Sensitivity to cold

o Diaphoresis · Increased basal metabolic rate, increased circulation, and vasodilation result in warm, moist skin. Menorrhagia, sensitivity to cold, and dry, brittle hair are associated with hypothyroidism.

The nurse understands which medication taken by a pregnant woman may show a delayed teratogenic effect in the offspring? o Aspirin o Heparin o Ethyl alcohol o Diethylstilbestrol

o Diethylstilbestrol · Diethylstilbestrol may cause vaginal cancer in a female child 18 or more years after birth. Aspirin suppresses contractions during labor and may cause bleeding in the mother. Heparin does not cause fetal harm but may cause osteoporosis in the mother. Ethyl alcohol causes drug dependence or alcohol withdrawal syndrome in neonates.

Which side effects of tretinoin are expected when prescribed for a client with severe facial acne? Select all that apply. o Rashes o Flaking o Pruritus o Alopecia o Erythema

o Flaking o Erythema · Flaking and erythema are side effects of tretinoin. Rashes, pruritus, and erythema indicate an allergic contact dermatitis, which may be an adverse reaction to the treatment and not a side effect. Alopecia is associated with chemotherapy.

A client who recently was diagnosed as having myelocytic leukemia discusses the diagnosis by referring to statistics, facts, and figures. The nurse determines that the client is using which defense mechanism? o Projection o Sublimation o Identification o Intellectualization

o Intellectualization · Intellectualization is the use of reasoning and thought processes to avoid the emotional aspects of a situation; this is a defense against anxiety. Projection is denying unacceptable traits and regarding them as belonging to another person. Sublimation is a defense wherein the person redirects the energy of unacceptable impulses into socially acceptable behaviors or activities. Identification is the reduction of anxiety by imitating someone respected or feared.

The nurse understands that which antipsychotic medications have the highest risk of causing tardive dyskinesia? Select all that apply. o Loxapine o Quetiapine o Haloperidol o Ziprasidone o Olanzapine

o Loxapine o Haloperidol · First-generation antipsychotic medications such as loxapine and haloperidol may cause tardive dyskinesia, an extrapyramidal reaction. Second-generation antipsychotic medications such as quetiapine, ziprasidone, and olanzapine have a lower risk of causing extrapyramidal reactions.

Which disease is caused by coronaviruses? o Pertussis o Inhalation anthrax o Coccidioidomycosis o Severe acute respiratory syndrome

o Severe acute respiratory syndrome · Severe acute respiratory syndrome is a respiratory infection caused by coronaviruses. Pertussis is caused by the bacterium Bordetella pertussis. Inhalation anthrax is caused by Bacillus anthracis. Coccidioidomycosis is caused by Coccidioides.

Which organism would the nurse explain was responsible for a client's recent diagnosis of malaria? o Vibrio o Sporozoa o Ringworm o Spirochetes

o Sporozoa · Sporozoa such as Plasmodium malariae cause malaria. Vibrio are curved rod-shaped bacteria; these microorganisms cause cholera. Ringworm such as tinea corporis may cause mycotic infections. Spirochetes are spiral-shaped bacteria; these microorganisms may cause leprosy and syphilis.