prepu questions test 4 211

The nurse is caring for a client with alcoholism who now presents for gastrointestinal bleeding. Which alteration is the nurse anticipate related to the bleedin?

An increase in ammonia level

Metastatic bone lesions are most closely associated with which types of primary tumors?

Breast cancer and prostate cancer

A nurse is assessing a patient with suspected substance abuse. Which of the following would be appropriate to use as an assessment tool?

CAGE MAST TWEAK CAGEAID

History of sickle cell anemia, predisposes the client to what renal or urologic disorder?

Chronic kidney disease

The client has been diagnosed with an acute leukemia. Which signs and symptoms with the practitioner expect to assess in this client?

Ecchymosis Epistaxis Fatigue Low-grade fever and weight loss

A nurse is caring for a client who is experiencing alcohol withdrawal. Which statement best indicates that the client understands the need for long-term treatment?

I will begin with inpatient treatment and participate in an aftercare program

When developing a care plan for a hospitalized adolescent with leukemia the nurse considers psychosocial needs. Which activity is best suited to help this adolescent, cope with a prolonged illness?

Keeping a journal or artistic scrapbook of experiences and thoughts

use of sunscreen is encouraging all children older than

Six months of age

The nurse is teaching the parents of a 15-year-old boy who is being treated for leukemia about the side effects of chemo. For which symptom should the parents seek medical care immediately?

Temperature of 101°F or greater

A client with chronic alcoholism has been found to have Wernicke encephalopathy. This irreversible complication is categorized by what?

Thiamine or vitamin B one deficiency

A client receiving chemotherapy for leukemia has poor nutritional intake. What is the first action the nurse should take?

ask if the client is experiencing nausea

Which treatment is used for basal cell carcinoma?

curettage with electrodesiccation

What is the most difficult risk factor for a child to overcome related to substance-abuse?

home environment where there is drug or alcohol abuse

Parents ask why their child is receiving prednisone to treat leukemia because it is not a chemotherapy drug. Which nursing instruction is the most accurate?

prednisone decreases, swelling caused by dead or dying cancer cells

A 16-year-old. Client requires chemotherapy for leukemia. The client's parents support the healthcare providers recommendation, but the client is refusing treatment. What is the nurses best initial action?

request that the healthcare provider thoroughly explain the benefits and consequences of treatment to the client After a discussion and understanding, if the client still refuses, then they can be instructed that the decision of their parents would be honored as they are under age

The nurse is assessing a client who is a poly substance abuse her with cocaine being one of the drugs most frequently used. Which physiological symptom is suggestive of early cocaine intoxication?

tremors Psycho motor agitation Cardiac arrhythmias Dilated pupils

The nurse is providing family education for the prevention or early recognition of vaso-occlusive events in sickle cell anemia. Which response by a family member indicates a need for further teaching?

" we should call the doctor for any fever over 100°" The nurse must emphasize that any febrile illness requires immediate attention

which chemical in the body is associated with the need to continue to abuse addictive substances?

Dopamine

A nurse is caring for a 29-year-old female client who was diagnosed with leukemia. The client is preparing for an allogenic bone marrow transplant. Which statement by the client demonstrates that she understands the informed consent she gave about the diagnosis and treatment?

I will only need chemotherapy treatment before receiving my bone marrow transplant

The nurse is educating a client with alcoholism that has been in rehab for two weeks to prepare for discharge. Which statement made by the client indicates that education was effective in a client is best prepared for discharge?

In order to give myself the best chance for sobriety, I will abstain from alcohol

A nurse is conducting a teaching session on complications of sickle cell anemia, with the parents of an adolescent who was admitted with the disease. Which complication would be of most concerned for the parents?

Leg ulcers this is due to diminished peripheral circulation to the legs

The nurse is caring for a teenager with sickle cell anemia when comparing new lab results with the clients baseline which results should the nurse prioritize requiring intervention?

Low pH on an arterial blood gas Elevated serum osmolality Elevated white blood cell count elevated Billy, Rubin and low hemoglobin are expected baseline findings in sickle cell anemia

A child with sickle cell disease is brought to the ED by his parents. He is in excruciating pain. A vaso-occlusive crisis is suspected and analgesia is prescribed. What would the nurse expect as least likely to be ordered?

Meperidine this is contra indicated for ongoing pain management in a child with a vaso-occlusive crisis, because it increases the risk for seizures

The presence of pallor ecchymosis and petechiae may indicate that cancer has invaded

The bone marrow, this leads to the interruption of normal production of red blood cells and platelets

A client has cancer of the neck and is receiving external beam radiation therapy to the site. The client is experiencing trauma to the irradiated skin. The nurse does all of the following

assesses the client for any sun exposure Avoids shaving the irradiated skin areas outside of the irradiated area are not damaged, lukewarm water should be used to be the area. Many over-the-counter ointment contain metal and can cause additional skin damage.

A four year old child with suspected leukemia is admitted to the hospital for diagnosis and treatment. What tests will the nurse teach the parents are used in diagnosing leukemia?

bone marrow aspiration and analysis Complete blood count Lumbar puncture

A client who has chronic alcoholism has developed Wernecke Korsakoff syndrome with an associated deficiency in thiamine. Which manifestation is most distinctive of this syndrome?

confabulation, which is the recitation of imaginary experiences to fill in gaps in memory

The nurse is assessing a client who uses alcohol daily. On which reasons with the nurse focus the assessment when the client denies a family history of alcohol use?

cope with life Relieve stress and tension Increase feelings of power Decrease psychological pain

A nurse is admitting a pregnant woman with sickle cell anemia to the emergency department. Which findings would lead the nurse to suspect that the client is in crisis?

fever Joint pain Fatigue pallor might be present but is not indicative of a crisis

what cancer is gene therapy currently being investigated in the treatment of?

melanoma

The nurse is developing a discharge plan with a client who is receiving chemo to treat lymphoma. What should the nurse include in the plan?

wear a mask when in crowded enclosed areas Rest as needed Avoid people with cold or flu Contact the healthcare provider, if a fever develops

How can the nurse best detect early signs and symptoms of thrombocytopenia?

Monitor daily platelet counts

When conditions occur that impair retinal blood flow, such as hyperviscosity of the blood or a sickle cell crisis, what can occur in the eye?

Neovascularization

The nurse assesses a client presenting with Pilo erection, pupillary, dilation and lacrimation the client reports nausea and vomiting 24 hours after admission the nurse suspects that the client is going through withdrawal from which substance?

Opioids

An adolescent client is brat for emergency care after being found stuporous from sniffing glue. Which treatment will the nurse anticipate for the client?

Oxygen therapy

The nurse has been trying to help a client wean off strong pain medication but the client keeps complaining that the new drug is not working. The nurse would suspect that this client is exhibiting which type of behavior?

Physical dependence

A client with Hodgkin lymphoma is exhibiting some central nervous system involvement. Which treatment measures will the healthcare provider likely prescribe?

Radiation and chemotherapy

Which factors in a clients history may indicate an increased risk for substance abuse?

Schizophrenia Major depression

A client admitted to the psychiatric unit for treatment of substance abuse. Tells the nurse at Health so wonderful to get high. What is an appropriate response?

You told me you got fired from your last job for missing too many days after taking drugs all night

Which option is an example of a primary preventative measure?

avoiding overexposure to the sun Primary preventive measures are designed to prevent or delay. The onset of specific illnesses, secondary preventive measures, promote early detection, and treatment of a disease.

The nurse is caring for a child with leukemia. The parent states a variety of symptoms. Which symptoms does the nurse identify as directly related to the child's cancer?

bruising Anorexia Sore throat Lymphadenopathy Platelets and hemoglobin would be decreased, not increased

When caring for a client diagnosed with cancer, the nurse should perform which assessments for safe administration of ondansetron?

determine if the client takes any antidepressants or antipsychotic drugs for possible interactions Assess if the client has any nausea or vomiting, and if so, the number of episodes and amount of vomitus Obtain baseline, vital signs and renal profile with electrolytes at baseline to compare with later labs

A patient with sickle cell anemia is to begin treatment for the disease with hydroxyurea. What does the nurse inform the patient will be the benefits of treatment with this medication?

fewer painful episodes of sickle cell crisis Lower incidence of acute chest syndrome Decreased need for blood transfusions

when caring for a client with alcoholism and cirrhosis, the nurse recognizes which potential complications of the disease?

liver failure Bleeding esophageal, varices Kidney failure

A nurse is talking with the parents of a child who is to begin radiation treatment for cancer. The parents ask what kind of a effects They might see soon after the child begins treatment. Which effects would the nurse include when instructing the parents?

loss of appetite Nausea Vomiting Skin redness/tenderness Extreme fatigue Long term affects may include shortening of the spine and sleepiness

What nursing interventions should the nurse expect to implement when caring for a child in a cute sickle cell crisis

maintaining adequate hydration Providing adequate pain control Frequently monitoring vital signs

A client who must use long-term immuno suppressant agents is at risk for what complications?

malignancies, especially lymphoma Hypertension Metabolic bone disease Renal and hepatic dysfunction

A client admitted to the alcohol detoxification program. Ask the nurse if there is a medication to stop me from wanting a drink so badly. The nurse should teach the client about which Drug?

naltrexone This is a drug that can decrease alcoholic cravings

The nurse is caring for a client who has sickle cell disease. The client is reporting pain in the back chest and extremities. The nurse anticipates that the client may present with what other clinical manifestations?

nausea Hypertension Tachypnea Swelling

The nurse is assessing a newly diagnosed patient with Hodgkin's lymphoma. Where should the nurse anticipate finding enlarged lymph nodes?

neck Axilla Supraclavicular area Lymph nodes above the level of the diaphragm, or where the initial lymph node involvement typically starts

The nurse is caring for a patient with Hodgkin's lymphoma in the hospital and is preparing discharge. Planning education. Knowing that this patient is at risk for the development of a second malignancy, what education would be beneficial to reduce the risk factors?

smoking cessation Decrease of alcohol intake Reduction of exposure to excessive sunlight decrease exposure to environmental carcinogens

A child is brought into the clinic for evaluation. The nurse suspects that the child has leukemia based on which assessment findings?

splenomegaly Lymphadenopathy Elevated leukocyte count Features of leukemia include fatigue, weakness, Paul, or fever, bruising, bleeding, weight, loss, swollen, gums, sore throat, recurrent infections, flu, like symptoms, abdominal pain, nausea, vomiting, bone pain, lymphedema, Pathy, splenomegaly, hepatosplenomegaly, elevated, leukocyte, count, decreased, hemoglobin, and decreased platelet, count

The nurse practitioner determines that the client receiving chemo has mild neutropenia. Which signs and symptoms with the practitioner expect to see in this client?

stomatitis diarrhea The early signs of infection due to neutropenia particularly those associated with a mild to moderate decrease in neutrophils include mild skin, lesions, stomatitis, pharyngitis, and diarrhea

Nurse is caring for a pregnant client with sickle cell anemia. What should a nursing care for the client include?

teach the client meticulous handwashing Assess hydration status of the client at each visit Urge the client to drink 8 to 10 glasses of fluid daily The nurse does not need to assess serum electrolyte levels of the client at each visit, or instruct them to consume protein, rich food

A female client is prescribed methotrexate for leukemia. What health education should the nurse prioritize?

using reliable forms of barrier contraception Antimetabolites are contraindicated for use during pregnancy and lactation, because of the potential for severe adverse effects on the fetus and the neonate. Oral contraceptives don't need to be stopped, but a barrier method should also be used.