NUR 201

A nurse cares for a client who has a new colostomy. Which action should the nurse take? a. Empty the pouch frequently to remove excess gas collection b. Change the ostomy pouch and wafer every morning c. Allow the pouch to completely fill with stool prior to emptying it d. Use surgical tape to secure the pouch and prevent leakage

a. Empty the pouch frequently to remove excess gas collection

A new nurse has been assigned a client who is in the hospital to receive iodine-131 treatment. Which action by the nurse is best? a. Ensure the client is placed in protective isolation b. Hand off a pregnant client to another nurse c. No special action is necessary to care for this client d. Read the policy on handling radioactive excreta

d. Read the policy on handling radioactive excreta This type of radioisotope is excreted in body fluids and excreta (urine and feces) and should not be handled directly. The nurse should read the facility's policy for handling and disposing of the type of waste.

A nurse is providing community education on the seven warning signs of cancer. What signs are included? Select all apply a. A sore that does not heal b. Changes in menstrual patterns c. Indigestion or trouble swallowing d. Near-daily abdominal pain e. Obvious change in a mole

a. A sore that does not heal b. Changes in menstrual patterns c. Indigestion or trouble swallowing e. Obvious change in a mole

A client has been diagnosed with fibromyalgia syndrome but does not want to take the prescribed medications. What nonpharmacologic measures can the nurse suggest to help manage this condition? (Select all apply) a. Acupuncture b. Stretching c. Supplements d. Tai chi e. Vigorous aerobics

a. Acupuncture b. Stretching d. Tai chi There are many nonpharmacologic means for controlling the symptoms of fibromyalgia, including acupuncture, stretching, tai chi, low-impact aerobics, swimming, biking, strengthening, massage, stress management, and hypnosis.

The nurse is taking a history of a 68 year old woman. What assessment findings would indicate a high risk for the development of breast cancer? Select all that apply a. Age greater than 65 years b. Increased breast density c. Osteoporosis d. Multiparity e. Genetic factors

a. Age greater than 65 b. Increased breast density e. Genetic factors

A client with fibromyalgia is in the hospital for an unrelated issue. The client reports that sleep, which is always difficult, is even harder now. What actions by the nurse are most appropriate? (Select all that apply.) a. Allow the client uninterrupted rest time. b. Assess the client's usual bedtime routine. c. Limit environmental noise as much as possible. d. Offer a massage or warm shower at night. e. Request an order for a strong sleeping pill.

a. Allow the client uninterrupted rest time. b. Assess the client's usual bedtime routine. c. Limit environmental noise as much as possible. d. Offer a massage or warm shower at night. Clients with fibromyalgia often have sleep disturbances, which can be exacerbated by the stress, noise, and unfamiliar environment of the hospital. Allowing uninterrupted rest time, adhering to the clients usual bedtime routine as much as possible, limiting noise and light, and offering massages or warm showers can help.

A nurse works on the oncology unit and delegates personal hygiene to an unlicensed assistive personnel (UAP). What action by the UAP requires intervention from the nurse? a. Allowing a very tired client to skip oral hygiene and sleep b. Assisting clients with washing the perianal area every 12 hours c. Helping the client use a soft-bristled toothbrush for oral care d. Reminding the client to rinse the mouth with water or saline

a. Allowing a very tired client to skip oral hygiene and sleep Even though clients may be tired, they still need to participate in hygiene to help prevent infection.

The nurse is formulating a teaching plan according to evidence-based breast cancer screening guidelines for a 50 year old woman with low risk factors. Which diagnostic methods should be included in the plan? Select all that apply a. Annual mammogram b. MRI c. Breast ultrasound d. Breast self-awareness e. Clinical breast examination

a. Annual mammogram d. Breast self-awareness e. Clinical breast examination

A client on interferon therapy is reporting severe skin itching and irritation. What actions does the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.) a. Apply moisturizers to dry skin. b. Apply steroid creams to the skin. c. Bathe the client using mild soap. d. Help the client with a hot water bath. e. Teach the client to avoid sunlight.

a. Apply moisturizers to dry skin c. Bathe the client using mild soap The nurse can delegate applying unscented moisturizer and using mild soap for bathing. Steroid creams are not used for this condition. Hot water will worsen the irritation. Client teaching is a nursing function.

A client has thrombocytopenia. What actions does the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.) a. Apply the client's shoes before getting the client out of bed. b. Assist the client with ambulation. c. Shave the client with a safety razor only. d. Use a lift sheet to move the client up in bed. e. Use the Waterpik on a low setting for oral care.

a. Apply the clients shoes before getting the client out of bed b. Assist the client with ambulation d. Use a lift sheet to move the client up in bed Clients with thrombocytopenia are at risk of significant bleeding even with minor injuries. The nurse instructs the UAP to put the clients shoes on before getting the client out of bed, assist with ambulation, shave the client with an electric razor, use a lift sheet when needed to reposition the client, and use a soft-bristled toothbrush for oral care.

A clients family members are concerned that telling the client about a new finding of cancer will cause extreme emotional distress. They approach the nurse and ask if this can be kept from the client. What actions by the nurse are most appropriate? (Select all that apply) a. Ask the family to describe their concerns more fully b. Consult with a social worker, chaplain, or ethics committee c. Explain the clients right to know and ask for their assistance d. Have the unit manager take over the care of this client and family e. Tell the family that this secret will not be kept from the client

a. Ask the family to describe their concerns more fully b. Consult with a social worker, chaplain, or ethics committee c. Explain the clients right to know and ask for their assistance

A client receiving chemotherapy has a white blood cell count of 1000/mm3. What actions by the nurse are most appropriate? (Select all that apply) a. Assess all mucous membranes every 4 to 8 hours b. Do not allow the client to eat meat or poultry c. Listen to lung sounds and monitor for cough d. Monitor the venous access device appearance with vital signs e. Take and record vital signs every 4 to 8 hours

a. Assess all mucous membranes every 4 to 8 hours c. Listen to lung sounds and monitor for cough d. Monitor the venous access device appearance with vital signs e. Take and record vital signs every 4 to 8 hours Depending on facility protocol, the nurse should assess this client for infection every 4 to 8 hours by assessing all mucous membranes, listening to lung sounds, monitoring for cough, monitoring the appearance of the venous access device, and recording vital signs.

A client in the emergency department reports difficulty breathing. The nurse assesses the clients appearance as depicted below: What action by the nurse is the priority? a. Assess blood pressure and pulse b. Attach the client to a pulse oximeter c. Have the client rate his or her pain d. Start high-dose steroid therapy

a. Assess blood pressure and pulse This client has superior vena cava syndrome, in which venous return from the head, neck, and trunk is blocked. Decreased cardiac output can occur.

A client with a history of prostate cancer is in the clinic and reports new onset of severe low back pain. What action by the nurse is most important? a. Assess the clients gait and balance b. Ask the client about the ease of urine flow c. Document the report completely d. Inquire about the clients job risks

a. Assess the clients gait and balance This client has manifestations of spinal cord compression, which can be seen with prostate cancer. This may affect both gait and balance and urinary function. For client safety, assessing gait and balance is the priority

A client is receiving chemotherapy through a peripheral IV line. What action by the nurse is most important ? a. Assessing the IV site every hour b. Educating the client on side effects c. Monitoring the client for nausea d. Providing warm packs for comfort

a. Assessing the IV site every hour IV chemotherapy can cause local tissue destruction if it extravasates into the surrounding tissues. Peripheral IV lines are more prone to this than centrally placed lines. The most important intervention is prevention, so the nurse should check hourly to ensure the IV site is patent, or frequently depending on facility policy.

A client has mucositis. What actions by the nurse will improve the client's nutrition? (Select all that apply.) a. Assist with rinsing the mouth with saline frequently. b. Encourage the client to eat room-temperature foods. c. Give the client hot liquids to hold in the mouth. d. Provide local anesthetic medications to swish and spit. e. Remind the client to brush teeth gently after each meal.

a. Assist with rinsing the mouth with saline frequently. b. Encourage the client to eat room-temperature foods. d. Provide local anesthetic medications to swish and spit. e. Remind the client to brush teeth gently after each meal. Mucositis can interfere with nutrition. The nurse can help with rinsing the mouth frequently with water or saline; encouraging the client to eat cool, slightly warm, or room-temperature foods; providing swish-and-spit anesthetics; an reminding the client to keep the mouth clean by brushing gently after each meal.

A nurse working with clients who experience alopecia knows that which is the best method of helping manage the psychosocial impact of this problem ? a. Assisting the client to pre-plan for this event b. Reassuring the client that alopecia is temporary c. Teaching the client ways to protect the scalp d. Telling the client that there are worse side effects

a. Assisting the client to pre-plan for this event Alopecia does not occur for all clients who have cancer, but when it does, it can be devastating. The best action by the nurse is to teach the client about the possibility and to give the client multiple choices for preparing for this event. Not all clients will have the same reaction, but some possible actions the client can take are buying a wig ahead of time, buying attractive hats and scarves, and having a hairdresser modify a wig to look like the clients own hair.

The nurse caring for oncology clients knows that which form of metastasis is the most common? a. Bloodborne b. Direct invasion c. Lymphatic spread d. Via bone marrow

a. Bloodborne

A nurse in the oncology clinic is providing preoperative education to a client just diagnosed with cancer. The client has been scheduled for surgery in 3 days. What action by the nurse is best? a. Call the client at home the next day to review teaching. b. Give the client information about a cancer support group. c. Provide all the preoperative instructions in writing. d. Reassure the client that surgery will be over soon.

a. Call the client at home the next day to review teaching.

A nurse is preparing to administer IV chemotherapy. What supplies does this nurse need? Select all apply a. Chemo gloves b. Facemask c. Isolation gown d. N95 respirator e. Shoe covers

a. Chemo gloves b. Facemask c. Isolation gown The OSHA and the oncology Nurses Society have developed safety guidelines for those preparing or administering IV chemotherapy. These include double gloves (or chemo gloves), a facemask, and a gown. An N95 respirator and shoe covers are NOT REQUIRED

A nurse reads on a hospitalized client's chart that the client is receiving teletherapy. What action by the nurse is best? a. Coordinate continuation of the therapy. b. Place the client on radiation precautions. c. No action by the nurse is needed at this time. d. Restrict visitors to only adults over age 18.

a. Coordinate continuation of the therapy The client needs to continue with radiation therapy, and the nurse coordinate this with the appropriate department

The nurse working with oncology clients understands that which age-related change increases the older clients susceptibility to infection during chemotherapy? a. Decreased immune function b. Diminished nutritional stores c. Existing cognitive deficits d. Poor physical reserves

a. Decreased immune function As people age, there is an age-related decrease in immune function, causing the older adult to be more susceptible to infection than other clients.

The nursing student learning about cancer development remembers characteristics does this include? Select all apply a. Differentiated function b. Large nucleus-to-cytoplasm ratio c. Loose adherence d. Nonmigratory e. Specific morphology

a. Differentiated function d. Nonmigratory e. Specific morphology

A woman diagnosed with breast cancer had these laboratory tests performed at an office visit: Alkaline phosphatase 125 U/L Total calcium 12 mg/dL Hematocrit 39% Hemoglobin 14 g/dL Which test results indicate to the nurse that some further diagnostics are needed? a. Elevated alkaline phosphatase and calcium suggests bone involvement b. Only alkaline phosphatase is decreased, suggesting liver metastasis c. Hematocrit and hemoglobin are decreased, indicating anemia d. The elevated hematocrit and hemoglobin indicate dehydration

a. Elevated alkaline phosphatase and calcium suggests bone involvement The alkaline phosphate (normal value 30 to 120 U/L) and total calcium (normal value 9 to 10.5) levels are both elevated, suggesting bone metastasis. Both the hematocrit and hemoglobin are within normal limits for females

A client hospitalized for chemotherapy has a hemoglobin of 6.1 mg/dL. What medication should the nurse prepare to administer? a. Epoetin alfa (Epogen) b. Filgrastim (Neupogen) c. Mesna (Mesnex) d. Oprelvekin (Neumega)

a. Epoetin alfa (Epogen) The clients hemoglobin is low, so the nurse should prepare to administer epoetin alfa, a colony-stimulating factor that increases production of red blood cells. Filgrastim is for neutropenia. Mesna is used to decrease bladder toxicity from some chemotherapeutic agents. Oprelvekin is used to increase platelet count

The nurse working with oncology clients understands that interacting factors affect cancer development, which factors does this include? Select all apply a. Exposure to carcinogens b. Genetic predisposition c. Immune function d. Normal doubling time e. State of euploidy

a. Exposure b. Genetic predisposition c. Immune function

A client is interested in learning about the risk factors for prostate cancer. Which factors does the nurse include in the teaching? Select all that apply a. Family history of prostate cancer b. Smoking c. Obesity d. Advanced age e. Eating too much red meat f. Race

a. Family history of prostate cancer d. Advanced age e. Eating too much red meat f. Race

A client is discharged to home after a modified radical mastectomy with two drainage tubes. Which statement by the client would indicate that further teaching is needed? a. I am glad that these tubes will fall out at home when I finally shower b. I should measure the drainage each day to make sure it is less than an ounce c. I should be careful how I lie in bed so that I will not kink the tubing d. If there is a foul odor from the drainage, I should contact my doctor

a. I am glad that these tubes will fall out at home when I finally shower

A nurse cares for a client who states, My husband is repulsed by my colostomy and refuses to be intimate with me. How should the nurse respond? a. Lets talk to the ostomy nurse to help you and your husband work through this b. You could try to wear longer lingerie that will better hide the ostomy appliance c. You should empty the pouch first so it will be less noticeable for your husband d. if you are not careful, you can hurt the stoma if you engage in sexual activity

a. Lets talk to the ostomy nurse to help you and your husband through this

A woman has been using acupuncture to treat the nausea and vomiting caused by the side effects of chemotherapy for breast cancer. Which conditions would cause the nurse to recommend against further use of acupuncture? Select all that apply a. Lymphedema b. Bleeding tendencies c. Low white blood cell count d. Elevated serum calcium e. High platelet count

a. Lymphedema b. Bleeding tendencies c. Low white blood cell count

A client asks the nurse if eating only preservative - and dye-free foods will decrease cancer risk. What response by the nurse is best? a. Maybe; preservatives, dyes, and preparation methods may be risk factors b. No; research studies have never shown those things to cause cancer c. There are other things you can do that will more effectively lower your risk d. Yes; preservatives and dyes are well known to carcinogens

a. Maybe; preservatives, dyes, and preparation methods may be risk factors

After a breast examination, the nurse is documenting assessment findings that indicate possible breast cancer. Which abnormal findings need to be included as part of the clients electronic medical record? Select all that apply a. Peau dorange b. Dense breast tissue c. Nipple retraction d. Mobile mass at two o'clock e. Nontender axillary nodes

a. Peau dorange c. Nipple retraction d. Mobile mass at two oclock In the documentation of a breast mass, skin changes, such as dimpling (peau dorange), nipple retractions, and whether the mass is fixed or movable are charted. The location of the mass should be stated by the face of a clock.

A nurse cares for a client who had a colostomy placed in the ascending colon 2 weeks ago. The client states, The stool in my pouch is still liquid. How should the nurse respond? a. The stool will always be liquid with this type of colostomy b. Eating additional fiber will bulk up your stool and decrease diarrhea c. Your stool will become firmer over the next couple of weeks d. This is abnormal. I will contact your health care provider

a. The stool will always be liquid with this type of colostomy

A client is diagnosed with metastatic prostate cancer. The client asks the nurse the purpose of his treatment with the luteinizing hormonereleasing hormone (LH-RH) agonist leuprolide (Lupron) and the bisphosphonate pamidronate (Aredia). Which statement by the nurse is most appropriate? a. The treatment reduces testosterone and prevents bone fractures b. The medications prevent erectile dysfunction and increase libido c. There is less gynecomastia and osteoporosis with this drug regimen d. These medications both inhibit tumor progression by blocking androgens

a. The treatment reduces testosterone and prevents bone fractures

The nurse is teaching a 45 year old woman about her fibrocystic breast condition. Which statement by the client indicates a lack of understanding? a. This condition will become malignant over time b. I should refrain from using hormone replacement therapy c. One cup of coffee in the morning should be enough for me d. This condition makes it more difficult to examine my breasts

a. This condition will become malignant over time

A nurse assesses a client who is prescribed 5-fluorouracil (5-FU) chemotherapy intravenously for the treatment of colon cancer. Which assessment finding should alert the nurse to contact the health care provider? a. White blood cell (WBC) count of 1500/mm3 b. Fatigue c. Nausea and diarrhea d. Mucositis and oral ulcers

a. White blood cell (WBC) count of 1500/mm3

A client is concerned about the risk of lymphedema after a mastectomy. Which response by the nurse is best? a. You do not need to worry about lymphedema since you did not have radiation therapy b. A risk factor for lymphedema is infection, so wear gloves when gardening outside c. Numbness, tingling, and swelling are common sensations after a mastectomy d. The risk for lymphedema is a real threat and can be very self-limiting

b. A risk factor for lymphedema is infection, so wear gloves when gardening outside Infection can create lymphedema; therefore, the client needs to be cautious with activities using the affected arm, such as gardening.

A client has received a dose of ondansetron (Zofran) for nausea. What action by the nurse is most important? a. Assess the client for a headache b. Assist the client in getting out of bed c. Instruct the client to reduce salt intake d. Weigh the client daily before the client eats

b. Assist the client in getting out of bed Ondansetron side effects include postural hypotension, vertigo, and bradycardia, all of which increase the clients risk for injury. The nurse should assist the client when getting out of bed.

While assessing a client who is 12 hours postoperative after a thoracotomy for lung cancer, a nurse notices that the lower chest tube is dislodged. Which action should the nurse take first? a. Assess for drainage from the site b. Cover the insertion site with sterile gauze c. Contact the provider and obtain a suture kit d. Reinert the tube using sterile technique

b. Cover the insertion site with sterile gauze Immediately covering the insertion site helps prevent air from entering the pleural space and causing a pneumothorax.

A client tells the oncology nurse about an upcoming vacation to the beach to celebrate completing radiation treatments for cancer. What response by the nurse is most appropriate ? a. Avoid getting salt water on the radiation site b. Do not expose the radiation area to direct sunlight c. Have a wonderful time and enjoy your vacation! d. Remember you should not drink alcohol for a year

b. Do not expose the radiation area to direct sunlight The skin overlying the radiation site is extremely sensitive to sunlight after radiation therapy has been completed. The nurse should inform the client to avoid sun exposure to this area. This advice continues for 1 year after treatment has been completed.

A nurse cares for a client newly diagnosed with colon cancer who has become withdrawn from family members. Which action should the nurse take? a. Contact the provider and recommend a psychiatric consult for the client b. Encourage the client to verbalize feelings about the diagnosis c. Provide education about new treatment options with successful outcomes d. Ask family and friends to visit the client and provide emotional support

b. Encourage the client to verbalize feelings about the diagnosis

A client with cancer has anorexia and mucositis, and is losing weight. The clients family members continually bring favorite foods to the client and are distressed when the client wont eat them. What action by the nurse is best? a. Explain the pathophysiologic reasons behind the client not eating b. Help the family show other ways to demonstrate love and caring c. Suggest foods and liquids the client might be willing to try to eat d. Tell the family the client isn't able to eat now no matter what they bring

b. Help the family show other ways to demonstrate love and caring Families often become distressed when their loved ones wont eat. Providing food is a universal sign of caring, and to some people the refusal to eat signifies worsening of the condition. The best option for the nurse is to help the family find other ways to demonstrate caring and love, because with treatment-related anorexia and mucositis, the client is not likely to eat anything right now.

After teaching a client who is recovering from a colon resection, the nurse assesses the clients understanding. Which statements by the client indicate a correct understanding of the teaching? Select all that apply a. I must change the ostomy appliance daily as needed b. I will use warm water and a soft washcloth to clean around the stoma c. I might start bicycling and swimming again once my incision has healed d. Cutting the flange will help it fit snugly around the stoma to avoid skin breakdown e. I will check the stoma regularly to make sure that it stays a deep red color f. I must avoid dairy products to reduce gas and odor in the pouch

b. I will use warm water and a soft washcloth to clean around the stoma c. I might start bicycling and swimming again once my incision has healed d. Cutting the flange will help it fit snugly around the stoma to avoid skin breakdown

If a patient is taking fluconazole (Diflucan) with an oral anticoagulant, the nurse will monitor for which possible interaction? a. Reduced action of oral anticoagulants b. Increased effects of oral anticoagulants c. Hypokalemia d. Decreased effectiveness of the antifungal drug

b. Increased effects of oral anticoagulants

The student nurse caring for clients who have cancer understands that the general consequences of cancer include which client problems? (Select all that apply.) a. Clotting abnormalities from thrombocythemia b. Increased risk of infection from white blood cell deficits c. Nutritional deficits such as early satiety and cachexia d. Potential for reduced gas exchange e. Various motor and sensory deficits

b. Increased risk of infection from white blood cell deficits c. Nutritional deficits such as early satiety and cachexia d. Potential for reduced gas exchange e. Various motor and sensory deficits The general consequences of cancer include reduced immunity and blood-producing functions, altered GI structure and function, decreased RR, and motor and sensory deficits.

A client has a platelet count of 9800/mm3. What action by the nurse is most appropriate? a. Assess the client for calf pain, warmth, and redness b. Instruct the client to call for help to get out of bed c. Obtain cultures as per the facility's standing policy d. Place the client on protective isolation precautions

b. Instruct the client to call for help to get out of bed A client with a platelet count this low is at high risk for serious bleeding episodes. To prevent injury, the client should be instructed to call for help prior to getting out of bed.

A nurse is participating in primary prevention efforts directed against cancer. In which activities is this nurse most likely to engage? Select all apply a. Demonstrating breast self-examination methods to women b. Instructing people on the use of chemoprevention c. Providing vaccinations against certain cancers d. Screening teenage girls for cervical cancer e. Teaching teens the dangers of tanning booths

b. Instructing people on the use of chemoprevention c. Providing vaccinations against certain cancers e. Teaching teens the dangers of tanning booths

A 65-year-old male client is embarrassed about having bilateral breast enlargement. Which statement by the nurse is the most appropriate? a. Breast cancer in men is quite rare b. It is good that you came to be carefully evaluated c. Gynecomastia usually comes from overeating d. When you get older, the male breast always enlarges

b. It is good that you came to be carefully evaluated The most appropriate statement is the one that is supportive of the client. A breast mass should be carefully evaluated for breast cancer, even if it is not common.

A client in the oncology clinic reports her family is frustrated at her ongoing fatigue 4 months after radiation therapy for breast cancer. What response by the nurse is most appropriate? a. Are you getting adequate rest and sleep each day? b. It is normal to be fatigued even for years afterward c. This is not normal and ill let the provider know d. Try adding more vitamins B and C to your diet

b. It is normal to be fatigued even for years afterward Regardless of the cause, radiation-induced fatigue can be debilitating and may last for months or years after treatment has ended. Rest and adequate nutrition can affect fatigue, but it is most important that the client understands this is normal.

The nurse is taking the history of a client who is scheduled for breast augmentation surgery. The client reveals that she took two aspirin this morning for a headache. Which action by nurse is best? a. Take the clients vital signs and record them in the chart b. Notify the surgeon about the aspirin ingestion by the client c. Warn the client that health insurance may not pay for the procedure d. Teach the client about avoiding twisting above the waist after the operation

b. Notify the surgeon about the aspirin ingestion by the client The surgeon must be notified immediately since the aspirin could cause increased bleeding during the procedure.

After receiving the hand-off report, which client should the oncology nurse see first? a. Client who is afebrile with a heart rate of 108 beats/min b. Older client on chemotherapy with mental status change c. Client who is neutropenic and in protective isolation d. Client scheduled for radiation therapy today

b. Older client on chemotherapy with mental status change Older clients often do not exhibit classic signs of infection, and often mental status changes are the first observation. Clients on chemotherapy who become neutropenic also often do not exhibit classic signs of infection. The nurse should assess the older client first.

A client has returned from a transurethral resection of the prostate with a continuous bladder irrigation. Which action by the nurse is a priority if bright red urinary drainage and clots are noted 5 hours after the surgery? a. Review the hemoglobin and hematocrit as ordered b. Take vital signs and notify the surgeon immediately c. Release the traction on the three-way catheter d. Remind the client not to pull on the catheter

b. Take vital signs and notify the surgeon immediately

A nurse prepares a client for a colonoscopy scheduled for tomorrow. The client states, My doctor told me that the fecal occult blood test was negative for colon cancer. I don't think I need the colonoscopy and would like to cancel it. How should the nurse respond? a. Your doctor should not have given you that information prior to the colonoscopy b. The colonoscopy is required due to the high percentage of false negatives with the blood test c. A negative fecal occult blood test does not rule out the possibility of colon cancer d. I will contact your doctor so that you can discuss your concerns about the procedure

c. A negative fecal occult blood test does not rule out the possibility of colon cancer

A nurse teaches a client who is at risk for colon cancer. Which dietary recommendation should the nurse teach this client? a. Eat low-fiber and low-residual foods b. White rice and bread are easier to digest c. Add vegetables such as broccoli and cauliflower to your new diet d. Foods high in animal fat help to protect the intestinal mucosa

c. Add vegetables such as broccoli and cauliflower to your new diet

What comfort measure can only be performed by a nurse, as opposed to an UAP, for a client who returned from a left modified radical mastectomy 4 hours ago? a. Placing the head of bed at 30 degrees b. Elevating the left arm on a pillow c. Administering morphine for pain at a 4 on a 0 to 10 scale d. Supporting the left arm while initially ambulating the client

c. Administering morphine for pain at a 4 on a 0-10 scale Only the nurse is authorized to administer medications

A nurse assessing a client with colorectal cancer auscultates high-pitched bowel sounds and notes the presence of visible peristaltic waves. Which action should the nurse take? a. Ask if the client is experiencing pain the right shoulder b. Perform a rectal examination and assess for polyps c. Contact the provider and recommend computed tomography d. Administer a laxative to increase bowel movement activity

c. Contact the provider and recommend computed tomography

The nurse is examining a woman's breast and notes multiple small mobile lumps. Which question would be the most appropriate for the nurse to ask? a. When was your last mammogram at the clinic? b. How many cans of caffeinated soda do you drink in a day? c. Do the small lumps seem to change with your menstrual period? d. Do you have a first-degree relative who has breast cancer?

c. Do the small lumps seem to change with your menstrual period? The most appropriate question would be one that relates to benign lesions that usually change in response to hormonal changes within a menstrual cycle.

A 35 year old woman is diagnosed with stage III breast cancer. She seems to be extremely anxious. What action by the nurse is best? a. Encourage the client to search the Internet for information tonight b. Ask the client if sexuality has been a problem with her partner c. Explore the idea of a referral to a breast cancer support group d. Assess whether there has been any mental illness in her past

c. Explore the idea of a referral to a breast cancer support group

A client is admitted with supervisor vena cava syndrome. What action by the nurse is most important? a. Administer a dose of allopurinol (Aloprim) b. Assess the clients serum potassium level c. Gently inquire about advance directives d. Prepare the client for emergency surgery

c. Gently inquire about advance directives Superior vena cava syndrome is often a late-stage manifestation. After the client is stabilized and comfortable, the nurse should initiate a conversation about advance directives.

The nursing instructor explains the difference between normal cells and benign tumor cells. What information does the instructor provide about these cells? a. Benign tumors grow through invasion of other tissue. b. Benign tumors have lost their cellular regulation from contact inhibition c. Growing in the wrong place or time is typical of benign tumors d. The loss of characteristics of the parent cells is called anaplasia

c. Growing in the wrong place or time is typical of benign tumors

With a history of breast cancer in the family, a 48-year-old female client is interested in learning about the modifiable risk factors for breast cancer. After the nurse explains this information, which statement made by the client indicates that more teaching is needed? a. I am fortunate that I breast-fed each of my three children for 12 months b. It looks as though I need to start working out at the gym more often c. I am glad that we can still have wine with every evening meal d. When I have menopausal symptoms, I must avoid hormone replacement therapy

c. I am glad that we can still have wine with every evening meal The client should lessen alcohol intake and not have wine 7 days a week.

A nurse cares for a client with colon cancer who has a new colostomy. The client states, I think it would be helpful to talk with someone who has had a similar experience. How should the nurse respond? a. I have a good friend with a colostomy who would be willing to talk with you b. The enterostomal therapist will be able to answer all your questions c. I will make a referral to the United Ostomy Associations of America d. You'll find that most people with colostomies don't want to talk about them

c. I will make a referral to the United Ostomy Associations of America

A nurse has taught a client about dietary changes that can reduce the chances of developing cancer. What statement by the client indicates the nurse needs to provide additional teaching? a. Foods high in Vitamin A and Vitamin C are important b. Ill have to cut down on the amount of bacon I eat c. I'm so glad I don't have to give up my juicy steaks d. Vegetables, fruit, and high-fiber grains are important

c. I'm so glad I don't have to gibe up my juicy steaks

The nurse is caring for a client with lung cancer who states, I don't want any pain medication because I am afraid ill become addicted. How should the nurse respond? a. I will ask the provider to change your medication to a drug that is less potent b. Would you like me to use music therapy to distract you from your pain? c. It is unlikely you will become addicted when taking medicine for pain d. Would you like me to give you acetaminophen (Tylenol) instead?

c. It is unlikely you will become addicted when taking medicine for pain Clients should be encouraged to take their pain medications; addiction usually is not an issue with a client in pain. The nurse would not request that the pain medication be changed unless it was not effective. Other methods to decrease pain can be used, in addition to pain medication

A client is starting hormonal therapy with tamoxifen (Nolvadex) to lower the risk for breast cancer. What information needs to be explained by the nurse regarding the action of this drug? a. It blocks the release of luteinizing hormone b. It interferes with cancer cell division c. It selectively blocks estrogen in the breast d. It inhibits DNA synthesis in rapidly dividing cells

c. It selectively blocks estrogen in the breast Tamoxifen (Nolvadex) reduces the estrogen available to breast tumors to stop or prevent growth.

Which finding in a female client by the nurse would receive the highest priority of further diagnostics? a. Tender moveable masses throughout the breast tissue b. A 3-cm firm, defined mobile mass in the lower quadrant of the breast c. Nontender immobile mass in the upper outer quadrant of the breast d. Small, painful mass under warm reddened skin

c. Nontender immobile mass in the upper outer quadrant of the breast Malignant lesions are hard, nontender, and usually located in the upper outer quadrant of the breast and would be the priority for further diagnostic study.

A nurse cares for a client who has developed esophagitis after undergoing radiation therapy for lung cancer. Which diet selection should the nurse provide for this client? a. Spaghetti with meat sauce, ice cream b. Chicken soup, grilled cheese sandwich c. Omelet, soft whole wheat bread d. Pasta salad, custard, orange juice

c. Omelet, soft whole wheat bread Side effects of radiation therapy may include inflammation of the esophagus. Clients should be taught that bland, soft, high-calorie foods are best, along with liquid nutritional supplements.

A 55 year old African American client is having a visit with his health care provider. What test should the nurse discuss with the client as an option to screen for prostate cancer, even though screening is not routinely recommended? a. Complete blood count b. Culture and sensitivity c. Prostate-specific antigen d. Cystoscopy

c. Prostate-specific antigen

A nurse teaches a client who is recovering from a colon resection. Which statement should the nurse include in this clients plan of care? a. You may experience nausea and vomiting for the first few weeks b. Carbonated beverages can help decrease acid reflux from anastomosis sites c. Take a stool softener to promote softer stools for ease of defecation d. You may return to your normal workout schedule, including weight lifting

c. Take a stool softener to promote softer stools for ease of defecation

A client has just returned from a right radical mastectomy. Which action by the UAP would the nurse consider unsafe? a. Checking the amount of urine in the urine catheter collection bag b. Elevating the right arm on a pillow c. Taking the blood pressure on the right arm d. Encouraging the client to squeeze a rolled washcloth

c. Taking the blood pressure on the right arm

A client has fibromyalgia and is prescribed duloxetine hydrochloride (Cymbalta). The client calls the clinic and asks the nurse why an antidepressant drug has been prescribed. What response by the nurse is best? a. A little sedation will help you get some rest b. Depression often accompanies fibromyalgia c. This drug works in the brain to decrease pain d. You will have more energy after taking this drug

c. This drug works in the brain to decrease pain Duloxetine works to increase the release of the neurotransmitters serotonin and norepinephrine, which reduces the pain from fibromyalgia.

A nurse assess clients at a community health center. Which client is at higher risk for the development of colorectal cancer? a. A 37 year old who drinks eight cups of coffee daily b. A 44 year old with irritable bowel syndrome (IBS) c. A 60 year old lawyer who works 65 hours per week d. A 72 year old who eats fast food frequently

d. A 72 year old who eats fast food frequently

During dressing change, the nurse assesses a client who has had breast reconstruction. Which finding would cause the nurse to take immediate action? a. Slightly reddened incisional area b. Blood pressure of 128/75 mm Hg c. Temperature of 99 F (37.2 C) d. Dusky color of the flap

d. Dusk color of the flap A dusky color of the breast flap could indicate poor tissue perfusion and a decreased capillary refill. The nurse should notify the surgeon to preserve the tissue.

A nurse and an UAP are caring for a client with an open radical prostatectomy. Which comfort measure could the nurse delegate to the UAP? a. Administering an antispasmodic for bladder spasms b. Managing pain through patient-controlled analgesia c. Applying ice to a swollen scrotum and penis d. Helping the client transfer from the bed to the chair

d. Helping the client transfer from the bed to the chair

A 37-year-old Nigerian woman is at high risk for breast cancer and is considering a prophylactic mastectomy and oophorectomy. What action by the nurse is most appropriate? a. Discourage this surgery since the woman is still of childbearing age b. Reassure the client that reconstructive surgery is as easy as breast augmentation c. Inform the client that this surgery removes all mammary tissue and cancer risk d. Include support people, such as the male partner, in the decision making

d. Include support people, such as the male partner, in the decision making

The nurse has taught a client with cancer ways to prevent infection. What statement by the client indicates that more teaching is needed? a. I should take my temperature daily and when I don't feel well b. I will wash my toothbrush in the dishwasher once a week c. I wont let anyone share any of my personal items or dishes d. Its alright for me to keep my pets and change the litter box

d. Its alright for me to keep my pets and change the litter box. Clients should wash their hands after touching their pets and should not empty or scoop the cat litter box.

A client is diagnosed with a fibrocystic breast condition while in the hospital and is experiencing breast discomfort. What comfort measure would the nurse delegate to the UAP? a. Aid in the draining of the cysts by needle aspiration b. Teach the client to wear a supportive bra to bed c. Administer diuretics to decrease breast swelling d. Obtain a cold pack to temporarily relieve the pain

d. Obtain a cold pack to temporarily relieve the pain All of the options would be comfort measures for a client with a fibrocystic breast condition. UAP can obtain the cold or heat therapy.

A nurse works with clients who have alopecia from chemotherapy. What action by the nurse take priority? a. Helping clients adjust to their appearance b. Reassuring clients that this change is temporary c. Referring clients to a reputable wig shop d. Teaching measures to prevent scalp injury

d. Teaching measures to prevent scalp injury All of the actions are appropriate for clients with alopecia. However, the priority is client safety, so the nurse should first teach ways to prevent scalp injury.

A client is in the oncology clinic for a first visit since being diagnosed with cancer. The nurse reads in the client's chart that the cancer classification is TISN0M0. What does the nurse conclude about this client's cancer? a. The primary site of the cancer cannot be determined. b. Regional lymph nodes could not be assessed. c. There are multiple lymph nodes involved already. d. There are no distant metastases noted in the report.

d. There are no distant metastases noted in the report.

A client with cancer is admitted to a short-term rehabilitation facility. The nurse prepares to administer the clients oral chemotherapy medications. What action by the nurse is most appropriate ? a. Crush the medications if the client cannot swallow them b. Give one medication at a time with a full glass of water c. No special precautions are needed for these medications d. Wear personal protective equipment when handling the medications

d. Wear personal protective equipment when handling the medications During the administration of oral chemotherapy agents, nurses must take the same precautions that are used when administering IV chemotherapy. This includes using personal protective equipment. These medications cannot be crushed, split, or chewed.

A nurse cares for a client who has a family history of colon cancer. The client states, My father and my brother had colon cancer. What is the chance that I will get cancer? How should the nurse respond? a. If you ear a low-fat and low-fiber diet, your chances decrease significantly b. You are safe. This is an autosomal dominant disorder that skips generations c. Preemptive surgery and chemotherapy will remove cancer cells and prevent cancer d. You should have a colonoscopy more frequently to identify abnormal polyps early

d. You should have a colonoscopy more frequently to identify abnormal polyps early