Pain/EOL Lipp

A nurse is assessing a woman who is receiving the second admin of chemo for breast cancer. When obtain this client's health history, the nurse should ask the client which questions? 1. has you hair been falling out in clumps 2. have you had nausea and vomiting 3. have you been sleeping at night? 4. do you have your usual energy level?

2. have you had nausea and vomiting

A client has been receving montly doses of chemo therapy for stage III colon cancer. Which lab should the nurse report to the oncologist before the next dose of chemo? select all 1. hmg 14.5 g/dL 2. platelet 40,000 3. BUN of 12 4. WBC 2,300 5. temp 101.2 6. urin specific gravity of 1.020

2. platelet 40,000 4. WBC 2,300 5. temp 101.2

The wife of an older adult who has been admitted to the hispital with kidney failure tells the nurse, "I know he does not want to die in a hospital but it is so hard for me to take care of him at home." Which statement by the nurse to the client's wife would be most appropriate? Select all that apply: 1. He is not going to die that soon judging by his current symptoms 2. what are your fears about your husband dying 3. i can imagine that it is hard for you to care for him at home 4. what do you and your husband know about advance directives 5. we can discuss types of hospice and home care available 6. what kind of arrangements do you think need to be made before he dies

2. what are your fears about your husband dying 3. i can imagine that it is hard for you to care for him at home 4. what do you and your husband know about advance directives 5. we can discuss types of hospice and home care available 6. what kind of arrangements do you think need to be made before he dies

A client with a family history of cancer asks the nurse what the single most important risk factor is for cancer. Which risk factor should the nurse discuss? 1. family hx 2. lifestyle choices 3. age 4. menopause or hormonal events

3. age

A client with pancreatic cancer has begun reciving morphine via a subcutaneous pump fo r2 weeks. The client is requiring an increased dose of morphine to manage the pain. The nurse should document that the client is: 1. tolerating the medication well 2. showing addiction to morphine 3. developing a tolerance for the medication 4. experiencing physical dependence

3. developing a tolerance for the medication

Lifestyle influences that are considered risk factors for colorectal cancer include: 1. diet low in vitamin c 2. high dietary intake of artificial sweetners 3. high-fat, low fiber diet 4. multiple sex partners

3. high-fat, low fiber diet

When a clietn and family receive the initial dx of colon cancer, the nurse can act as an advocate by: 1. helping them maintain a sense of optimism and hopefulness 2. determining their understanding of the results of the diagnostic testing 3. listening carefully to their perceptions of what their needs are 4. providing them with written materials about the cancer site and its treatment

3. listening carefully to their perceptions of what their needs are

A client had a craniotomy for removal of a malignant brain tumor in the occiptial region. The nurse should question a prescription for which of these drugs? 1. ibuprofen 2. naproxen 3. morphine sulfate 4. acetaminiphen

3. morphine sulfate causes respirartory depression

A nurse is conducting a cancer risk screening program. Which client is at greatest risk for skin cancer? 30-year-old butcher 60-year-old mountain biker 15-year-old high school student 45-year-old health care worker

60-year-old mountain biker Explanation: Basal cell carcinoma occurs most commonly in sun-exposed areas of the body. The incidence of skin cancer is highest in older people who live in the

When a client and family receive the initial diagnosis of colon cancer, the nurse can act as an advocate by: A. Listening carefully to their perceptions of what their needs are. B. Helping the client and family maintain a sense of optimism. C. Determine the client's and family understanding of written materials. D. Teaching family about test diagnosis.

A Rationale: The best nursing advocacy intervention is listening carefully to the client's and family's perceptions of their needs. Studies have demonstrated that these needs are not necessarily what the nurse thinks they are. Intervening without listening carefully may result in a lack of responsiveness to the real needs. Helping the client and family maintain a sense of optimism and hopefulness is appropriate but is not necessarily advocacy. Determining the client's and family's understanding of the results of the diagnostic testing and providing written materials about the cancer site and its treatment are exam

A nurse is assessing a client with bone cancer pain. Which part of a thorough pain assessment is most significant for the client? 1. intensity 2. cause 3. aggravating factors 4. location

1. intensity

A client with lung cancer is being cared for by his wife at home. His pain is increasing in severity. The nurse recognizes that teaching has been effective when the wife: Select all that apply: 1. gives her husband a long-acting or sustained released oral pain med regularly around the clock 2. uses an immediate release mediation (oxycodone) for breakthrough pain. 3. Avoids long-acting opioids due to her concern about addiction 4. uses music for distraction, heat or cold therapy 5. substitutes acetaminophen to avoid tolerance 6. has her husbadn use a pain rating scale to measure the effectiveness at reaching his individual pain goal

1,2,4,6

The family of a hospitalized client demonstrates the understanding of the teaching about legal documents related to EOL care such as advance directives and power of attorney when they make which statements? Select all that apply: 1. Advance directive give instructions about future medical care and treatment 2. if people are not capable of communicating their wishes, healthcare providers and family together can agree on measures or actions that will be taken 3. ethics experts agree that the family is the sole deciding factor when the client is competent 4. POA gives primarily financial access to the designee 5. POA is a document that lists who can make healthcare decisions should a person be unable to make an informed decision for himself or herself. 6. Advance directives give details about the client's past medical history.

1,2,5

Assessment of a client taking a NSAID for pain management should include specific questions regarding which body system? 1. GI 2. Renal 3. Pulmonary 4. Cardiac

1. GI

A terminally ill client's husband tells the nurse, "I wish we had taken that trip to europe last year. we just kept putting it off and now i am furious that we did not go." The nurse interprets the husband's statement as indicating which stage of adaption of dying? 1. anger 2. denial 3. bargaining 4. depression

1. anger

The incidence and risk of cancer INCREASE WHEN SMOKING IS COMBINED WITH: 1. asbestos exposure and alcohol consumption 2. ultraviolet radiation exposure and alcohol 3. asbestos exposure and ultraviolet radiation 4. alcohol consumption and HPV infection

1. asbestos exposure and alcohol consumption

a client is dx with cancer is receving chemotherapy. The nurses should assess which doagnostic value while the client is receiving chemo? 1. bone marrow cells 2. liver tissues 3. heart tissues 4. pancreatic enzymes

1. bone marrow cells

Which philosophy should thenurse intergrate into the POC for a client and family to help them best cope during the final stages of the client's illnesses: 1. living each day as it comes as fully as possible 2. reliving the pleasant memories of days gone by 3. expecting the worst and being grateful when it does not happen 4. planning ahead for the remaining good times that will be spent together

1. living each day as it comes as fully as possible

The client who is receiving chemotherapy is not eating well but otherwise feels healthy. Which meal suggestion would be best for this client? 1. cereal with milk and strawberries 2. Broiled chicken, green beans, and cottage cheese. 3. toast, gelatin dessert, and cookies 4. steak and french friees

2. Broiled chicken, green beans, and cottage cheese.

The nurse teaches the client with chronic cancer pain about optimal pain control. Which recommendation is MOST effective for pain control? 1. Get used to some pain, and use a little less medication than needed to keep from being addicted. 2. Take prescribed analgesics on an around-the-clock schedule to prevent recurrent pain. 3. Take analgesics only when pain returns 4. Take enough analgesics around the clock so that you can sleep 12-16 hours a day to block pain.

2. Take prescribed analgesics on an around-the-clock schedule to prevent recurrent pain.

a client receiving chemo for cancer has an elevated serum creatinine level. The nurse should next: 1. cancel the next chemo session 2. administer the scheduled dose of chemo 3. notify the HCP 4. obtain a urine specimen

3. notify the HCP

After completing the nursing assessment for a client and family entering the palliative care program, the nurse shoudl develop a teaching plan that includes an understanding of which outcome? Select all that apply: 1. alteration in the family's usual coping strategies 2. achievement of a dignified and respectful death 3. improvement in the client's quality of life 4. provision of comfort during the dying process 5. provision of support for client and family 6. advocation for prolonging life while curing the disease

2. achievement of a dignified and respectful death 3. improvement in the client's quality of life 4. provision of comfort during the dying process 5. provision of support for client and family

A 42-year-old is interested in making dietary changes to reduce the risk of colon cancer. What dietary selections should the nurse suggest? 1. croissant, granola, and peanut butter squares, whole milk 2. bran muffin, skim milk, stir fried broccoli 3. granola, bagel with cream cheese, cauliflower salad 4. otameal raisin cookies, baked potato with sour cream, turkey sandwhich

2. bran muffin, skim milk, stir fried broccoli

The nurse is assessing a client with chronic pain. What findings are expected for a client in chronic pain? Select all that apply. 1.facial grimacing 2. normal vital signs 3. physical inactivity 4. moaning 5. depression

2. normal vital signs 3. physical inactivity

A nurse is planning an educational program about cancer prevention and detection. Which group would benefit most from education regarding potential risk factors for melanoma? 1. adults older than age 35 2. senior citizens who have been repeatedly exposed to the effects of ultraviolet A and B ray 3. parents with children 4. employees of a chemical family

3. parents with children

Which client is at the highest risk for colorectal cancer? 1. the client who smokes 2. the client who eats vegertarian diet 3. the client who has been treated for Crohn's disease for 20 years 4. the client who has a family hx of lung cancer?

3. the client who has been treated for Crohn's disease for 20 years

The nurse can be an important advocate for the client who is considering an alternative method of cancer treatment. Which statement best demonstrates the nurse as client advocate? The nurse will: 1. provide the information about standar therapies. 2. monitor blood tests as indicated by the alternative therapy 3. document the client's desire to try an alternative therapy 4. allow the client ot make healthcare choices but will assist in ensuring the client is fully informed when making those decisions.

4. allow the client ot make healthcare choices but will assist in ensuring the client is fully informed when making those decisions.

A client is receiving chemo that has potention pulmonary toxicity. Which signs or symptoms indicate a toxic repsonse to chemo? 1. decrease in appetite 2. drowsiness 3. spasms of diaphragm 4. cough and SOB

4. cough and SOB

The most reliable early indicator of infection in a client who is neutropenic is: 1. fever 2. chills 3. tachycardia 4. dyspnea

1. fever

The nurse is conducting a caner risk assessment for a middle-aged client. Which environmental factor increases the risk of cancer? 1. gender 2. nutrition 3. immunologic status 4. age

2. nutrition

A client with chronic cancer pain has been receiving opiates for 5 months. She rated the pain 8/10 before starting the opioid meds. Following thorough examination, there in no new evidence of increased disease, yet the pain is close to 8 again. The mostly liekly explanation for the increase pain is" 1. development of an addiction to opioids 2. tolerance to the opioid 3. w/d 4. placebo effect has decreased

2. tolerance to the opioid

A client in a hospice program has increasing pain. The nurse and client collaborate to schedule analgesics to provide: 1. doses of analgesic when pain is 5 on a 10 scale 2. enough analgesia to keep the client semisomnolent 3. an analgesia-free period so that the client can carry out daily hygienic activities 4. around-the-clock routine administration of analgesics for continous pain relief

4. around-the-clock routine administration of analgesics for continous pain relief

A 52 year old male was d/c from the hospital for cancer-related pain. His pain appeared to be well controlled on the IV morphine. He was switched or oral 2 days ao. He reports his pain 8/10 and wants IV morphine. Which explanation is the MOST likely for the cleint's report of inadequate pain control? 1. He is addicted 2. he is going through w/d 3. he is physically dependent on IV morphine 4. he is undermedicated on oral opioid

4. he is undermedicated on oral opioid

A client who is receiving chemotherapy develops stomatitis. Which of the following actions is appropriate for the nurse to incorporate into the plan of care? A.) Rinse client's mouth with full-strength hydrogen peroxide every 4 hours. B.) Encourage client to use a soft bristled toothbrush after each meal. C.) Provide hot tea with honey to soothe the client's painful oral mucosa. D.) Avoid using dental floss until the client's stomatitis is resolved.

B.) Encourage client to use a soft bristled toothbrush after each meal. Stomatitis is an inflammation of the mucous membranes of the mouth resulting from chemotherapy. Using a soft-bristled toothbrush prevents further bleeding and irritation to the already irritated bums and mucous membranes. Hydrogen peroxide can further irritate the mouth. Fluids need to be lukewarm instead of hot; dental floss can be used if its done gently.