Patho/Pharm 1 Exam 2

cancer staging: I

-tumor limited to the tissue of origin -localized tumor growth

what is the IV solution that is hung with blood products?

0.9% normal saline

what are the 3 systems that maintain acid-base?

1. respiratory 2. renal 3. chemical buffer

what is the primary intervention if a blood transfusion reaction is suspected?

discontinue the infusion immediately

partially compensated ABGs

-pH is abnormal -PaCO2 and HCO3 are both abnormal

uncompensated ABGs

-pH is abnormal -PaCO2 or HCO3 are abnormal

compensated ABGs

-pH is normal -PaCO2 and HCO3 are both abnormal

Emily, a 45-year-old white female with strawberry blonde hair and blue eyes, works at a garden center. She has come to the dermatology clinic because she noticed that the mole on her left shoulder has increased in size and darkened in color. Document the assessment of Emily's mole using the ABCDE rule.

-A: asymmetrical, 5 mm x 8 mm -B: border irregularity, shaped like a jagged pebble -C: color changes, brown to black -D: diameter, greater than 6 mm to 8 mm -E: evolving in appearance, patient describes increasing size plus color change and texture change

-pH = 7.57 -PaCO2 = 45 mmHg -PaO2 = 87 mmHg -HCO3 = 38 mEq/L provide a summary of the treatment for this patient.

-As in all acid-base imbalances, determination and treatment of the underlying cause is necessary. -The potassium that is lost in an alkalosis must be replaced to prevent dysrhythmias, and contributing drugs must be discontinued. -Vomiting with bicarbonate is treated as in the previous case analysis.

-pH = 7.20 -PaCO2 = 35 mmHg -PaO2 = 81 mmHg -HCO3 = 18 mEq/L provide a summary of the treatment for this patient.

-Determination of the underlying cause is necessary to treat the acidosis. -Diabetic acidosis is treated with insulin to normalize glucose metabolism, and carbohydrate (glucose) is provided in the case of starvation. -Dialysis may be used to treat renal failure, and other underlying causes are treated as appropriate.

-pH = 7.50 -PaCO2 = 28 mmHg -PaO2 = 85 mmHg -HCO3 = 24 mEq/L provide a summary of the treatment for this patient.

-Determination of the underlying cause is necessary to treat the alkalosis. -Having the patient rebreathe into a paper bag can increase CO2 retention and thus decrease the pH. -Correction of hypoxemia with oxygen therapy and bronchodilators can also be useful.

Emily, a 45-year-old white female with strawberry blonde hair and blue eyes, works at a garden center. She has come to the dermatology clinic because she noticed that the mole on her left shoulder has increased in size and darkened in color. You assess Emily's mole and note that it is 5 mm × 8 mm in diameter, shaped like a jagged pebble. She describes the changes she has noticed: the color has changed from brown to black and it has increased in size and feels bumpy. What other questions would you ask Emily regarding her mole?

-How would she describe the original size, shape, and color of the mole? -When did she notice the mole beginning to change? -Does she have any pain at the site to palpation? -Does she have any other moles of concern?

TNM classification: distant mestastases (M)

-M0: no evidence of distant metastases -M1-4: ascending degrees of metastatic involvement, including distant nodes -Mx: cannot be determined

-pH = 7.20 -PaCO2 = 35 mmHg -PaO2 = 81 mmHg -HCO3 = 18 mEq/L describe a patient who would have these ABGs, including history and assessment findings.

-Metabolic acidosis most commonly occurs in uncontrolled diabetes, but may also be caused by lactic acidosis, starvation, severe diarrhea, renal failure, or shock. -Assessment findings may include drowsiness and confusion leading to coma; deep, rapid respirations (compensation); hypotension and arrhythmias; warm, dry, flushed skin; and nausea, vomiting, and abdominal pain.

TNM classification: regional lymph node spread (N)

-N0: no evidence of disease in lymph nodes -N1-4: ascending degrees of nodal involvement -Nx: regional lymph nodes unable to be assessed clinically

-pH = 7.50 -PaCO2 = 28 mmHg -PaO2 = 85 mmHg -HCO3 = 24 mEq/L describe a patient who would have these ABGs, including history and assessment findings.

-Respiratory alkalosis most commonly occurs with hypoxemia from acute pulmonary disorders. -Anxiety, CNS disorders, and mechanical over-ventilation also increase the ventilation rate, leading to respiratory alkalosis. -Assessment findings may include tingling and numbness of the fingers, restlessness, hyperreflexia, tetany, headache, dizziness, confusion, tachycardia, dysrhythmias, nausea, vomiting, and epigastric pain.

Emily, a 45-year-old white female with strawberry blonde hair and blue eyes, works at a garden center. She has come to the dermatology clinic because she noticed that the mole on her left shoulder has increased in size and darkened in color. An incisional biopsy is done on Emily's mole and diagnosis of malignant melanoma is confirmed. Her mole is excised and her axillary lymph nodes on the right side are dissected to assess for metastasis. Lymph nodes are negative for cancer cells. How would this mole be classified in terms of tumor staging? Would you expect Emily to require additional treatment after excision?

-Stage 0 -This is not required for a stage 0 tumor in which the entire margin of the mole is excised and the lymph nodes are negative.

metabolic acidosis

due to a decrease in bicarbonate -pH < 7.35 -HCO3 < 22 mEq/L

Emily, a 45-year-old white female with strawberry blonde hair and blue eyes, works at a garden center. She has come to the dermatology clinic because she noticed that the mole on her left shoulder has increased in size and darkened in color. What are the risk factors for Emily?

-Strawberry blonde hair -Blue eyes -Sun exposure (from working in a garden center) -Possible chemical exposure at work

TNM classification: primary tumor size and invasiveness (T)

-T0: no evidence of primary tumor -Tis: carcinoma has its own designation since it has all the histologic characteristics of cancer except invasion - a primary feature of the TNM staging system -T1-4: ascending degrees of increase in tumor size and involvement

-pH = 7.57 -PaCO2 = 45 mmHg -PaO2 = 87 mmHg -HCO3 = 38 mEq/L describe a patient who would have these ABGs, including history and assessment findings.

-The history of a patient with metabolic alkalosis may include severe vomiting or excessive gastric suctioning, diuretic therapy, potassium deficit, excessive intake of sodium bicarbonate (baking soda), or excessive mineralocorticoid therapy. -Assessment findings may include nervousness and confusion, tachycardia and dysrhythmias, nausea and vomiting, tremors, hypertonic muscles, tetany, and tingling of the fingers and toes.

-pH = 7.20 -PaCO2 = 58 mmHg -PaO2 = 59 mmHg -HCO3 = 24 mEq/L describe a patient who would have these ABGs, including history and assessment findings.

-The hypoxemia may be reflected by restlessness, confusion, or stupor. -Respiratory and cardiac findings could include rapid, shallow breathing, rhonchi, crackles, diminished breath sounds, increased work of breathing with use of accessory muscles, orthopnea, tachycardia, and arrhythmias.

Emily, a 45-year-old white female with strawberry blonde hair and blue eyes, works at a garden center. She has come to the dermatology clinic because she noticed that the mole on her left shoulder has increased in size and darkened in color. Postoperatively, Emily examines her shoulder. She tearfully expresses concern regarding the size of the incision and its location on her shoulder. What are some suggestions that you could make to assist Emily in adapting and camouflaging her scar?

-Wearing short sleeve shirts rather than sleeveless to conceal the scar -Adding scarves or shawls to a sleeveless dress or blouse -Try using makeup to conceal the scar when wearing sleeveless shirts, bathing suits, etc.

normal ABGs: HCO3

22-28 mEq/L

what should urine output per hour be?

30-50 mL

normal ABGs: PaCO2

35-45 mmHg

normal ABGs: pH

7.35-7.45

what is a normal body pH?

7.35-7.45

normal ABGs: PO2

80-100 mmHg

metabolic alkalosis

due to an increase in bicarbonate -pH > 7.45 -HCO3 > 28 mEq/L

Holly is a 15-year-old female patient who is visiting the nurse practitioner today because she feels "ugly" and "cannot stand" the pimples on her face anymore. The practitioner questions Holly about the types of interventions (e.g., washing her face, over-the-counter creams, sun exposure) she is currently using. The practitioner prescribes benzoyl peroxide topically in a cleansing bar and a gel at night. What is the mechanism of action of benzoyl peroxide in the treatment of acne?

Benzoyl peroxide is effective in combating acne because it slowly and continuously liberates active oxygen in the skin, resulting in antibacterial, antiseptic, drying, and keratolytic actions. These actions create an environment that is unfavorable for the continued growth of the P. acnes bacteria, and they soon die.​

alkalosis

H+ decreases below normal -pH > 7.45

acidosis

H+ increases above normal -pH < 7.35

what are the respiratory system's efforts to compensate for the increase in metabolic acids in the body?

Kussmaul respirations

what is the most commonly used loop diuretic?

Lasix (furosemide)

what is the diuretic used to treat cerebral edema?

Mannitol

what are the blood products that are typically used for a patient suffering from anemia?

PRBCs

Holly is a 15-year-old female patient who is visiting the nurse practitioner today because she feels "ugly" and "cannot stand" the pimples on her face anymore. The practitioner questions Holly about the types of interventions (e.g., washing her face, over-the-counter creams, sun exposure) she is currently using. The practitioner prescribes benzoyl peroxide topically in a cleansing bar and a gel at night. What side effects should be included in the patient teaching for Holley about the use of benzoyl peroxide?

Side effects include peeling skin, red skin, or a sensation of warmth. Blistering or swelling of the skin is generally considered an allergic reaction to the product and is an indication to stop treatment.​

Holly is a 15-year-old female patient who is visiting the nurse practitioner today because she feels "ugly" and "cannot stand" the pimples on her face anymore. The practitioner questions Holly about the types of interventions (e.g., washing her face, over-the-counter creams, sun exposure) she is currently using. The practitioner prescribes benzoyl peroxide topically in a cleansing bar and a gel at night. Holly asks, "How long will it take for my face to get better?" What will be the nurse's response?

The nurse will tell the patient that benzoyl peroxide generally produces signs of improvement within four to six weeks.​

Emily, a 45-year-old white female with strawberry blonde hair and blue eyes, works at a garden center. She has come to the dermatology clinic because she noticed that the mole on her left shoulder has increased in size and darkened in color. Emily questions the type of surgery that was performed and how it was determined that all of the tumor was excised. What type of surgical procedure was likely used to excise the mole?

The surgical procedure that was likely used to excise Emily's mole is the Mohs procedure. It would be used to excise the tumor in layers, examining each layer to determine whether the margin and the depth of the tumor have been reached.

-pH = 7.20 -PaCO2 = 58 mmHg -PaO2 = 59 mmHg -HCO3 = 24 mEq/L provide a summary of the treatment for this patient.

Treatment includes treatment of any underlying respiratory infections, bronchodilator therapy, corticosteroids, hydration therapy, chest PT and postural drainage, breathing exercises, low-flow oxygen therapy, and mechanical ventilation if the patient continues to deteriorate.

what is an inflammation of the urinary epithelium that is usually caused by bacteria from the gut flora?

UTI

Jane is a 17-year-old patient who is being seen in the dermatology clinic for treatment of acne vulgaris. The nurse practitioner prescribes benzoyl peroxide topically four times a day. Jane tells the nurse that she wants to take the drug more frequently so the acne will go away quickly. A few months later, it is determined that Jane is not responding to treatment and is now prescribed isotretinoin. Which statement will the nurse include when teaching Jane about isotretinoin therapy? a. "Call your prescriber immediately if you experience any signs of depression." b. "If you become pregnant, the dose of isotretinoin will be cut in half." c. "Isotretinoin is administered by subcutaneous injection directly into the acne areas." d. "Isotretinoin should not be used with any form of birth control."

a. "Call your prescriber immediately if you experience any signs of depression."

The nurse is giving discharge instructions to a patient diagnosed with pyelonephritis. Which statement by the patient would indicate that learning has occurred? a. "Pyelonephritis is an infection of the kidney." b. "Pyelonephritis is an inflammation of the bladder." c. "Pyelonephritis is an infection of the lower urinary tract." d. "Pyelonephritis is a blockage in the tube from the kidney to the bladder."

a. "Pyelonephritis is an infection of the kidney."

An older adult patient has been discharged following treatment for a mild case of heart failure. He will be taking a furosemide. Which instruction(s) from the nurse are appropriate? Select all that apply. a. "Take the diuretic at the same time each morning." b. "Take the diuretic only if you notice swelling in your feet." c. "Be sure to stand up slowly because the medicine may make you feel dizzy if you stand up quickly." d. "Drink at least 10 glasses of water each day." e. "Here is a list of foods that are high in potassium; you need to avoid these." f. "Please call your doctor immediately if you notice muscle weakness or increased dizziness."

a. "Take the diuretic at the same time each morning." c. "Be sure to stand up slowly because the medicine may make you feel dizzy if you stand up quickly." f. "Please call your doctor immediately if you notice muscle weakness or increased dizziness."

A female patient asks the nurse about ways to prevent recurrent cystitis. What is an appropriate nursing response? a. "Void before and as soon as possible after sexual intercourse." b. "Clean the perineal area from back to front." c. "Soak in a bathtub at least once a week." d. "Wear clean, nylon underpants."

a. "Void before and as soon as possible after sexual intercourse."

What is the normal range of carbon dioxide in the arterial blood? a. 35-45 mmHg b. 22-26 mmHg c. 10-15 mmHg

a. 35-45 mmHg

The nurse assesses the arm of a patient with an arteriovenous fistula for the presence of which finding? a. A bruit upon auscultation b. A thrill upon auscultation c. A bruit upon palpation d. A thrill upon inspection

a. A bruit upon auscultation

Six days after a kidney transplant from a deceased donor, a patient develops a temperature of 101.2°F (38.5°C), tenderness at the transplant site, and oliguria. The nurse recognizes that these findings indicate which of the following? a. Acute rejection, which is not uncommon and is usually reversible.​ b. Hyperacute rejection, which will necessitate the removal of the transplanted kidney.​ c. An infection of the kidney, which can be treated with IV antibiotics.​ d. The onset of chronic rejection of the kidney with eventual failure of the kidney.​

a. Acute rejection, which is not uncommon and is usually reversible.​

A nurse is caring for a client with end-stage renal disease who has a mature arteriovenous (AV) fistula. What nursing care should be included in the client's plan of care? Select all that apply. a. Auscultate for a bruit b. Palpate the site to identify a thrill c. Irrigate with saline to maintain patency d. Avoid drawing blood from the affected extremity e. Keep the fistula clamped until ready to perform dialysis

a. Auscultate for a bruit b. Palpate the site to identify a thrill d. Avoid drawing blood from the affected extremity

Gina is being discharged home with furosemide (Lasix). When providing discharge teaching, which instruction will the nurse include? a. Avoid prolonged exposure to the sun. b. Avoid foods high in potassium content. c. Stop taking the medication if you feel dizzy. d. Weigh yourself once a week and report a gain or loss of more than 1 lb.

a. Avoid prolonged exposure to the sun.

A patient is receiving a loop diuretic for treatment of edema. The nurse determines the patient is experiencing an excessive response to the treatment when the client demonstrates which of the following? a. BUN 28 mg/dL, HCT 45%, and an 8 lb weight loss in 24 hours. b. BUN 21 mg/dL, HCT 29%, and an 8 lb weight gain in 24 hours. c. BUN 16 mg/dL, HCT 31%, and an 8 lb weight loss in 24 hours. d. BUN 25 mg/dL, HCT 33%, and an 8 lb weight gain in 24 hours

a. BUN 28 mg/dL, HCT 45%, and an 8 lb weight loss in 24 hours.

The cells of which type of tumor are fairly normal, like parent cells? a. Benign b. Malignant

a. Benign

Which type of neoplasm has slight vascularity? a. Benign b. Malignant

a. Benign

Which type of neoplasm rarely recurs? a. Benign b. Malignant

a. Benign

The nurse is monitoring a patient who has developed thrombocytopenia after two rounds of chemotherapy. Which signs or symptoms will the nurse look for in this patient? (Select all that apply.) a. Bruising b. Increased fatigue c. Ulcerations on mucous membranes inside the mouth d. Temperature above 100.5 F (38.1 C) e. Increased bleeding from venipunctures

a. Bruising c. Ulcerations on mucous membranes inside the mouth e. Increased bleeding from venipunctures

Which of these drugs is used for the treatment of many solid tumors, such as bladder, lung, testicular, and ovarian tumors? a. Cisplatin (Platinol) b. Cyclophosphamide (Cytoxan) c. Mechlorethamine (Mustargen)

a. Cisplatin (Platinol)

A school-age client is admitted to the hospital with respiratory acidosis. Which chronic lung illness in the client's health history does the nurse suspect is causing the current diagnosis? a. Cystic fibrosis b. Aspiration c. Hyperthyroidism d. Pneumonia

a. Cystic fibrosis

The nurse is caring for a client admitted with renal failure and metabolic acidosis. Which clinical manifestation would indicate to the nurse that planned interventions to relieve the metabolic acidosis have been effective? a. Decreased respiratory depth b. Palpitations c. Increased deep tendon reflexes d. Respiratory rate of 38

a. Decreased respiratory depth

A client is admitted to a medical unit with the diagnosis of acute kidney injury. The nurse reviews the client's laboratory data, performs a physical assessment, and obtains the client's vital signs. What should the nurse conclude the client is most likely experiencing? a. Hyperkalemia b. Hyponatremia c. Hypouricemia d. Hypercalcemia

a. Hyperkalemia

Which condition does the nurse anticipate when assessing a patient with tumor lysis syndrome? a. Hyperuricemia b. Hypophosphatemia c. Hyperkalemia d. Hypokalemia

a. Hyperuricemia

To prevent the debilitating cycle of fatigue-depression-fatigue in patients receiving radiation therapy, what should the nurse encourage the patient to do? a. Implement a walking program. b. Ignore the fatigue as much as possible. c. Do the most stressful activities when fatigue is tolerable. d. Schedule rest periods throughout the day whether fatigue is present or not.

a. Implement a walking program.

A nurse is assessing a client with a diagnosis of kidney failure for clinical indicators of metabolic acidosis. What should the nurse conclude is the reason why metabolic acidosis develops with kidney failure? a. Inability of the renal tubules to secrete hydrogen ions and conserve bicarbonate b. Depressed respiratory rate by metabolic wastes, causing carbon dioxide retention c. Inability of the renal tubules to reabsorb water to dilute the acid contents of blood d. Impaired glomerular filtration, causing retention of sodium and metabolic waste products

a. Inability of the renal tubules to secrete hydrogen ions and conserve bicarbonate

A patient is admitted with signs of chronic renal failure. Which finding would alert the nurse to possible metabolic acidosis? a. Kussmaul's respirations b. Low urine output c. Muscle cramps d. Diarrhea

a. Kussmaul's respirations

When administering a loop diuretic to a patient, it is most important for the nurse to determine if the patient is also taking which drug? a. Lithium (Eskalith) b. Acetaminophen (Tylenol) c. Penicillin d. Theophylline

a. Lithium (Eskalith)

The nurse is planning the care of a patient with chronic glomerulonephritis. What should be the goal of treatment for this patient? a. Maintaining renal function b. Achieving maximum independence c. Returning to work as soon as possible d. Successful lifestyle adaptation

a. Maintaining renal function

A client has been admitted for dehydration after fasting for 5days. For which of the following acid-base imbalances would the nurse anticipate that this client is at risk? a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis

a. Metabolic acidosis

A client is brought to the emergency department (ED) after passing out in a local department store. The client has been fasting and has ketones in the urine. Which acid-base imbalance would the nurse expect to assess in this client? a. Metabolic acidosis b. Respiratory alkalosis c. Metabolic alkalosis d. Respiratory acidosis

a. Metabolic acidosis

The nurse is caring for the client experiencing hypovolemic shock and metabolic acidosis. Which therapies would the nurse question if planned for this client? Select all that apply. a. Monitor weight on admission and discharge. b. Monitor ECG for conduction problems. c. Limit the intake of fluids. d. Administer sodium bicarbonate. e. Keep the bed in the locked and low position.

a. Monitor weight on admission and discharge. c. Limit the intake of fluids.

When caring for an adult receiving an intravenous (IV) infusion of 3% sodium chloride, the nurse places priority on monitoring which of the following to detect complications of therapy? Select all that apply. a. Neurological exam b. Urine specific gravity c. Serum glucose levels d. Lung sounds e. Serum sodium levels

a. Neurological exam d. Lung sounds e. Serum sodium levels

Review the following ABG values and determine if they are normal, alkalosis, or acidosis: -pH: 7.35 -PaCO2: 35 mmHg -HCO3: 25 mEq/L a. Normal b. Alkalosis c. Acidosis

a. Normal

Which word identifies a mutation of protooncogenes? a. Oncogenes b. Retrogenes c. Oncofetal antigens d. Tumor angiogenesis fact

a. Oncogenes

Which of the following lab values is indicative of hypokalemia? a. Serum potassium of 3.25 mEq/L b. Serum potassium of 5.45 mEq/L c. Serum sodium of 125 mEq/L d. Serum sodium of 155 mEq/L

a. Serum potassium of 3.25 mEq/L

What is the most common risk factor for bladder cancer? a. Smoking b. Chemicals c. Age

a. Smoking

A woman who is taking isotretinoin calls the office to say that she thinks she may be pregnant. What will the nurse instruct the patient to do first? a. Stop the isotretinoin immediately. b. Reduce the dosage of the isotretinoin to every other day. c. Switch to tretinoin (retinoic acid). d. Consult an obstetrician.

a. Stop the isotretinoin immediately.

When teaching a patient who is receiving outpatient chemotherapy about potential problems, the nurse needs to mention signs and symptoms of an oncologic emergency, which include which of the following? (Select all that apply.) a. Swollen tongue b. Alopecia c. Blood in the urine d. Nausea and vomiting e. Temperature of 100.5° F (38.1° C) or higher f. Chills

a. Swollen tongue c. Blood in the urine e. Temperature of 100.5° F (38.1° C) or higher f. Chills

Which answer choice best describes the principle of diffusion in dialysis? a. The movement of solutes from an area of greater concentration to an area of lesser concentration​. b. The movement of fluid from an area of lesser concentration of solutes to an area of greater concentration​.

a. The movement of solutes from an area of greater concentration to an area of lesser concentration​.

A patient is scheduled to have an arteriovenous (AV) fistula created for hemodialysis. Which education should the nurse provide regarding this fistula? Select all that apply. a. The opposite arm should be used for blood pressure readings. b. A functioning fistula has a palpable pulse and bruit. c. The health care provider should be contacted if the hand is cool and painful. d. The fistula can be used immediately after its creation. e. Venipunctures should be performed on the arm with the fistula.

a. The opposite arm should be used for blood pressure readings. b. A functioning fistula has a palpable pulse and bruit.

The nurse, administering epoetin alfa (Epogen) to a patient on dialysis, explains that the medication will help replace which function of the kidney? a. Treats the anemia seen in chronic renal failure patients on dialysis b. Combats the effects of dialysis on bone marrow c. Promotes elimination of nephrotoxic drugs from the body d. Enhances absorption of iron and folate in the intestinal tract

a. Treats the anemia seen in chronic renal failure patients on dialysis

Cancer is the leading cause of death in people 40 to 79 years of age. a. True b. False

a. True

High urea concentration and abundant glycoproteins in the urinary tract interfere with the growth of bacteria. a. True b. False

a. True

In ultrafiltration, excess fluid moves into the dialysate. a. True b. False

a. True

Nitrosoureas and miscellaneous alkylators have different chemical structures than nitrogen mustards and work by alkylation. a. True b. False

a. True

Overall, both the incidence and mortality rate of cancer have been declining. a. True b. False

a. True

People may have a genetic disposition toward getting melanoma. a. True b. False

a. True

Several mechanical and physiological defense mechanisms aid in maintaining sterility in the urinary tract and preventing UTIs. a. True b. False

a. True

The antibacterial characteristics of urine are maintained by a normally acidic pH (less than 6.0). a. True b. False

a. True

The first alkylating drugs were developed from mustard gas agents that were used for chemical warfare before and during World War I. Mechlorethamine, which is also known as "nitrogen mustard" is still in use today as a cancer treatment a. True b. False

a. True

Ultrafiltration is water and fluid removal. a. True b. False

a. True

Up to 14.5 million Americans are alive today who have a history of cancer. a. True b. False

a. True

The nurse monitors a CKD patient's daily weights because of the risk for fluid retention. What instructions does the nurse give to the UAP? a. Weigh the patient daily at the same time each day, same scale, with the same amount of clothing. b. Weigh the patient daily and add 1 kilogram of weight for the intake of each liter of fluid. c. Weigh the patient in the morning before breakfast and weigh the patient at night just before bedtime. d. Ask the patient what his or her normal weight is and then weigh the patient before and after each voiding.

a. Weigh the patient daily at the same time each day, same scale, with the same amount of clothing.

For clients with cancer, what should the nurse regularly monitor to assess for cachexia? a. Weight b. Blood pressure c. Heart rate d. Temperature

a. Weight

Ms. L. recently underwent a biopsy of a lump near her breast. Several days later, her physician calls and tells her that the lump is noncancerous and therefore is not an immediate threat to life. She is relieved to hear, then, that it is (Blank). a. benign b. fatal c. malignant

a. benign

Mr. G. is receiving chemotherapy with a drug that is considered cytotoxic during any phase of the cellular growth cycle. This drug is known as (Blank). a. cell cycle-nonspecific b. cell cycle-specific c. selective

a. cell cycle-nonspecific

Ms. F. has been given her first chemotherapy treatment. However, it soon becomes apparent that the adverse effects she is experiencing prevent her from being given dosages that will be high enough to be effective. These are (Blank) adverse effects. a. dose-limiting b. trough c. therapeutic

a. dose-limiting

Mr. C. is very interested in his chemotherapy process. As you are discussing a drug's action, he hears you use the term (Blank), and he asks you what it means. You explain that this is the point at which the lowest neutrophil count occurs after administration of a chemotherapy agent that causes bone marrow suppression. a. nadir b. neutropenia c. thrombocytopenia

a. nadir

An alkalinizing solution often given intravenously to clients with severe acute metabolic acidosis is: a. sodium bicarbonate. b. sodium chloride. c. potassium chloride. d. dextrose.

a. sodium bicarbonate.

Mr. H. is told that his cancer has metastasized. His physician explains to him that this means it has (Blank) to other areas of his body. a. spread b. swelled c. shrunk

a. spread

The primary protective role of the immune system related to malignant cells is: a. surveillance for cells with tumor-associated antigens. b. binding with free antigens released by all cancer cells. c. producing blocking factors that immobilize cancer cells. d. reacting to a new set of antigenic determinants on cancer cells.

a. surveillance for cells with tumor-associated antigens.

what is an infection of one or both upper urinary tracts?

acute pyelonephritis

what is a colloid fluid that is a natural protein normally produced by the liver?

albumin

what type of relationship do calcium and phosphorus have?

an inverse relationship

A client with anemia is prescribed synthetic erythropoietin. When teaching the client about the therapeutic effect of this treatment, which is appropriate for the nurse to include? a. Increase in platelets b. Increase in red blood cells c. Decrease in white blood cells d. Decrease in lymph fluid

b. Increase in red blood cells

During an assessment, the nurse learns that a client who is seeking emergency treatment for a headache and nausea works in a mill without air conditioning. The current air temperature outside is 88 degrees, and the client reports drinking water several times throughout the day because of heavy sweating. Based on this data, which instruction is most appropriate for the nurse to give the client? a. "Eat something sweet when drinking water." b. "Eat something salty when drinking water." c. "Double the amount of water you are drinking." d. "Drink juices and carbonated sodas instead of water."

b. "Eat something salty when drinking water."

The nurse instructs a group of community members about ways to reduce the development of cancer. Which participant statements indicate that teaching has been effective? Select all that apply. a. "I should eat at least two servings of fruits or vegetables each day." b. "Sunscreen should be applied before spending time outdoors." c. "I need to cut down on my smoking." d. "I need to get my home tested for radon." e. "I need to minimize my child's exposure to secondhand smoke."

b. "Sunscreen should be applied before spending time outdoors." d. "I need to get my home tested for radon." e. "I need to minimize my child's exposure to secondhand smoke."

A patient diagnosed with a symptomatic urinary tract infection (UTI) is prescribed phenazopyridine (Pyridium). Which medication education should the nurse provide? a. "Don't worry if your skin turns a yellowish color." b. "This medication will make your urine orange or red." c. "This medication will kill the bacteria in your urine." d. "Take this medication until the prescription is finished."

b. "This medication will make your urine orange or red."

Which solution should the nurse administer with packed red blood cells? a. Lactated Ringer's solution b. 0.9% sodium chloride c. D5W d. 0.45% sodium chloride

b. 0.9% sodium chloride

What is the normal ABG for HCO3? a. 7.35-7.45 mEq/L b. 22-28 mEq/L c. 35-45 mEq/L

b. 22-28 mEq/L

Renal cell carcinoma (adenocarcinoma) is the most common type of kidney cancer. What is the average age of the patient at diagnosis? a. 44 years b. 64 years c. 84 years

b. 64 years

How many cases of bladder cancer are diagnosed each year in the US? a. About 42,000 cases b. About 82,000 cases c. About 122,000 cases

b. About 82,000 cases

A client who had cardiac surgery 24 hours ago has had a urine output averaging 20 mL/hour for 2 hours. The client received a single bolus of 500 mL of intravenous fluid. Urine output for the subsequent hour was 25 mL. Daily laboratory results indicate that the blood urea nitrogen level is 45 mg/dL and the serum creatinine level is 2.2 mg/dL. On the basis of these findings, the nurse would anticipate that the client is at risk for which problem? a. Hypovolemia b. Acute kidney injury c. Glomerulonephritis d. Urinary tract infection

b. Acute kidney injury

Jane is a 17-year-old patient who is being seen in the dermatology clinic for treatment of acne vulgaris. The nurse practitioner prescribes benzoyl peroxide topically four times a day. Jane tells the nurse that she wants to take the drug more frequently so the acne will go away quickly. During a regular follow-up visit, Jane points out a sore that she has developed on her mouth. She is diagnosed with herpes simplex. Which medication does the nurse anticipate Jane will receive? a. Miconazole (Monistat) b. Acyclovir (Zovirax) c. Clotrimazole (Lotrimin) d. Anthralin (Anthra-Derm)

b. Acyclovir (Zovirax)

The nurse is caring for a patient who has just undergone a cystoscopy. Which assessment finding necessitates an immediate intervention by the nurse? a. Back pain b. Bright red urine c. Urinary frequency d. Burning on urination

b. Bright red urine

Which of the following foods should the nurse instruct the client with end stage renal disease (ESRD) to avoid? Select all that apply. a. White bread b. Cantaloupe c. Green beans d. Apple juice e. Raisins f. Potatoes

b. Cantaloupe e. Raisins f. Potatoes

Which complication is avoided when a nurse administers a parenteral preparation of potassium slowly and cautiously via an infusion pump? a. Acidosis b. Cardiac arrest c. Psychotic-like reactions d. Edema of the extremities

b. Cardiac arrest

Which of these drugs is used for the treatment of cancers of the bone and lymph and is also used in the treatment of leukemias and multiple myeloma? a. Cisplatin (Platinol) b. Cyclophosphamide (Cytoxan) c. Mechlorethamine (Mustargen)

b. Cyclophosphamide (Cytoxan)

The nurse suspects a client with one functioning lung is developing chronic respiratory acidosis. Which manifestation did the nurse most likely assess in this client? a. Warm, flushed skin b. Daytime sleepiness c. Irritability d. Blurred vision

b. Daytime sleepiness

Diuretics are commonly used to treat each of these conditions except: a. Hypertension b. Diabetes c. Congestive heart failure d. Edema

b. Diabetes

While preparing an infusion of mannitol (Osmitrol), the nurse notices small crystals in the IV tubing. What is the most appropriate action by the nurse? a. Administer the infusion slowly. b. Discard the solution and obtain another bag of medication. c. Obtain a filter and then infuse the solution. d. Return the fluid to the IV bag to dissolve the crystals.

b. Discard the solution and obtain another bag of medication.

Which of the following defining characteristics is consistent with fluid volume excess inthe patient diagnosed with end stage renal disease? a. A 1-lb (0.5 kg) weight gain, pale yellow urine b. Distended neck veins, crackles in lungs, edematous feet c. Dry mucous membranes, postural hypotension, tachycardia d. Bounding radial pulse, flat neck veins when supine

b. Distended neck veins, crackles in lungs, edematous feet

What is the most common UTI pathogen? a. Candida albicans b. Escherichia coli (E. coli) c. Fungus or parasite

b. Escherichia coli (E. coli)

Cancer is a disease of aging because the majority of cases diagnosed in those over age 55 years. a. True b. False

b. False

Thiazide diuretics are more potent than loop diuretics. a. True b. False

b. False

A client is admitted to the hospital with a diagnosis of chronic kidney failure. For signs of what electrolyte imbalance should the nurse monitor the client? a. Hypokalemia b. Hypocalcemia c. Hypernatremia d. Hyperglycemia

b. Hypocalcemia

The nurse is preparing to administer 20 mEq of potassium chloride to a client who has been vomiting. Which information about the purpose of this medication should the nurse explain to the client? a. It is vital in regulating muscle contraction and relaxation. b. It is needed to maintain skeletal, cardiac, and neuromuscular activity. c. It controls and regulates water balance in the body. d. It is used to synthesize protein and DNA within the body's cells.

b. It is needed to maintain skeletal, cardiac, and neuromuscular activity.

A compensatory mechanism that may indicate to a nurse that a client is experiencing metabolic acidosis includes: a. headache. b. Kussmaul respirations. c. vomiting. d. decreased level of consciousness.

b. Kussmaul respirations.

Mr. K. has been treated with methotrexate for its folate-antagonistic properties. Now, however, he seems to be experiencing a toxicity reaction. The treatment he will receive will be (Blank) rescue. a. chemotherapy b. Leucovorin c. prescription

b. Leucovorin

For which type of neoplasm is the mode of growth infiltrative and expansive? a. Benign b. Malignant

b. Malignant

The cells of which type of tumor are poorly differentiated? a. Benign b. Malignant

b. Malignant

Which neoplasm is rarely encapsulated? a. Benign b. Malignant

b. Malignant

When receiving hemodialysis, the complication of the removal of too much sodium may occur. For which clinical findings associated with hyponatremia should the nurse assess the client? Select all that apply. a. Chvostek sign b. Muscle cramps c. Extreme fatigue d. Cardiac dysrhythmias e. Increased temperature

b. Muscle cramps c. Extreme fatigue

A patient is hypokalemic and will be receiving IV potassium. The patient is not on a heart monitor. How should the nurse administer the potassium replacement? a. IV push b. No more than 10 mEq/hour c. No more than 20 mEq/hour d. 40 mEq/hour

b. No more than 10 mEq/hour

What is the age group of 90% of patients diagnosed with bladder cancer? a. Between 25 and 45 years b. Older than 55 years c. Older than 75 years

b. Older than 55 years

The movement of fluid from an area of lesser concentration of solutes to an area of greater concentration​ is best described as which of the following principles of dialysis? a. Diffusion b. Osmosis c. Ultrafiltration

b. Osmosis

A client with acute kidney injury has a serum potassium level of 6.0 mEq/L. The nurse should plan which action as a priority? a. Check the sodium level. b. Place the client on a cardiac monitor. c. Encourage increased vegetables in the diet. d. Allow an extra 500 mL of fluid intake to dilute the electrolyte concentration.

b. Place the client on a cardiac monitor.

Which location is the area where the highest percentage of sodium and water is resorbed back into the bloodstream? a. Glomerulus b. Proximal tubule c. Ascending loop of Henle d. Distal tubule

b. Proximal tubule

The nurse assumes care for a client who was brought to the hospital after a morphine overdose. What acid-base imbalance does the nurse expect to observe in this client? a. Respiratory alkalosis b. Respiratory acidosis c. Metabolic alkalosis d. Metabolic acidosis

b. Respiratory acidosis

The nurse is caring for a client with pneumonia and finds the following ABG results in the client's chart: -pH 7.30 -PaCO2 58 mmHg -HCO3 26mEq/L -PaO2 72 mmHg What is the priority nursing intervention? a. Place the client in a left-sided lying position. b. Sit the client up to a semi-Fowler's position. c. Assist the client to breathe into a paper bag. d. Administer a sedative to the client.

b. Sit the client up to a semi-Fowler's position.

If extravasation of an antineoplastic drug occurs, what will the nurse do first? a. Remove the intravenous catheter immediately. b. Stop the drug infusion without removing the intravenous catheter. c. Aspirate residual drug or blood from the tube if possible. d. Administer the appropriate antidote.

b. Stop the drug infusion without removing the intravenous catheter.

Gina is ordered furosemide (Lasix). Before administering furosemide, it is most important for the nurse to assess the patient for allergies to which drug class? a. Aminoglycosides b. Sulfonamides c. Macrolides d. Penicillins

b. Sulfonamides

What are the two systems in the body that work to regulate pH in acid-base balance & which one works fastest? a. The Respiratory & Renal systems; Renal b. The Respiratory & Renal systems; Respiratory c. The Renal & GI systems; Renal

b. The Respiratory & Renal systems; Respiratory

The nurse is assigned to care for a group of clients. On review of the clients' medical records, the nurse determines that which client is at risk for fluid volume excess? a. The client taking diuretics b. The client with kidney disease c. The client with an ileostomy d. The client who requires gastrointestinal suctioning

b. The client with kidney disease

When a patient is undergoing brachytherapy, what is it important for the nurse to be aware of when caring for this patient? a. The patient will undergo simulation to identify and mark the field of treatment. b. The patient is a source of radiation and personnel must wear film badges during care. c. The goal of this treatment is only palliative and the patient should be aware of the expected outcome. d. Computerized dosimetry is used to determine the maximum dose of radiation to the tumor within an acceptable dose to normal tissue.

b. The patient is a source of radiation and personnel must wear film badges during care.

The nurse performing a blood draw for arterial blood gases first performs a modified Allen test for what purpose? a. To reduce the risk of bleeding or bruising of the arm b. To determine if arterial puncture can safely be performed c. To determine the oxygen saturation of the blood in the artery d. To determine the pressure of the blood in the artery

b. To determine if arterial puncture can safely be performed

A patient with a serum potassium of 6.0mEq/L is ordered polystyrene sulfonate (Kayexalate) via the nasogastric tube. What additive should be included with the Kayexalate administration? a. Sorbitol b. Water c. An antacid d. A laxative

b. Water

A patient is taken to the trauma unit after a motorcycle accident. It is estimated that he has lost 30% of his blood volume and he is in hypovolemic shock. The nurse anticipates a transfusion with which blood product? a. PRBCs b. Whole blood c. Cryoprecipitate d. FFP

b. Whole blood

To prevent fever and shivering during an infusion of rituximab (Rituxan), the nurse should premedicate the patient with: a. aspirin. b. acetaminophen. c. sodium bicarbonate. d. meperidine (Demerol).

b. acetaminophen.

client with acute kidney injury states, "Why am I twitching and my fingers and toes tingling?" The nurse should respond, "This is caused by: a. acidosis." b. calcium depletion." c. potassium retention." d. sodium chloride depletion

b. calcium depletion."

Mr. Y.'s physician is not surprised to find that Mr. Y. has nausea and vomiting; the methotrexate therapy is displaying a strong (Blank) potential in this patient. a. allergic b. emetic c. therapeutic

b. emetic

Mr. B. has just undergone a series of chemotherapeutic treatments when it is discovered that the anti-neoplastic drug has leaked into surrounding tissues; in other words, (Blank) of the drug has occurred. a. inactivation b. extravasation c. destruction

b. extravasation

Ms. H. has a hematologic malignancy. Her bone marrow is being rapidly replaced with leukemic blasts; she also has abnormal numbers (and forms) of immature white blood cells in her circulation, and even her lymph nodes, spleen, and liver are being infiltrated. Ms. H.'s type of cancer is known as (Blank). a. myeloma b. leukemia c. lymphoma

b. leukemia

As the nurse is preparing to give the patient chemotherapy, the patient asks the nurse why more than one drug is used. The nurse will explain that combinations of chemotherapeutic drugs are used to: a. reduce drug resistance. b. reduce the incidence of adverse effects. c. decrease the cost of treatment. d. reduce treatment time.

b. reduce the incidence of adverse effects.

The nurse explains to a patient undergoing brachytherapy of the cervix that she: a. must undergo simulation to locate the treatment area. b. requires the use of radioactive precautions during nursing care. c. may have desquamation of the skin on the abdomen and upper legs. d. requires shielding of the ovaries during treatment to prevent ovarian damage.

b. requires the use of radioactive precautions during nursing care.

The nurse is instructing a client with a history of acidosis on the use of sodium bicarbonate. Which client statement indicates that additional teaching is needed? a. "I should contact the doctor if I have any gastric discomfort with chest pain." b. "I need to purchase antacids without salt." c. "I should use the antacid for at least 2 months." d. "I should call the doctor if I get short of breath or start to sweat with this medication."

c. "I should use the antacid for at least 2 months."

Jane is a 17-year-old patient who is being seen in the dermatology clinic for treatment of acne vulgaris. The nurse practitioner prescribes benzoyl peroxide topically four times a day. Jane tells the nurse that she wants to take the drug more frequently so the acne will go away quickly. What information will the nurse provide to Jane? a. "Improvement is usually seen in 1 week." b. "If you want faster results, a pill form of benzoyl peroxide will be used." c. "Overuse of this drug can result in painful, reddened skin." d. "Benzoyl peroxide causes the skin to blister or swell to clear the acne."

c. "Overuse of this drug can result in painful, reddened skin."

In the early stage of kidney cancer, patients are asymptomatic. The cancer is often an incidental finding for an unrelated condition. What percent of kidney cancer patients have metastasis when diagnosed? a. 5% b. 15% c. 25%

c. 25%

Renal failure is suspected when urine production is below: a. 60 ml/hr b. 45 ml/hr c. 30 ml/hr d. 10 ml/hr

c. 30 ml/hr

What is the normal range for arterial blood pH? a. 7.38-7.46 b. 7.40-7.52 c. 7.35-7.45

c. 7.35-7.45

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

c. A 32-year-old who uses a tanning booth twice a week.

A patient is diagnosed with postrenal acute renal failure. Which finding is associated with this type of renal failure? a. Sepsis b. Hypovolemia c. An enlarged prostate d. Drug toxicity

c. An enlarged prostate

How many cases of kidney cancer are diagnosed each year in the US? a. Approximately 15,000 cases b. Approximately 32,000 cases c. Approximately 63,000 cases

c. Approximately 63,000 cases

The nurse is caring for a client who has been admitted to the unit with respiratory failure and respiratory acidosis. Which data from the nursing history would the nurse suspect contributed to the client's current state of health? a. Use of ibuprofen for the control of pain b. A recent trip to South America c. Aspiration pneumonia d. Recent recovery from a cold virus

c. Aspiration pneumonia

A client with chronic kidney disease has been prescribed calcium carbonate. What is the rationale for this particular medication? a. Diminishes incidence of gastric ulcer formation b. Alleviates constipation c. Binds with phosphorus to lower concentrations d. Increases tubular reabsorption of sodium

c. Binds with phosphorus to lower concentrations

A child with acute asthma has a PaCO2 of 48 mmHg, a pH of 7.31, and a normal HCO3 blood gas value. The nurse interprets these findings as indicative of which condition? a. Metabolic acidosis b. Respiratory alkalosis c. Respiratory acidosis d. Metabolic alkalosis

c. Respiratory acidosis

A pregnant woman has been diagnosed with cancer and is meeting with her oncologist to plan treatment. Which statement about chemotherapy and pregnancy is true? a. She will have to wait until the baby is born before starting chemotherapy. b. The greatest risk of fetal harm from chemotherapy is during the third trimester. c. Chemotherapy treatment during the second or third trimester poses less risk to the fetus. d. Chemotherapy is unsafe during pregnancy, but radiation therapy is safe in low doses.

c. Chemotherapy treatment during the second or third trimester poses less risk to the fetus.

Which client is at the highest risk for developing chronic kidney disease? a. Client with severe acute glomerulonephritis b. Client with an allergic reaction to a blood transfusion c. Client with poorly controlled long-term hypertension d. Client who received IV aminoglycosides for an infection

c. Client with poorly controlled long-term hypertension

During an assessment, the nurse becomes concerned that a client is at risk for developing metabolic alkalosis. What did the nurse assess that caused this concern? a. Daily ingestion of a banana with breakfast b. Daily weight consistent c. Daily use of sodium bicarbonate for gastric upset d. Daily use of prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) for arthritic pain

c. Daily use of sodium bicarbonate for gastric upset

A client develops kidney damage as a result of a transfusion reaction. What is the most significant clinical response that the nurse should assess when determining kidney damage? a. Glycosuria b. Blood in the urine c. Decreased urinary output d. Acute pain over the kidney

c. Decreased urinary output

The nurse is caring for a patient who received chemotherapy 24 hours ago. The patient's white blood cell count is 4,400 mcL. Which symptom, if experienced by the patient, should the nurse report to the prescriber immediately? a. Fatigue b. Diarrhea c. Fever d. Nausea and vomiting

c. Fever

The client has been vomiting for several days. The nurse knows that the client is at risk for metabolic alkalosis because gastric secretions have which characteristic? a. Gastric secretions are green in color. b. Gastric secretions are alkaline. c. Gastric secretions are acidic. d. Gastric secretions have a foul smell.

c. Gastric secretions are acidic.

The nurse is reviewing laboratory values for a female client suspected of having a fluid imbalance. Which laboratory value should indicate a diagnosis of dehydration to the nurse? a. Serum osmolality 230 mOsm/kg b. Hematocrit 30% c. Hematocrit 53% d. Serum potassium 3.8 mEq/L

c. Hematocrit 53%

The nurse is caring for a client with heart failure who is receiving high doses of a diuretic. On assessment, the nurse notes that the client has flat neck veins, generalized muscle weakness, and diminished deep tendon reflexes. The nurse suspects hyponatremia. What additional signs would the nurse expect to note in a client with hyponatremia? a. Muscle twitches b. Decreased urinary output c. Hyperactive bowel sounds d. Increased specific gravity of the urine

c. Hyperactive bowel sounds

Two days after admission, the nurse is reviewing laboratory results for Gina. Which is the most common electrolyte finding resulting from the administration of furosemide (Lasix)? a. Hypocalcemia b. Hypophosphatemia c. Hypokalemia d. Hypomagnesemia

c. Hypokalemia

During a home visit, the nurse evaluates teaching provided to a client recently hospitalized for metabolic alkalosis. Which observation indicates that additional teaching is required? a. Drinks 2 cups of black coffee each day. b. Consumes one orange each day with breakfast. c. Ingests bicarbonate of soda after each meal. d. Monitors and tracks daily weights.

c. Ingests bicarbonate of soda after each meal.

Which of these drugs is used for the treatment of Hodgkin and non-Hodgkin lymphoma? a. Cisplatin (Platinol) b. Cyclophosphamide (Cytoxan) c. Mechlorethamine (Mustargen)

c. Mechlorethamine (Mustargen)

The nurse is caring for a client who has had a nasogastric tube connected to low intermittent suction for the last three days. The nurse should monitor the client for which acid-base disorder? a. Respiratory alkalosis b. Respiratory acidosis c. Metabolic alkalosis d. Metabolic acidosis

c. Metabolic alkalosis

During chemotherapy, the nurse will monitor the patient for which symptoms of stomatitis? a. Indigestion and heartburn b. Severe vomiting and anorexia c. Pain or soreness of the mouth d. Diarrhea and perianal irritation

c. Pain or soreness of the mouth

Which condition does the nurse identify as a late manifestation of hypokalemia? a. Muscle weakness b. Hypotension c. Palpitations d. Lethargy

c. Palpitations

When working with a patient who is neutropenic, the nurse identifies which as the most effective measure to prevent the patient from developing an infection? a. Administer prophylactic antibiotics. b. Stop administration of the chemotherapeutic drug. c. Perform hand hygiene. d. Vaccinate the patient to prevent bacterial infection.

c. Perform hand hygiene.

An allogeneic hematopoietic stem cell transplant is considered as a treatment for a patient with acute myelogenous leukemia. What information should the nurse include when teaching the patient about this procedure? a. There is no risk for graft-versus-host disease because the donated marrow is treated to remove cancer cells. b. The patient's bone marrow will be removed, treated, stored, and then reinfused after intensive chemotherapy. c. Peripheral stem cells are obtained from a donor who has a human leukocyte antigen (HLA) match with the patient. d. There is no need for posttransplant protective isolation because the stem cells are infused directly into the blood.

c. Peripheral stem cells are obtained from a donor who has a human leukocyte antigen (HLA) match with the patient.

A client with acute kidney injury has been treated with sodium polystyrene sulfonate by mouth. The nurse should evaluate this therapy as most effective if which value was noted on follow-up laboratory testing? a. Calcium 9.8 mg/dL (2.45 mmol/L) b. Sodium 142 mEq/L (142 mmol/L) c. Potassium 4.9 mEq/L (4.9 mmol/L) d. Phosphorus 3.9 mg/dL (1.26 mmol/L)

c. Potassium 4.9 mEq/L (4.9 mmol/L)

What features of cancer cells are similar to normal cells? a. Cells lack contact inhibition. b. Cells return to a previous undifferentiated state. c. Proliferation occurs when there is a need for more cells. d. New proteins characteristic of embryonic stage emerge on cell membrane.

c. Proliferation occurs when there is a need for more cells.

The client is admitted to the emergency department (ED) with symptoms of a panic attack, including hyperventilation. Based on this data, the nurse plans care for which health problem? a. Hypoventilation b. Vomiting c. Respiratory alkalosis d. Memory loss

c. Respiratory alkalosis

The client's arterial blood gases reveal values of: -pH 7.30 -PaCO2 47mmHg -PaO2 88 mmHg -HCO3 16.5 mEq/L Which medication would the nurse anticipate being ordered? a. Sodium chloride b. Ammonium chloride c. Sodium bicarbonate d. Potassium chloride

c. Sodium bicarbonate

A patient on chemotherapy and radiation for head and neck cancer has: -WBC count of 1.9 × 10^3/μL -hemoglobin of 10.8 g/dL -platelet count of 99 × 10^3/μ Based on the CBC results, what is the most serious clinical finding? a. Cough, rhinitis, and sore throat b. Fatigue, nausea, and skin redness at site of radiation c. Temperature of 101.9° F, fatigue, and shortness of breath d. Skin redness at site of radiation, headache, and constipation

c. Temperature of 101.9° F, fatigue, and shortness of breath

A client being treated for cancer has a tumor designation of T4, N3, M1. What does this staging indicate to the nurse? a. The tumor will respond to chemotherapy. b. The tumor is small in size. c. The tumor has metastasized with lymph node involvement. d. There is one single tumor to treat.

c. The tumor has metastasized with lymph node involvement.

The nurse is analyzing the intake and output record for a client being treated for dehydration. The client weighs 176 lb and had a 24-hour intake of 2000 mL and urine output of 1200 mL. Based on this data, which conclusion by the nurse is the most appropriate? a. Treatment needs to include a diuretic. b. Treatment has not been effective. c. Treatment is effective and should continue. d. Treatment has been effective and should end.

c. Treatment is effective and should continue.

While hanging a new infusion bag of a chemotherapy drug, the nurse accidentally spills a small amount of solution on the floor. What is the nurse's best action? a. Let it dry, then mop the floor. b. Wipe the area with a paper towel. c. Use a spill kit to clean the area. d. Ask the housekeeping department to wipe the floor.

c. Use a spill kit to clean the area.

The goals of cancer treatment are based on the principle that: a. surgery is the single most effective treatment for cancer. b. initial treatment is always directed toward cure of the cancer. c. a combination of treatment modalities is effective for controlling many cancers. d. although cancer cure is rare, quality of life can be increased with treatment modalities.

c. a combination of treatment modalities is effective for controlling many cancers.

Your patient is receiving methotrexate. Your instructor asks for a full description of its mechanism of action, so you explain that it will inhibit dihydro-folic reductase from converting (Blank) acid to a reduced folate and thus ultimately prevent the synthesis of DNA and cell reproduction. The result, you explain, is that the cell will die. a. citric b. carbonic c. folic

c. folic

Ms. P. had a biopsy performed on the same day that Ms. L. did. When her biopsy specimen is analyzed, however, the results are the opposite of Ms. L.'s (noncancerous and not an immediate threat to her life); that is, her lump is considered (Blank). a. a cyst b. benign c. malignant

c. malignant

A client is admitted to the hospital with sudden, severe abdominal pain. The client is diagnosed with respiratory alkalosis. Which arterial blood gas value does the nurse document to support this diagnosis? a. pH is 7.33 and PaCO2 is 36. b. pH is 7.51 and HCO3 is 30. c. pH is 7.47 and PaCO2 is 25. d. pH is 7.35 and PaO2 is 88.

c. pH is 7.47 and PaCO2 is 25.

cancer staging: 0

cancer in situ

what is the type of diuretic used in the treatment of open-angle glaucoma?

carbonic anhydrase inhibitors

respiratory alkalosis

caused by a decrease in carbonic acid due to hyperventilation -pH > 7.45 -PaCO2 < 35 mmHg

respiratory acidosis

caused by an increase in carbonic acid due to hypoventilation -pH < 7.35 -PaCO2 > 45 mmHg

Urine is composed of what percentage of water? a. 65% water b. 75% water c. 85% water d. 95% water

d. 95% water

The nurse is caring for a patient receiving peritoneal dialysis. After completing the exchange and draining the dialysate, the nurse observes the dialysate is cloudy. How should the nurse evaluate this finding? a. A sign of possible bowel perforation b. A sign of vascular access occlusion c. The normal appearance of dialysate d. A sign of infection

d. A sign of infection

A client with acute kidney failure becomes confused and irritable. Which does the nurse determine is the most likely cause of this behavior? a. Hyperkalemia b. Hypernatremia c. A limited fluid intake d. An increased BUN level

d. An increased BUN level

An older adult client has a history of heart disease and dementia and takes several medications. His wife states that sometimes he forgets to take his medications, or he takes multiple doses of his medications, due to his dementia. An accidental overdose of which medication could result in metabolic acidosis? a. Losartan (an angiotensin II receptor blocker to reduce hypertension) b. Simvastatin (a statin to reduce blood cholesterol levels) c. Rivastigmine (a cholinesterase inhibitor to reduce symptoms of dementia) d. Aspirin (a salicylate to decrease risk of heart attack)

d. Aspirin (a salicylate to decrease risk of heart attack)

The patient is learning about skin care related to the external radiation that he is receiving. Which instructions should the nurse include in this teaching? a. Moisturize skin with lotion b. Keep the area covered if it is sore c. Dry the skin thoroughly after cleansing it d. Avoid extreme temperatures to the area

d. Avoid extreme temperatures to the area

The nurse teaches a patient with chronic kidney disease about the prevention of complications. What should the nurse include in the teaching plan? a. Monitor for proteinuria daily with a urine dipstick.​ b. Perform self-catheterization every four hours to measure urine. c. Take calcium-based phosphate binders on an empty stomach.​ d. Check weight daily and report a gain of greater than four pounds.​

d. Check weight daily and report a gain of greater than four pounds.​

A client's arterial blood gas report indicates the pH is 7.52, PCO2 is 32 mmHg, and HCO3 is 24 mEq/L. What does the nurse identify as a possible cause of these results? a. Airway obstruction b. Inadequate nutrition c. Prolonged gastric suction d. Excessive mechanical ventilation

d. Excessive mechanical ventilation

A patient has the following arterial blood gas (ABG) results: pH 7.48, PaO2 86 mm Hg, PaCO2 44 mm Hg, HCO3 29 mEq/L. When assessing the patient, the nurse would expect the patient to experience: a. Warm, flushed skin. b. Respiratory rate of 36. c. Blood pressure of 94/52. d. Hypertonic muscles with cramping.

d. Hypertonic muscles with cramping.

What defect in cellular proliferation is involved in the development of cancer? a. A rate of cell proliferation that is more rapid than that of normal body cells b. Shortened phases of cell life cycles with occasional skipping of G1 or S phases c. Rearrangement of stem cell RNA that causes abnormal cellular protein synthesis d. Indiscriminate and continuous proliferation of cells with loss of contact inhibition

d. Indiscriminate and continuous proliferation of cells with loss of contact inhibition

What type of renal failure would the nurse expect to see in a patient who overdosed accidentally on tobramycin? a. Prerenal failure b. Postrenal failure c. Extrarenal failure d. Intrarenal failure

d. Intrarenal failure

Gina, a patient with a creatinine clearance of 20 mL/min is admitted to the medical-surgical unit. The patient is in need of rapid diuresis. Which class of diuretic does the nurse anticipate administering? a. Potassium-sparing b. Thiazide c. Osmotic d. Loop

d. Loop

The nurse is assessing a patient who has been diagnosed with MRSA on the right arm. The nurse anticipates use of which medication to treat the MRSA? a. Bacitracin b. Neomycin c. Polymyxin B d. Mupirocin (Bactroban)

d. Mupirocin (Bactroban)

What classification of diuretic works in the entire renal tubule? a. Loop diuretics b. Thiazide diuretics c. Carbonic Anhydrase Inhibitors (CAIS) d. Osmotic diuretics

d. Osmotic diuretics

The nurse is reviewing the latest arterial blood gas results for a client with metabolic alkalosis. Which result indicates that the metabolic alkalosis is compensated? a. pH 7.32 b. PaCO2 18 mmHg c. HCO3 8 mEq/L d. PaCO2 48 mmHg

d. PaCO2 48 mmHg

A patient who is receiving high-dose chemotherapy with methotrexate is also receiving leucovorin. What is the purpose of the leucovorin? a. Produces an additive effect with the methotrexate by increasing its potency against the cancer cells. b. Reduces the incidence of cardiomyopathy caused by the methotrexate. c. Adds its anti-inflammatory effects to the treatment regimen. d. Reduces the BMS caused by the methotrexate.

d. Reduces the BMS caused by the methotrexate.

Which of the following systems does not maintain acid-base? a. Chemical buffers b. Lungs c. Kidneys d. Stomach

d. Stomach

An elderly patient is admitted to the hospital with cardiac complications associated with diabetes. What should be of concern to the nurse regarding this patient's medications? a. Whether the patient is taking the prescribed dosages b. Which vitamins and supplements the patient is taking c. The cost of the patient's medications d. The type and amount of medications in relation to the patient's renal function

d. The type and amount of medications in relation to the patient's renal function

Arterial blood gases results indicate a pH of 7.33 and a PaCO2 of 38 mmHg following arrest and subsequent resuscitation of a 3-year-old child. Which nursing intervention should be employed to attempt to correct this metabolic disorder? a. Administer sodium bicarbonate 1 mEq/kg IV. b. Assess the effectiveness of the respiratory pattern. c. Determine whether the endotracheal tube is positioned correctly. d. Treat the cause of the acidosis.

d. Treat the cause of the acidosis.

The nurse is assessing the skin of a patient with ESKD. Which clinical manifestation is considered a sign of very advanced disease? a. Ecchymoses b. jaundice c. Pallor d. Uremic frost

d. Uremic frost

Which assessment would indicate to the nurse that a patient has oliguria related to an intrarenal acute kidney injury? a. Urinary sodium levels are low.​ b. The serum creatinine level is normal.​ c. Oliguria is relieved after fluid replacement. ​ d. Urine testing shows a specific gravity of 1.010.​

d. Urine testing shows a specific gravity of 1.010.​

A patient is receiving leucovorin as part of his chemotherapy regimen. The nurse expects that the patient is receiving which antineoplastic drug? a. cladribine (Leustatin) b. fluorouracil (Adrucil) c. vincristine (Vincasar PFS) d. methotrexate (Trexall)

d. methotrexate (Trexall)

The nurse counsels the patient receiving radiation therapy or chemotherapy that: a. effective birth control methods should be used for the rest of the patient's life. b. after successful treatment, patients can expect a return to their previous level of function. c. the cycle of fatigue-depression-fatigue that may occur during treatment may be reduced by restricting activity. d. nausea and vomiting can usually be managed with antiemetic drugs, diet modification, and other interventions.

d. nausea and vomiting can usually be managed with antiemetic drugs, diet modification, and other interventions.

A characteristic of the stage of progression in cancer development is: a. oncogenic viral transformation of target cells. b. a reversible steady growth facilitated by carcinogens. c. a period of latency before clinical detection of cancer. d. proliferation of cancer cells despite host control mechanisms.

d. proliferation of cancer cells despite host control mechanisms.

The most effective method of administering a chemotherapy agent that is a vesicant is to: a. give it orally. b. give it intraarterially. c. use an Ommaya reservoir. d. use a central venous access device.

d. use a central venous access device.

Which of the following is not considered a risk factor of malignant melanoma? a. Red or blonde hair b. Fair skin that freckles c. Chronic sun exposure d. Light-colored eyes e. All of the answer choices are risk factors for malignant melanoma.

e. All of the answer choices are risk factors for malignant melanoma.

what is a problem of fluid distribution that results in accumulation of fluid within the interstitial spaces?

edema

what is the hormone responsible for RBC production?

erythropoietin

cancer staging: III

extensive local and regional spread

Which of the following is considered to be a cause of acute kidney injury (AKI)? a. Recent infection b. Certain medications c. Severe dehydration d. Exposure to heavy metals or toxic solvents e. Blood loss, shock f. All of the answer choices are considered to be causes of acute kidney injury

f. All of the answer choices are considered to be causes of acute kidney injury

what is polycystic kidney disease typically caused by?

genetics

what is the filtration of plasma per unit of time and is directly related to the perfusion pressure of the glomerular capillaries?

glomerular filtration rate (GFR)

what is it called when sodium levels are greater than 145?

hypernatremia

cancer staging: II

limited local spread

what is the buffering system that regulates retention or elimination of CO2 and therefore H2CO3 concentration?

lung ventilation

-pH = 7.20 -PaCO2 = 35 mmHg -PaO2 = 81 mmHg -HCO3 = 18 mEq/L what imbalance is this and why?

metabolic acidosis -pH < 7.35 -HCO3 < 22 mEq/L

-pH = 7.57 -PaCO2 = 45 mmHg -PaO2 = 87 mmHg -HCO3 = 38 mEq/L what imbalance is this and why?

metabolic alkalosis -pH > 7.45 -HCO3 > 28 mEq/L

cancer staging: IV

metastasis

when is the recommended time of day to take a diuretic?

morning

pH = 7.41 PaCO2 = 38 mmHg HCO3 = 24 mEq/L

normal values

pH = 7.62 PaCO2 = 27 mmHg HCO3 = 15 mEq/L

partially compensated -pH = alkalosis -PaCO2 = alkalosis -HCO3 = acidosis

what medication is used to treat discomfort from a UTI and also turns the urine orange?

phenazopyridine

what is the type of acute kidney injury that is caused by neurogenic bladder?

post-renal

what is the type of diuretic that may cause hyperkalemia?

potassium sparing diuretic

what are the blood vessels of the kidneys that arise at the fifth branches of the abdominal aorta, divide into anterior and posterior branches at the hilum, and then subdivide into lobar arteries supplying blood to the lower, middle, and upper thirds of the kidney?

renal arteries

what occurs with decreased alveolar ventilation, which in turn causes an increase in carbon dioxide concentration and increased carbonic acid concentration?

respiratory acidosis

pH = 7.25 PaCO2 = 59 mmHg HCO3 = 25 mEq/L

respiratory acidosis, uncompensated -pH = acidosis -PaCO2 = acidosis -HCO3 = normal

-pH = 7.50 -PaCO2 = 28 mmHg -PaO2 = 85 mmHg -HCO3 = 24 mEq/L what imbalance is this and why?

respiratory alkalosis -pH > 7.45 -PaCO2 < 35 mmHg -normal HCO3 reflects no compensation

-pH = 7.20 -PaCO2 = 58 mmHg -PaO2 = 59 mmHg -HCO3 = 24 mEq/L what imbalance is this and why?

uncompensated respiratory acidosis with hypoxemia -pH < 7.35 -PaCO2 > 45 mmHg -PaO2 < 80 mmHg -could occur with a respiratory infection causing an exacerbation in a patient with COPD

what is a common cause of urinary tract obstruction in adults?

urinary calculi (stones)