RNSG 1517: Protection and Regulation Semester 1 Quiz

A client undergoing chemotherapy for cancer gave birth to a newborn with limb malformations. Which medication may have caused the limb malformations in this neonate? 1.Methotrexate 2.Nitrofurantoin 3.Carbamazepine 4.Dexamethasone

1.Methotrexate

An adolescent has been admitted with a history of symptoms of fatigue, intermittent fever, weight loss, and arthralgia, and the diagnosis is systemic lupus erythematosus. What is the best intervention at this time? 1.Implementation of corticosteroids 2.Education about diet, rest, and exercise 3.Sun avoidance and calcium supplements 4.Avoidance of destructive coping mechanisms

2.Education about diet, rest, and exercise

A client suspected to have a prostate disorder is encouraged to have a rectal examination. What position of the client will facilitate a rectal examination by the registered nurse (RN)? 1.Sims position 2.Prone position 3.Dorsal recumbent position 4.Lateral recumbent position

1.Sims position In Sims position, hips and knees are flexed, which results in exposure of the rectal area.

A 6-year-old child who just completed a cycle of chemotherapy is to be discharged home. What is the priority teaching point at discharge? 1.Purchasing a wig 2.Ensuring adequate rest 3.Offering sufficient fluids 4.Performing thorough hand washing

4.Performing thorough hand washing

A client with a history of rheumatic fever and a heart murmur reports gaining weight in spite of nausea and anorexia. The client also reports shortness of breath several times each day and when performing minor tasks. Which additional information should the nurse obtain? 1.Retrospective 24-hour calorie count 2.Elimination pattern during the last 30 days 3.Complete gynecological and sexual history 4.Presence of a cough and pulmonary secretions

4.Presence of a cough and pulmonary secretions The presence of a cough and pulmonary secretions, in addition to a history of rheumatic fever, requires an assessment for other cardiopulmonary problems and fluid overload.

A client underwent a mastectomy 24 hours ago. Which information is most important for the nurse to include in the plan of care? 1.The drainage container will be kept level with the affected arm. 2.The affected arm will be abducted at the shoulder with the elbow extended. 3.The hand and elbow of the affected arm will be elevated above the shoulder. 4.The elbow and shoulder of the affected arm will be elevated, with the hand resting on the abdomen

3.The hand and elbow of the affected arm will be elevated above the shoulder. Elevation of the hand and elbow supports venous return by gravity and promotes mobility of the arm.

A nurse is caring for a client who is scheduled to have an abdominal perineal resection for colorectal cancer. The client has type B negative blood. If a blood infusion is needed, which type is preferred for administration? 1.A positive 2.B negative 3.O negative 4.AB positive

3. B negative B negative is the same as the client's blood type and is preferred; only in an emergency will type O negative blood be given.

A client with rheumatoid arthritis is to begin taking ibuprofen 800 mg by mouth three times a day. The nurse provides education about the medication's side effects. The nurse concludes that the teaching was effective when the client makes which statement? 1."I need to have my blood work checked periodically." 2."I need to balance exercise with rest." 3."I need to change positions slowly." 4."I need to take the medication between meals."

1."I need to have my blood work checked periodically." If the client will be taking the medication long term, periodic diagnostic tests are necessary because ibuprofen is nephrotoxic, is hepatotoxic, and prolongs the bleeding time.

A nurse is teaching the parents of a 5-year-old girl who is to continue chemotherapy at home. What statement indicates that the parents understand the discharge instructions? 1."We'll let her eat at her own pace." 2."We'll plan structured play activities each day." 3."We'll encourage her to rinse her mouth with mouthwash." 4."We'll keep her from coming into contact with children her age."

1."We'll let her eat at her own pace."

A nurse is providing counseling to a client with the diagnosis of systemic lupus erythematosus (SLE). Which recommendations are essential for the nurse to include? Select all that apply. 1."Wear a large-brimmed hat." 2."Take your temperature daily." 3."Balance periods of rest and activity." 4."Use a strong soap when washing the skin." 5."Expose the skin to the sun as often as possible.

1."Wear a large-brimmed hat." 2."Take your temperature daily." 3."Balance periods of rest and activity."

A client with metastatic breast cancer is started on a multiple drug regimen that includes docetaxel. The nurse assesses the client for which nontherapeutic effects of docetaxel? Select all that apply. 1.Alopecia 2.Constipation 3.Febrile neutropenia 4.Increased blood pressure 5.Hypersensitivity reaction

1.Alopecia 3.Febrile neutropenia 5.Hypersensitivity reaction

A nurse is teaching a group of adults about the signs and symptoms of colorectal cancer. Which common clinical manifestations should the nurse include in the teaching program? Select all that apply. 1.Anemia 2.Rectal pain 3.Rectal bleeding 4.Change in bowel habits 5.Severe abdominal distention

1.Anemia 3.Rectal bleeding 4.Change in bowel habits

Which medication should the nurse anticipate the healthcare provider will prescribe to relieve the pain experienced by a client with rheumatoid arthritis? 1.Aspirin 2.Hydromorphone 3.Meperidine 4.Alprazolam

1.Aspirin Because of its antiinflammatory effect, acetylsalicylic acid is useful in treating arthritis symptoms

A nurse is interviewing a client who was diagnosed with systemic lupus erythematosus (SLE). Which common responses to this disease can the nurse expect the client to exhibit? Select all that apply. 1.Butterfly facial rash 2.Firm skin fixed to tissue 3.Inflammation of the joints 4.Muscle mass degeneration 5.Inflammation of small arteries

1.Butterfly facial rash 3.Inflammation of the joints

A client is scheduled to begin chemotherapy 2 weeks after surgery for colon cancer. What explanation does the nurse give to explain the delay following surgery? 1.Chemotherapy interferes with cell growth and delays wound haling. 2.Because chemotherapy causes vomiting, it endangers the integrity of the incisional area. 3.Chemotherapy decreases red blood cell production, and the resultant anemia will add to postoperative fatigue. 4.Chemotherapy increases edema in areas distal to the incision by blocking lymph channels with destroyed lymphocytes

1.Chemotherapy interferes with cell growth and delays wound healing.

A client with rheumatoid arthritis has refused prescribed cortisone. Later, the nurse gives an evasive answer to the client's questions while administering the cortisone. The client takes the medication and later discovers that it was cortisone. The client intends to sue. Which elements must be considered in a legal action? Select all that apply. 1.Clients have a right to refuse treatment. 2.Nurses are required to answer clients truthfully. 3.The healthcare provider should have been notified. 4.The client had insufficient knowledge to make such a decision. 5.Legally prescribed medications are administered despite a client's objections

1.Clients have a right to refuse treatment. 2.Nurses are required to answer clients truthfully. 3.The healthcare provider should have been notified.

The nurse is caring for different clients in a healthcare setting who are diagnosed with respiratory disorders. Which client may have the anteroposterior chest diameter equal to the lateral chest and the slope of the ribs more horizontal to the spine? 1.Cystic Fibrosis 2.Bronchiectasis 3.Metabolic Acidosis 4.Pulmonary edema

1.Cystic Fibrosis Client 1 with cystic fibrosis may have increased anteroposterior diameter; that is, the anteroposterior chest diameter is equal to the lateral chest measurement and the slope of the ribs are more horizontal to the spine.

An elderly client undergoing cancer therapy reports diffused redness and large blisters on the skin with evident systemic toxicity. What should be the priority intervention in this client? 1.Discontinue the drug 2.Monitor body temperature 3.Monitor fluid and electrolyte balance 4.Administer topical antibacterial medication

1.Discontinue the drug

A client with rheumatoid arthritis arrives in the clinic stating, "I don't take any medications because they are too expensive." The client reports that family members are arranging for the medications to be obtained from another country. What is the nurse's best response? 1.Discuss alternative solutions with the client. 2.Encourage the client to use any method possible to obtain the medications. 3.Contact the primary healthcare provider immediately to discuss the client's plan. 4.Explain that medical regimens must be followed to continue to receive care in the clinic

1.Discuss alternative solutions with the client. The nurse should discuss alternatives in terms of funding, such as Medicaid, research projects, and special aid. Standards outside the United States may be different, and purchasing medications in another country should not be encouraged.

A client who has cervical cancer is hospitalized for internal radiation therapy. What is the nursing intervention after the radiation source is loaded? 1.Ensuring that the client's diet is low residue 2.Placing the client in the high-Fowler position 3.Checking the client's voiding and catheterizing if necessary 4.Staying with the client for half an hour and assessing her for signs of radiation sickness

1.Ensuring that the client's diet is low residue Clients with internal radiation for cervical cancer are given a low-residue diet and often medications to suppress peristalsis and prevent pressure from bowel movements.

A nurse is assessing a child with leukemia who is undergoing chemotherapy. Which side effect does the nurse anticipate? 1.Epistaxis 2.Tachycardia 3.Flushed skin 4.Increased temperature

1.Epistaxis Nosebleeds (epistaxis) are expected in a child with leukemia who is undergoing chemotherapy because the bone marrow is depressed and the number of platelets decreases substantially.

A client is admitted to the hospital for surgery for rectosigmoid colon cancer, and the nurse is obtaining a health history as part of the admission process. What clinical findings associated with rectosigmoid colon cancer does the nurse expect the client to report? Select all that apply. 1.Feeling tired 2.Rectal bleeding 3.Inability to digest fat 4.Change in the shape of stools 5.Feeling of abdominal bloating

1.Feeling tired 2.Rectal bleeding 4.Change in the shape of stools 5.Feeling of abdominal bloating

Which cytokine medication is administered to treat chemotherapy-induced neutropenia? 1.Filgrastim 2.Oprelvekin 3.Aldesleukin 4.Darbepoetin alfa

1.Filgrastim

After 2 weeks of radiation therapy for cancer of the breast a client experiences some erythema over the area being irradiated. The area is sensitive but not painful. The client states that she has been using tepid water and a soft washcloth when cleansing the area and applying an ice pack three times a day. What does the nurse conclude from this information? 1.Further teaching on skin care is necessary. 2.No other intervention is needed at this time. 3.The radiation team should be notified of this problem. 4.Health teaching on the side effects of radiation is needed.

1.Further teaching on skin care is necessary. Further teaching is needed because extremes of temperature should be avoided; ice constricts blood vessels, interfering with circulation.

A client suffering from cancer is at the last stage of life. Which actions should be performed by the nurse to support the client's family members? Select all that apply. 1.Helping the family to set up home care 2.Taking time to make sure that the family is comfortable 3.Staying with the client in the absence of family members 4.Giving the family about the information of dying process 5.Making sure that the family knows about what to do at the time of death

1.Helping the family to set up home care 4.Giving the family about the information of dying process 5.Making sure that the family knows about what to do at the time of death

A client with a history of hemoptysis and cough for the last six months is suspected of having lung cancer. A bronchoscopy is performed. Two hours after the procedure the nurse identifies an increase in the amount of bloody sputum. What is the nurse's priority? 1.Immediately contact the primary healthcare provider 2.Document the amount of sputum 3.Monitor vital signs every hour 4.Increase the frequency of coughing and deep breathing

1.Immediately contact the primary healthcare provider The observation may be indicative of bleeding, and the healthcare provider should be notified.

The nurse is providing education to a client with systemic lupus erythematosus. Which education will the nurse consider as high priority? 1.Instructing about ways to protect the skin 2.Helping the client to identify coping strategies 3.Teaching methods to monitor body temperature 4.Teaching about the effects of the disease on lifestyle

1.Instructing about ways to protect the skin

Arrange the steps required to stimulate antibody-mediated immunity in its correct sequence. 1.Invasion of new antigens in the body 2.Neutralization or elimination of the antigen 3.Production of antibodies by B-lymphocytes 4.Sensitization of B-lymphocyte to the new antigen 5.Interaction of the macrophage and helper T-cells to recognize the antigen 6.Binding of antibodies to the antigen and formation of immune complex

1.Invasion of new antigens in the body 2.Interaction of the macrophage and helper T-cells to recognize the antigen 3.Sensitization of B-lymphocyte to the new antigen 4.Production of antibodies by B-lymphocytes 5.Binding of antibodies to the antigen and formation of immune complex 6.Neutralization or elimination of the antigen

What clinical manifestations does a nurse expect a client with systemic lupus erythematosus (SLE) most likely to exhibit? Select all that apply. 1.Joint pain 2.Facial rash 3.Pericarditis 4.Weight gain 5.Hypotension

1.Joint pain 2.Facial rash 3.Pericarditis

In the postanesthesia care unit a client received intrathecal morphine intraoperatively to control pain. Considering the administration of this medication, what should the nurse include as part of the client's initial 24-hour postoperative care? 1.Monitoring of respiratory rate hourly 2.Assessing the client for tachycardia 3.Administering naloxone every 3 to 4 hours 4.Observing the client for signs of central nervous system (CNS) excitement

1.Monitoring of respiratory rate hourly Intrathecal morphine can depress respiratory function depending on the level it reaches within the spinal column; hourly assessments during the first 12 to 24 hours will allow for early intervention with an antidote if respiratory depression needs to be corrected.

The public health nurse presents a program on breast self-examination. After a return demonstration, the nurse concludes that she needs to review certain aspects of the teaching program. Which behavior by one of the students supports this conclusion? 1.Palpating each breast while in the sitting position 2.Checking her breasts for any deviation from what is expected 3.Palpating each breast with the palmar surface of her extended fingers 4.Checking her breasts for symmetry while holding her arms above her head

1.Palpating each breast while in the sitting position Breast palpation should be performed in the supine position with a small rolled towel under the shoulder of the palpated side; it may also be done standing in the shower, but the sitting position is not recommended.

A 7-year-old child was recently found to have juvenile idiopathic arthritis. The parents are concerned about the lifelong effects of the disorder and are investigating other therapies to use with the medications. What referral should the nurse recommend? 1.Physical therapy 2.Special education 3.Nutritional therapy 4.Herbal supplement

1.Physical therapy A physical therapist can prescribe an exercise protocol to keep the joints as mobile as possible; a routine can be developed to help the child alleviate morning stiffness.

A nurse is caring for a client who is scheduled for a modified radical mastectomy. What should the nurse tell the client to expect in the immediate postoperative period? 1.Portable wound drainage system 2.Sling to support the affected arm 3.High-carbohydrate diet to promote healing 4.Large pressure dressing over the incision site

1.Portable wound drainage system

During chemotherapy, altered nutrition is a common side effect. Knowing that compromised nutrition can contribute to an increased risk of infection and other problems, what can the nurse do to offset nutritional deficiencies? 1.Provide oral supplements. 2.Offer the client's favorite foods. 3.Restrict intake from dairy products. 4.Encourage the client to drink low-protein shakes

1.Provide oral supplements.

Which are examples of actively acquired specific immunity? Select all that apply. 1.Recovery from measles 2Recovery from chickenpox 3.Maternal immunoglobulin in the neonate 4.Immunization with live or killed vaccines 5.Injection of human gamma immunoglobulin

1.Recovery from measles 2Recovery from chickenpox 4.Immunization with live or killed vaccines Naturally acquired active-type immunity is seen in a client who has recovered from measles or chickenpox or who has been immunized with a live- or killed-virus vaccine. Maternal immunoglobulin in a neonate and an injection of human gamma immunoglobulin into a client are examples of passively acquired specific immunity.

A nurse is teaching the parents of a child with juvenile idiopathic arthritis how to prevent loss of joint function. Which activities should be encouraged? Select all that apply. 1.Riding a bicycle 2.Walking to school 3.Watching videos after school 4.Swimming in the community pool 5.Playing computer games after school

1.Riding a bicycle 2.Walking to school 4.Swimming in the community pool

A foreign language-speaking client needs to undergo chemotherapy; a signed consent form is required. What should the nurse do to explain the terms of the consent to the client? 1.Seek the help of an official interpreter. 2.Seek the help of the primary healthcare provider to assist the client. 3.Seek help from the client's family friend who speaks the client's language. 4.Seek help from the client's caregiver who speaks the same language as the client

1.Seek the help of an official interpreter.

During post-operative care, the nurse finds that a client has hypotension. Which priority intervention does the nurse expects to begin? 1.Starting O2 therapy 2.Inspecting the surgical incision 3.Administration of IV fluid boluses 4.Administration of vasoconstrictive agents

1.Starting O2 therapy Treatment of hypotension in postoperative clients should always begin with oxygen therapy to promote oxygenation of hypoperfused organs.

The parents of a 12-year-old child with juvenile idiopathic arthritis ask a nurse why their child is not receiving steroid therapy when it is so effective for adults with rheumatoid arthritis. Which reason that steroids are avoided at this time takes priority in the nurse's explanation? 1.Steroids could affect growth. 2.Body image is adversely affected. 3.Steroids could lead to flat emotions. 4.Steroids have adverse effects on sexuality

1.Steroids could affect growth.

A client is admitted with full-blown anaphylactic shock that developed due to a type 1 latex allergic reaction. Which findings will the nurse observe upon assessment? Select all that apply. 1.Stridor 2.Fissuring 3.Hypotension 4.Dyspnea 5.Cracking of the skin

1.Stridor 3.Hypotension 4.Dyspnea Full-blown anaphylactic shock produces stridor, hypotension, and dyspnea. Fissuring and cracking of the skin occurs in individuals with a type IV contact dermatitis.

What is the priority nursing care for a client who is prescribed hydroxychloroquine (Plaquenil) 1.Teaching the client to report blurred vision 2.Teaching the client to report signs of infection 3.Teaching the client to report shortness of breath 4.Teaching the client to report stomach discomfort

1.Teaching the client to report blurred vision

A nurse is helping a 7-year-old child with juvenile idiopathic arthritis (JIA) perform range-of-motion exercises. What outcome indicates that the exercises have been effective? 1.The knees are more mobile. 2.The pedal pulses become stronger. 3.Subcutaneous nodules at the joints recede. 4.The child states that the pain is diminished

1.The knees are more mobile.

The nurse is caring for an older client during the intraoperative stage. The anesthesia process has already begun and the nurse has already removed the dentures, eyeglasses, and hearing aids. After the nurse performs these actions, what would be the order the intraoperative nursing interventions should take place? 1.The nurse should cover the client's head and feet. 2.The client is lifted into position to prevent shearing forces. 3.The nurse should use a small pillow under the client's head. 4.The nurse should follow aseptic technique. 5.The nurse should pad bony prominences to prevent pressure sores. 6.The nurse should use warming device to prevent hypothermia. 7.The nurse should carefully monitor the input and output of fluids including blood. 8.The nurse should position arthritic and artificial joints carefully to prevent postoperative pain. 9.The nurse should warm intravenous and irrigation fluids as indicated by agency policy and manufacturer's recommendations.

1.The nurse should use a small pillow under the client's head. 2.The client is lifted into position to prevent shearing forces. 3.The nurse should position arthritic and artificial joints carefully to prevent postoperative pain. 4.The nurse should pad bony prominences to prevent pressure sores. 5.The nurse should use warming device to prevent hypothermia. 6.The nurse should cover the client's head and feet. 7.The nurse should warm intravenous and irrigation fluids as indicated by agency policy and manufacturer's recommendations. 8.The nurse should follow aseptic technique. 9.The nurse should carefully monitor the input and output of fluids including blood

A nurse checking the perineum of a client with a radium implant for cervical cancer observes the packing protruding from the vagina. The nurse notifies the primary healthcare provider to have the packing removed. What is the primary reason that the packing needs to be removed immediately? 1.The radioactive packing will injure healthy tissue. 2.Removal of the packing will prevent excessive blood loss. 3.The exposure of radium to the environment will diminish its effectiveness. 4.Removal of the packing will minimize life-threatening contact with the radiation

1.The radioactive packing will injure healthy tissue. Packing maintains a radium implant in its correct placement; correct placement minimizes the effect on healthy tissue.

A client with colon cancer is receiving hospice care at home. What is the focus of hospice care? 1.To ease the pain from illness 2.To provide curative treatment 3.To assist with activities of daily living 4.To adapt to the limitations due to illness

1.To ease the pain from illness

After undergoing minor surgery, a postoperative child has recovered from anesthesia. Which observations may indicate that the child is fit to be discharged? Select all that apply. 1.Vital signs are stable. 2.Temperature is 101° F. 3.The child is alert and oriented. 4.Pain rate is at baseline level. 5.Oxygen saturation is 75% on room air.

1.Vital signs are stable. 3.The child is alert and oriented. 4.Pain rate is at baseline level.

The nurse in the pediatric clinic is reviewing the health history of a 10-year-old girl with a diagnosis of juvenile idiopathic arthritis (JIA). Currently the child is experiencing recurrent pain and swelling of the joints, particularly her knees and ankles. What organ is commonly affected in children with this disorder? 1.Ears 2.Eyes 3.Liver 4.Brain

2. Eyes Juvenile idiopathic arthritis can cause inflammation of the iris and ciliary body of the eyes, which may lead to blindness.

A client with rheumatoid arthritis takes aspirin routinely to reduce pain. The client asks whether it is the arthritis, the aspirin, or some other ear problem that causes the bilateral ear buzzing the client is now experiencing. What is an appropriate nursing response? 1."The ringing in your ears is a sign of an ear infection." 2."Aspirin may have caused some nerve damage in your ear." 3."Accumulation of ear wax causes ringing in the ears." 4."Your symptoms are an expected response to the aging process."

2."Aspirin may have caused some nerve damage in your ear."

While caring for a female client, the nursing student feels tenderness and a lump in the client's breast. The nursing student tells the registered nurse, "I think this client has breast cancer." Which statements of the registered nurse would be appropriate in accordance with the knowing element of Swanson's theory? Select all that apply. 1."Try to comfort the client." 2."Avoid making assumptions." 3."Assess the client thoroughly." 4."Check for other signs of breast cancer." 5."Try to provide support and care to the client."

2."Avoid making assumptions." 3."Assess the client thoroughly." 4."Check for other signs of breast cancer."

The nurse is teaching a nursing student about the care given to a client before a prostate specific antigen (PSA) test. Which statement made by the nursing student indicates a need for further teaching? 1."Clients should not take saw palmetto for 2 weeks before the test." 2."I will ask the client to have nothing by mouth (NPO) before the test." 3."I need to assess the venipuncture site for hematoma and bleeding." 4."PSA is produced by cancerous and noncancerous prostate tissue."

2."I will ask the client to have nothing by mouth (NPO) before the test." It is not necessary to ask the client to have nothing by mouth (NPO) before a prostate specific antigen (PSA) test, so this would require further teaching. PSA is a protein that is produced by both cancerous and noncancerous prostate tissue. Saw palmetto is an herb used for sexual potency that can produce a false negative PSA result, so the nurse should instruct the client to discontinue taking it for 1 to 2 weeks before PSA testing. The PSA test is a blood test requiring venipuncture, so the nurse should observe the puncture site for bleeding and hematoma.

A 5-year-old girl is undergoing a course of chemotherapy. One day the nurse sees the child crying. The child tells the nurse, "All my hair is gone, and everyone stares at me." What is the best response by the nurse? 1."Let's take the hair off your doll so you two will look alike." 2."Let's ask your mother to bring in a hat for you to wear until your hair grows back." 3."You just think that everyone is staring at you because you feel funny without your hair." 4."You shouldn't have to look at yourself without hair, so I'm going to take this mirror out of your room.

2."Let's ask your mother to bring in a hat for you to wear until your hair grows back."

The nurse is performing a breast assessment. Which statement made by the client indicates the risk of breast cancer? Select all that apply. 1."I had a late onset of menarche." 2."My first child was born when I was 32." 3."I noticed a slight discharge from a nipple." 4."I perform breast self-examinations frequently." 5."I consume two to four glasses of alcohol a day."

2."My first child was born when I was 32." 3."I noticed a slight discharge from a nipple." 5."I consume two to four glasses of alcohol a day. Clients who gave birth to a first child after the age of 30 are at a risk of breast cancer.

A client is admitted for a biopsy of a tumor in her left breast. The client states, "I know it can't be cancer, because it doesn't hurt." What is the nurse's most therapeutic response? 1."Let's hope that it isn't malignant." 2."What do you know about breast cancer?" 3.Most lumps in the breast are not malignant." 4."Has your primary healthcare provider told you that it wasn't cancer?

2."What do you know about breast cancer?"

A 49-year-old client is admitted with a diagnosis of cervical cancer. As the nurse is obtaining her health history, she says, "I haven't had a Pap smear for more than 5 years. I probably wouldn't be in the hospital today if I'd had those tests more often." What is the nurse's most appropriate response? 1."Please tell me why you waited so long." 2."You feel as though you've neglected your health." 3."It's never too late to start taking care of yourself." 4."Most women hate to have Pap smears done, but they're really important."

2."You feel as though you've neglected your health."

What would be the first step in advanced prehospital emergency care for a client stung by a bee? The client has a history of allergic reactions to bee stings. 1.Administering oxygen 2.Administering epinephrine 3.Administering oral liquid diphenhydramine 4.Monitoring for the development of toxic venom effects

2.Administering epinephrine

A client is admitted to the emergency department with joint pain and swelling. Upon assessment the nurse suspects rheumatoid arthritis. Which findings support the nurse's conclusion? Select all that apply. 1.Obesity 2.Antinuclear antibodies 3.Inflammatory disease pattern 4.Disease in the bilateral symmetric joints 5.Disease in the distal intrapharyngeal joints 6.Disease in the weight-bearing joints and hands

2.Antinuclear antibodies 3.Inflammatory disease pattern 4.Disease in the bilateral symmetric joints

Which type of immunity will clients acquire through immunizations with live or killed vaccines? 1.Natural active immunity 2.Artificial active immunity 3.Natural passive immunity 4.Artificial passive immunity

2.Artificial active immunity Artificial active immunity is acquired through immunization with live or killed vaccines. Natural active immunity is acquired when there is natural contact with antigens through a clinical infection. Natural passive immunity is acquired through the transfer of colostrums from mother to child. Artificial passive immunity is acquired by injecting serum from an immune human.

The healthcare team is caring for a client who has undergone surgery for lung cancer. The client needs respiratory therapy. Which task can be safely delegated to a respiratory therapist paired with a registered nurse? 1.Placing a Foley catheter 2.Assessing the respirations 3.Placing an intravenous (IV) catheter 4.Administering patient-controlled analgesia

2.Assessing the respirations

An older widow with lung cancer is now in the terminal stage of her illness. Her family is puzzled by her mood changes and apparent anger at them. The nurse explains to the family that the client is doing what? 1.Trying to avoid her situation 2.Coping with her impending death 3.Attempting to reduce family dependence on her 4.Hurting because the family will not take her home to die

2.Coping with her impending death

A client who recently was told by her primary healthcare provider that she has extensive terminal metastatic carcinoma of the breast tells the nurse that she believes an error has been made. She states that she does not have breast cancer, and she is not going to die. The nurse determines that the client is experiencing which stage of death and dying? 1.Anger 2.Denial 3.Bargaining 4.Acceptance

2.Denial

A nurse is caring for a client during the early postoperative period after a prostatectomy. Which action is the priority? 1.Have the client stand to void. 2.Discourage straining for a bowel movement. 3.Use a bulb syringe to aspirate urine from the retention catheter. 4.Notify the primary healthcare provider if the client does not void by bedtime

2.Discourage straining for a bowel movement.

A primary healthcare provider decides to omit a treatment that was part of a course of chemotherapy for a client because the client demonstrates myelosuppression. What information would be appropriate for the nurse to give to the client regarding myelosuppression? 1.Calcium carbonate and vitamin D must be increased in the diet because of the effects of myelosuppression. 2.Eating a balanced diet, resting, and trying to prevent bleeding and infections are appropriate at this time. 3.The development of myelosuppression explains why the client has nausea, vomiting, anorexia, and alopecia. 4.Frequent testing for restlessness, muscle control, and pupillary response is necessary because the meninges may be irritable

2.Eating a balanced diet, resting, and trying to prevent bleeding and infections are appropriate at this time.

What information from a client's history should the nurse identify as risk factors for the development of colon cancer? Select all that apply. 1.Hemorrhoids 2.Increased age 3.High-fiber diet 4.Ulcerative colitis 5.Low hemoglobin level

2.Increased age 4.Ulcerative colitis

Which drugs are used for the treatment of clients with rheumatoid arthritis that inhibit tumor necrosis factor-A? Select all that apply. 1.Anakinra 2.Infliximab 3.Abatacept 4.Etanercept 5.Golimumab

2.Infliximab 4.Etanercept 5.Golimumab

A hospital organization plans to conduct a study on the effect of dried plums for lowering the risk of colon cancer. After selecting the subjects, a nurse researcher provides adequate information about the research and then inquires about the preference of the subjects to associate with the research. What does this procedure indicate? 1.Anonymity 2.Informed consent 3.Inductive reasoning 4.Performance improvement

2.Informed consent

A client with cervical cancer is to undergo a course of internal radiation. The client returns to her lead-lined room on the oncology unit with an indwelling urinary catheter and a vaginal applicator in place. Once the primary healthcare provider has loaded the applicator with the radiation source, what should the nurse's plan of care include? 1.Changing linens several times a day 2.Leaving the urinary catheter undisturbed 3.Cleansing the perineal area with a mild antiseptic twice daily 4.Removing equipment from the room immediately after it is used

2.Leaving the urinary catheter undisturbed Preventing the occurrence of complications is a major goal during internal radiation treatment. If the source of radiation is disturbed, injury to the client, as well as the personnel caring for her, may result.

A client was treated with methotrexate for cancer during the 6th month of her pregnancy. Which teratogenic effect may be seen in the child? 1.Stillbirth 2.Mental retardation 3.Holoprosencephaly 4.Normal development of the child

2.Mental retardation

A postmenopausal woman who has cancer of the breast decides to have a lumpectomy followed by chemotherapy. After receiving chemotherapy for several weeks, she tells the nurse that she does not feel well. The nurse reviews the medical record and notices WBCs 2200/mm3 (2.2 x 109/L), RBCs 4.0 million/mm3 (4.7 x 1012/L), hemoglobin 12.0 g/dL (120 mmol/L), hematocrit 38%, platelets 170,000/mm3 (170 x 109/L). Vital signs are heart rate 97 beats/minute, respiration rate 25 breaths/minute, oral temperature 99.1 ºF (37.3 ºC), blood pressure 110/72. Based on this information, what does the nurse conclude is the client's priority need? 1.Promoting rest 2.Preventing infection 3.Avoiding bodily harm 4.Maintaining fluid balance

2.Preventing infection The prevention of infection is the priority because an infection can be life threatening for a client who is immunocompromised

The client receives dosages of sedative and opioid drugs during the postoperative period following surgical correction of a small bowel obstruction. What is the most critical assessment to be performed as a nursing safety priority? 1.Urinary assessment 2.Respiratory assessment 3Cardiovascular assessment 4Neuromuscular assessment

2.Respiratory assessment

A client who recently started receiving oral corticosteroids for a severe allergic reaction is instructed that the dosage will be reduced gradually until all medication is stopped at the end of two weeks. What reason does the nurse provide for this gradual reduction in dosage? 1.Discontinuing the drug too fast will cause the allergic reaction to reappear. 2.Slow reduction of the drug will prevent a physiologic crisis because the adrenal glands are suppressed. 3.The healthcare provider is attempting to determine the minimal dose that will be effective for the allergy. 4.Sudden cessation of the drug will cause development of serious side effects, such as moon face and fluid retention.

2.Slow reduction of the drug will prevent a physiologic crisis because the adrenal glands are suppressed. The body's natural corticosteroid production has been suppressed during treatment; avoiding abrupt cessation of the drug will give the body time to adjust to less and less of the exogenous source and to resume secretion of endogenous corticosteroid.

The nurse is providing postoperative care to a client with lung cancer who had a partial pneumonectomy. When inspecting the client's dressing, the nurse notes puffiness of the tissue around the surgical site. When the nurse palpates the site, the tissue feels spongy and crackles can be felt. How does the nurse describe this assessment finding? 1.Respiratory stridor 2.Subcutaneous emphysema 3.Bilateral 2+ pitting edema 4.Chest distention

2.Subcutaneous emphysema

A nurse is obtaining a health history from a client with newly diagnosed cervical cancer. Which aspect of the client's life is most important for the nurse to explore at this time? 1.Sexual history 2.Support system 3.Obstetric history 4.Elimination patterns

2.Support system During a health crisis the client will need support from significant others.

Range-of-motion exercises are prescribed for a child with juvenile idiopathic arthritis. What criterion should the nurse use to evaluate the effectiveness of the exercises? 1.The pain is relieved. 2.The affected joints can flex and extend. 3.The pedal and radial pulses are diminished. 4.The subcutaneous nodules at the joints recede.

2.The affected joints can flex and extend.

A nurse is teaching a woman how to perform breast self-examination. Which statement indicates that the client requires further education? 1."I examine my breasts about a week after my period starts." 2."I've been looking for dimpling and checking for lumps." 3."My breasts are so tender right before my period that I hate doing it." 4."My grandmother examines her breasts on the first Monday of each month."

3."My breasts are so tender right before my period that I hate doing it." Breast self-examination should be performed about a week after menstruation, when the breasts are less engorged and tender.

A nurse is caring for a client during the early postoperative period after a modified radical mastectomy. What should the nurse teach her regarding limiting edema in the affected arm? 1."Turn to the unaffected side every 2 hours." 2."Avoid moving the affected arm for 24 hours." 3."Use pillows to elevate the affected arm above the level of the heart." 4."Maintain the positive pressure drainage bag below the level of the arm."

3."Use pillows to elevate the affected arm above the level of the heart." Elevating the arm allows gravity to facilitate venous return and lymph drainage from the arm.

A client who underwent chemotherapy has leukopenia. Which instruction from the nurse will be beneficial for the client? 1."You should avoid exposure to the sun." 2."You should eat high-fiber foods and increase fluid intake." 3."You should avoid large crowds and people with infections." 4."You should consume iron supplements and erythropoietin."

3."You should avoid large crowds and people with infections."

A 63-year-old woman with the diagnosis of estrogen receptor-positive cancer of the breast undergoes lumpectomy and radiation therapy, and tamoxifen is prescribed. The client asks the nurse how long she will have to take the medication. How will the nurse respond? 1."You'll have to take it for the rest of your life." 2."You'll need to take it for 10 days, like an antibiotic." 3."You'll need to take it for 5 years, after which it will be discontinued." 4."You'll need to take it for several months, until the bone pain subsides."

3."You'll need to take it for 5 years, after which it will be discontinued."

A client admitted to the hospital with an acute episode of rheumatoid arthritis (RA) asks why physical therapy has not been prescribed. What is the most appropriate nursing response? 1."Your primary healthcare provider must have forgotten to prescribe it." 2."Your condition is not severe enough to have physical therapy approved." 3."Your joints are still inflamed, and physical therapy can be harmful." 4."Physical therapy is not helpful for persons who suffer from RA."

3."Your joints are still inflamed, and physical therapy can be harmful."

The nurse is preparing an intraoperative care plan for a client. Which intervention should be excluded from the care plan? 1.Ensuring the client's skin integrity 2.Reviewing the preoperative instructions 3.Administering general anesthetic to the client 4.Placing the client in the correct position on the operating table

3.Administering general anesthetic to the client

What action describes artificial active immunity? 1.Antibodies are passed from one person to another 2.Antibodies against an antigen are made naturally in the body 3.Antibodies are made after an antigen is injected into the body 4.Antibodies are transferred into the body after being made in another body or animal

3.Antibodies are made after an antigen is injected into the body

Aspirin is prescribed on a regular schedule for a client with rheumatoid arthritis. The nurse understands that the drug is being used primarily for which of its properties? 1.Analgesic 2.Antipyretic 3.Antiinflammatory 4.Antiplatelet

3.Antiinflammatory

The nurse is providing post-procedure care to a client after an arthroscopy. What will be the nurse's priority while providing care to the client? 1.Encouraging the client to perform exercises 2.Elevating the affected extremity for 12 to 24 hours 3.Assessing the neurovascular status of the client's affected limb 4.Administering analgesics as prescribed by the primary healthcare provider

3.Assessing the neurovascular status of the client's affected limb. The priority for post-procedure care after arthroscopy is to assess the neurovascular status of the client's affected limb

The nurse is caring for a child with a very low platelet count related to chemotherapy. The nurse will monitor this child's urine for the presence what component? 1.Protein 2.Glucose 3.Erythrocytes 4.Lymphocytes

3.Erythrocytes

A client responds well after extensive pulmonary surgery for lung cancer and is discharged. A week after discharge the home care nurse observes the client's downcast eyes and lack of interest in the environment. The client's family states that this behavior started a few days after discharge. How should the nurse interpret these findings? 1.Unusual, indicating mental illness 2.Normal, and no follow-up is required 3.Expected, but needs to be addressed 4.Serious, needing immediate acute care

3.Expected, but needs to be addressed Depression is an expected part of grieving that requires supportive care.

The nurse is performing an assessment of the client's reproductive system. Which finding of the past medical history indicates the client is at risk of cervical cancer? 1.Vaginal discharge 2.Ovarian dysfunction 3.Human papilloma virus infection 4.Hematuria and urinary incontinence

3.Human papilloma virus infection A human papilloma virus (HPV) infection increases the risk of cervical cancer.

What are the priority care issues during chemotherapy? Select all that apply. 1.Resources available for the nurse 2.Handling the chemotherapy drugs 3.Managing the client's complications 4.Protecting the client from side effects 5.Treatment areas in which to serve clients

3.Managing the client's complications 4.Protecting the client from side effects Managing the client's complications and protecting the client from side effects are the high-priority care issues to be considered during chemotherapy.

The nurse suspects that an intraoperative client has a distended bladder. Which method is correct to assess for this condition? 1.Inspect and palpate in the epigastric region. 2.Auscultate and percuss in the inguinal areas. 3.Percuss and palpate in the hypogastric region. 4.Percuss and palpate bilaterally in the lumbar areas

3.Percuss and palpate in the hypogastric region. To detect a distended bladder, percussion and palpation should be performed over the hypogastric region of the abdomen.

A 28-year-old woman is diagnosed as having cancer of the left breast. A simple mastectomy is performed. What should the plan of care include immediately after surgery? 1.Changing the client's pressure dressing as necessary 2.Inviting a member of Reach to Recovery to visit the client 3.Placing the client in the semi-Fowler position with the left arm elevated 4.Waiting for a cessation of drainage before the client resumes any activity

3.Placing the client in the semi-Fowler position with the left arm elevated

A nurse is reviewing the laboratory values of a school-aged child with rheumatic heart disease. Which finding does the nurse conclude is related to this condition? 1.Negative C-reactive protein 2.Increased reticulocyte count 3.Positive antistreptolysin titer 4.Low erythrocyte sedimentation rate

3.Positive antistreptolysin titer

What findings should a nurse expect when examining the laboratory report of a preschooler with rheumatic fever? 1.Negative C-reactive protein 2.Increased reticulocyte count 3.Positive antistreptolysin titer 4.Decreased sedimentation rate

3.Positive antistreptolysin titer A positive antistreptolysin titer is present with rheumatic fever because of the previous infection with streptococci.

A client with cancer of the prostate requests the urinal at frequent intervals but either does not void or voids in very small amounts. Which does the nurse conclude is most likely the causative factor? 1.Edema 2.Dysuria 3.Retention 4.Suppression

3.Retention An enlarged prostate constricts the urethra, interfering with urine flow and causing retention.

A nurse is evaluating a client's understanding regarding postoperative concerns after a mastectomy. Which unanticipated development near and around the incision noted by the client should be reported to her primary healthcare provider? 1.Persistent itching 2.Decreased sensation 3.Swelling with erythema 4.Irregular-appearing skin

3.Swelling with erythema Swelling and erythema are signs of infection and should be reported to the primary healthcare provider immediately.

The registered nurse is caring for a client undergoing chemotherapy. Which statement made by the client shows a need for the registered nurse (RN) to delegate unlicensed assistive personnel (UAP) to help the client with activities of daily living (ADL)? Select all that apply. 1."I have severe nausea." 2."I developed rashes after therapy." 3."I am unable to bear the pain of chemotherapy." 4."I am unable to eat by myself due to the intravenous (IV) catheter." 5."I am unable to get out of bed because I am so weak from the therapy."

4."I am unable to eat by myself due to the intravenous (IV) catheter." 5."I am unable to get out of bed because I am so weak from the therapy."

The nurse is reviewing the breast self-examination procedure with a client. What comment by the client should the nurse consider significant for follow-up? 1."My breasts feel larger when I'm having a period." 2."My breasts feel lumpy right before my period starts." 3."My left breast has always been a little bigger than my right one." 4."My right breast feels thicker and seems bigger than the left one.

4."My right breast feels thicker and seems bigger than the left one

A client who is receiving chemotherapy for lung cancer has nausea and vomiting because of the therapy. The client wants to know if it is true that smoking marijuana will help. What is the nurse's best response? 1."Smoking marijuana is not legal in any state." 2."Marijuana is effective for nausea and vomiting if it is injected." 3."Marijuana is not proven to be effective in preventing chemotherapy-induced nausea and vomiting." 4."There are some tetrahydrocannabinol (THC)-based medications that contain marijuana that control chemotherapy-induced nausea and vomiting in some people."

4."There are some tetrahydrocannabinol (THC)-based medications that contain marijuana that control chemotherapy-induced nausea and vomiting in some people."

On the first day after a mastectomy, a nurse encourages the client to perform exercises such as flexion and extension of the fingers and pronation and supination of the hand. The client asks why she has to do these exercises. What is the best response by the nurse? 1."They preserve muscle tone." 2."They prevent joint contractures." 3."They help us assess the extent of lymphedema." 4."They will help stimulate peripheral circulation."

4."They will help stimulate peripheral circulation." These exercises require muscle contractions that put pressure on blood vessels; muscle contraction promotes circulation, increasing tissue oxygen

A client with systemic lupus erythematosus (SLE) is at 39 weeks' gestation. What does the nurse anticipate regarding this client? 1.A large-for-gestational age newborn 2.The possible need for postpartum dialysis 3.Greater prominence of the butterfly-shaped rash 4.A need to discontinue the client's salicylate therapy

4.A need to discontinue the client's salicylate therapy Salicylate therapy is used because clients with SLE have an increased risk of thrombus formation; as the time of birth approaches salicylate therapy should be discontinued to reduce the possibility of bleeding in the newborn.

A client with a tentative diagnosis of lung cancer is scheduled for a mediastinoscopy with biopsy. Which is a priority nursing action? 1.Tell the client that chest tubes will be present after the procedure. 2.Explain that the procedure will allow visualization of lungs and chest cavity. 3.Inform the client that some pleural fluid will be removed during this procedure. 4.Advise the client to avoid eating or drinking anything for several hours before the test.

4.Advise the client to avoid eating or drinking anything for several hours before the test. To prevent aspiration during the procedure

The nurse informs a client's family that the client is in pain and does not wish to proceed with chemotherapy. What is the role of the nurse in this situation? 1.Manager 2.Educator 3.Caregiver 4.Advocate

4.Advocate

A nurse in the women's health clinic is counseling clients about the signs of gynecologic problems. Teaching by the nurse would be deemed effective if the clients stated that which early manifestation of cervical cancer should prompt them to seek professional care? 1.Abdominal heaviness 2.Pressure on the bladder 3.Foul-smelling discharge 4.Bloody spotting after intercourse

4.Bloody spotting after intercourse Any sign of abnormal vaginal bleeding may indicate cervical cancer and must be investigated

A client has colorectal cancer and is receiving cetuximab. Which process does cetuximab inhibit? 1.Proteasome activity 2.BCR-ABL tyrosine kinase (TK) 3.Anaplastic lymphoma kinase 4.Epidermal growth factor receptors (EGFRs)

4.Epidermal growth factor receptors (EGFRs) Cetuximab is an EGFR-tyrosine TK inhibitor that acts by inhibiting EGFRs in clients with colorectal cancer.

The nurse is caring for a client with rheumatoid arthritis. When should the nurse expect the client to experience the most pain and limited movement of the joints? 1.After assistive exercise 2.When the room is cool 3.During the evening hours 4.In the morning on awakening

4.In the morning on awakening Inactivity over an extended time increases stiffness and pain in joints.

Which factor identified in a client's history places her at increased risk for breast cancer? 1.Active lifestyle 2.Low-income background 3.Delayed onset of menarche 4.Late beginning of childbearing

4.Late beginning of childbearing Advanced age at the time of a first child's birth is one of the risk factors for malignancy of the breast.

A nurse obtains the history of a client with early colon cancer. Which clinical finding does the nurse consider consistent with a diagnosis of cancer of the descending, rather than the ascending, colon? 1.Pain 2.Fatigue 3.Anemia 4.Obstruction

4.Obstruction Signs and symptoms of obstruction occur earlier with cancer in the descending colon because the consistency of the stool is formed rather than liquid.

The nurse finds that a client has dysuria, hesitancy, urinary urgency, and leaking. The laboratory reports of the client reveal serum PSA levels of 5 ng/mL and elevated prostatic acid phosphatase (PAP) levels. Which disease condition does the nurse suspect? 1.Orchitis 2.Hydrocele 3.Prostatitis 4.Prostate cancer

4.Prostate cancer The normal range of PSA levels is 0-4 ng/mL

A nurse is caring for a client with a diagnosis of cancer of the prostate. The nurse should teach the client that which serum level will be monitored throughout the course of the disease? 1.Albumin 2.Creatinine 3.Blood urea nitrogen (BUN) 4.Prostate-specific antigen (PSA)

4.Prostate-specific antigen (PSA)

A nurse is teaching a school-aged child with juvenile idiopathic arthritis (JIA) activities to prevent the loss of joint function. What should the nurse caution the child to avoid? 1.Bicycle riding 2.Walking to school 3.Isometric exercises 4.Sedentary activities

4.Sedentary activities

The nurse is caring for a postpartum client with a history of rheumatic heart disease. The nurse plans care for this client with what knowledge regarding this client? 1.She should increase her oral fluid intake. 2.She should maintain bed rest for a minimum of 4 days. 3.She is out of immediate danger, because the stress associated with pregnancy is over. 4.She requires monitoring during the first 48 hours because of the stress on the cardiopulmonary system

4.She requires monitoring during the first 48 hours because of the stress on the cardiopulmonary system

Which type of immune preparation, made from donated blood, contains antibodies that provide passive immunity? 1.Toxoid 2.Killed vaccine 3.Live attenuated vaccine 4.Specific immune globulin

4.Specific immune globulin Specific immune globulins contain a high concentration of antibodies directed at specific antigens. Toxoid vaccines contain a bacterial toxin that has been changed to a nontoxic form. Killed vaccines contain killed microbes or isolated microbes. Live attenuated vaccines are composed of live microbes that have been weakened or rendered completely avirulent.

A client with small-cell lung cancer is receiving chemotherapy. A complete blood count is prescribed before each round of chemotherapy. Which component of the complete blood count is of greatest concern to the nurse? 1.Platelets 2.Hematocrit 3.Red blood cells (RBCs) 4.White blood cells (WBCs)

4.White blood cells (WBCs)

A client with rheumatoid arthritis has been given a prescription for acetylsalicylic acid. The client asks the nurse, "What kind of drug is acetylsalicylic acid?" The nurse recalls that this drug has which property? 1.Sedative 2.Hypnotic 3.Analgesic 4.Antibiotic

3.Analgesic

A school-aged child is to receive a blood transfusion. What should the nurse do first if an allergic reaction to the blood occurs? 1.Shut off the infusion. 2.Slow the rate of flow. 3.Administer an antihistamine. 4.Call the healthcare provider.

1.Shut off the infusion.

A nurse plans care to prevent deformities in a client with rheumatoid arthritis. Which intervention should be alternated with periods of rest? 1.Active exercises 2.Passive massage 3.Bracing of joints 4.Isometric exercises

1.Active exercises Active exercises, alternated with periods of rest, offer the best chance at preventing the joint deformities associated with rheumatoid arthritis, because they can move each involved joint through its full range of motion.

A 7-year-old child with juvenile idiopathic arthritis (JIA) complains of knee pain. What does the nurse expect to be prescribed to help relieve this discomfort? 1.Application of moist heat 2.Massage of the swollen areas 3.Use of pillows under the knees 4.Immobilization of the affected leg

1.Application of moist heat

A client with systemic lupus erythematosus is taking prednisone. The nurse anticipates that the steroid may cause hypokalemia. What food will the nurse encourage the client to eat? 1.Broccoli 2.Oatmeal 3.Fried rice 4.Cooked carrots

1.Broccoli

In an ongoing research study a nurse asks participants, who are breast cancer survivors, to briefly share information about their lives after surviving cancer. The nurse then compiles the views to determine the cancer survivors' quality of life. Which type of study is being conducted? 1.Historical research 2.Descriptive research 3.Qualitative research 4.Correlational research

3.Qualitative research

During admission a client appears anxious and says to the nurse, "The doctor told me I have lung cancer. My father died from cancer. I wish I had never smoked." What is the nurse's best response? 1."You seem concerned about your diagnosis." 2."You are feeling guilty about your smoking." 3."There have been advances in lung cancer therapy." 4."Trust your healthcare provider, who is very competent in treating cancer."

1."You seem concerned about your diagnosis."

An isolated older adult is diagnosed with cancer and fears death. Which intervention provided would help to induce relaxation and to communicate interest in the client? 1.Touch 2.Reminiscence 3.Reality orientation 4.Therapeutic communication

1.Touch Touch is a therapeutic tool that helps induce relaxation, provide physical and emotional comfort, and communicate interest in an older adult. Reminiscence helps to bring meaning and understanding to the client's present situation and resolves current conflicts by recollecting the past.

A nurse is making room assignments on the pediatric unit. Who is the best choice of roommate for a 10-year-old boy with juvenile idiopathic arthritis? 1.An 11-year-old girl with colitis 2.A 10-year-old boy with asthma 3.A 10-year-old girl with a fractured femur 4.An 11-year-old boy who has undergone splenectomy

4.An 11-year-old boy who has undergone splenectomy Same sex, close to same age, asthma pt might be too stressful

A client with the diagnosis of breast cancer is scheduled to receive radiation therapy to the affected area. The nurse teaches the client about how to care for the area that will be irradiated. Which client statement indicates the nurse needs to follow up? 1."I will leave the skin markings intact." 2."I will protect the skin from sources of heat." 3."I will wear soft clothing over the upper body." 4."I will use an oatmeal-based lotion after each treatment."

4."I will use an oatmeal-based lotion after each treatment" While undergoing radiation therapy, lotions, powders, and ointments should not be applied to the area.

A home health nurse teaches a father how to provide oral care for his 8-year-old child who is undergoing chemotherapy. The nurse observes a return demonstration and determines that he needs further teaching when he tries to use which dental hygiene product? 1.A cotton swab 2.Mild toothpaste 3.Saline mouthwash 4.An electric toothbrush

4.An electric toothbrush An electric toothbrush vigorously massages the gums; this may be irritating and could cause the gums to hemorrhage.

What should a nurse include in the discharge instructions for a woman who has undergone breast-conserving surgery (lumpectomy) for breast cancer? 1.Assuring her that a supportive brassiere is unnecessary 2.Emphasizing the importance of breast self-examination 3.Instructing her to return the next day for removal of the drain 4.Explaining why it is unnecessary to exercise the arm on the unaffected side

2.Emphasizing the importance of breast self-examination

The nurse is assessing four clients in the postanesthesia care unit (PCU) who are on opioid treatment. Which client does the nurse expect will benefit from an immediate treatment with naloxone? A.Frequently drowsy, arousable, drifts off to sleep during conversation. RR: 15 B.Slightly drowsy, easily aroused RR: 24 C.Awake and alert RR:32 D.Minimal response to verbal and physical stimulation RR:10

D.Minimal response to verbal and physical stimulation RR:10

A client with terminal cancer is to receive 4 mg of hydromorphone intravenously (IV) every 4 hours as needed for severe breakthrough pain. It is supplied at 10 mg/mL. When the client complains of severe pain, how much solution of hydromorphone should the nurse administer? Record your answer using one decimal place and leading zero if applicable. ___ mL

0.4 mL

A client who is to undergo a mastectomy for breast cancer tells the nurse that she is worried about what she will look like after the surgery. What is the most appropriate initial response by the nurse? 1."I understand that you'd be concerned." 2."Try not to think about the surgery now." 3."Everyone having this surgery feels the same way." 4."Perhaps you should discuss this with your husband

1."I understand that you'd be concerned."

The nurse reviews the medical records of four male clients. Which client will the nurse assess most closely for developing prostate cancer? 1.Black 55-year-old 2.White 45-year-old 3.Asian 55-year-old 4.Hispanic 45-year-old

1.Black 55-year-old Cancer of the prostate is rare before age 50 years but increases with age; black men develop cancer of the prostate more often and at an earlier age than white men. Black men develop prostate cancer more often than any other ethnic group. Asian American men have a lower incidence than white men.

A client is experiencing an exacerbation of systemic lupus erythematosus. To reduce the frequency of exacerbations, what would be important for the nurse to include in the client's teaching plan? 1.Basic principles of hygiene 2.Techniques to reduce stress 3.Measures to improve nutrition 4.Signs of an impending exacerbation

2. Techniques to reduce stress Systemic lupus erythematosus is an autoimmune disorder, and physical and emotional stresses have been identified as contributing factors to the occurrence of exacerbations.

Which diseased condition associated with the client's heart is an example of an autoimmune disease? 1.Uveitis 2.Rheumatic fever 3.Myasthenia gravis 4.Graves' disease

2.Rheumatic fever Rheumatic fever is a heart disorder that is an example of an autoimmune disease.

A client who has been taking ibuprofen for rheumatoid arthritis asks the nurse if acetaminophen can be substituted instead. What is the appropriate nursing response? 1."Acetaminophen is the preferred treatment for rheumatoid arthritis." 2."Acetaminophen irritates the stomach more than ibuprofen does." 3."Ibuprofen has antiinflammatory properties and acetaminophen does not." 4."Yes, both are antipyretics and have the same effect."

3."Ibuprofen has antiinflammatory properties and acetaminophen does not."

The primary healthcare provider instructs the nurse to manage fluid replacement therapy in a client with cancer. What type of care is the client receiving? 1.Palliative care 2.Comfort care 3.Supportive care 4.End-of-life care

3.Supportive care In oncology departments, medical professionals use supportive care to improve the client's quality of life. Supportive care is mainly based on the use of medical interventions to support client health

A 26-year-old woman whose sister recently had a lumpectomy for breast cancer calls the local women's health center for an appointment for a mammogram. What guidance should the nurse provide the client in preparation for the test? 1.Do not eat for 6 hours before the test. 2.The room will be darkened throughout the procedure. 3.The first mammogram is usually performed at 50 years of age. 4.During the procedure, each breast will be compressed firmly between two plates.

4.During the procedure, each breast will be compressed firmly between two plates.

A 75-year-old male with a history of cancer of the prostate is admitted for a prostatectomy. The client's prostate specific antigen (PSA) levels have been increasing. This finding should prompt the nurse to include what in the client's plan of care? 1.Measure intake and output. 2.Institute seizure precautions. 3.Monitor the plasma pH for acidosis. 4.Handle the client gently when turning

4.Handle the client gently when turning

A 7-year-old child with juvenile idiopathic arthritis has difficulty getting ready for school in the morning because of joint pain and stiffness. Which recommendation should the nurse make to the family? 1.Administer acetaminophen before bedtime. 2.Ice the joints that are painful in the evening. 3.Encourage a program of active exercise after awakening. 4.Provide warm, moist heat to the affected joints before arising

4.Provide warm, moist heat to the affected joints before arising

A school-aged child is undergoing chemotherapy. How can the nurse best manage a common side effect of chemotherapy? 1.Restricting fluid intake 2.Instituting contact precautions 3.Keeping the hair closely cropped 4.Providing meticulous oral hygiene

4.Providing meticulous oral hygiene

The nurse is assessing four clients in the postoperative unit. Which client will be monitored for fluid volume overload as nursing safety priority? A.Client with lymph node dissection B.Client with laparoscopic cholecystechtomy C.Client with surgical intervention for hemorrhoids D.Client with liver transplantation

A.Client with lymph node dissection The nursing safety priority for client A with lymph node dissection is monitoring for manifestations of fluid overload.

Which client should the nurse most likely suspect to have a bacterial infection when dressing the wounds of four postoperative clients? A.Foul odor from wound when dressing is changed B.Increased tenderness at wound margins C.Erythema of the incision on each side of wound D.Necrosis of skin edges

A.Foul odor from wound when dressing is changed

Arrange the sequence of steps required to stimulate antibody-mediated immunity in its correct sequence. 1.Exposure of antigen 2.Antigen recognition 3.Antibody production 4.Antibody-antigen binding 5.Sensitization 6.Antigen elimination

1.Exposure of antigen 2.Antigen recognition 3.Sensitization 4.Antibody production 5.Antibody-antigen binding 6.Antigen elimination

Which manifestations may indicate a client has systemic lupus erytheWhich manifestations may indicate a client has systemic lupus erythematosus (SLE)? Select all that apply. 1.Pericarditis 2.Esophagitis 3.Fibrotic skin 4.Discoid lesions 5.Pleural effusions

1.Pericarditis 4.Discoid lesions 5.Pleural effusions

What assessment findings indicate that a client is experiencing an allergic reaction to antibiotic therapy? Select all that apply. 1.Pruritus 2.Confusion 3.Wheezing 4.Muscle aches 5.Bronchospasm

1.Pruritus 3.Wheezing 5.Bronchospasm

When a client who has had a mastectomy returns from surgery, a dressing and a portable wound drainage system to the axillary area are in place. The nurse notes an excessive amount of serosanguineous drainage on the mastectomy dressing. What is the nurse's next action? 1.Notifying the surgeon 2.Applying a pressure dressing 3.Checking the function of the drainage system 4.Using additional pillows to elevate the affected arm

3.Checking the function of the drainage system

A nurse is caring for a 9-year-old child with juvenile idiopathic arthritis (JIA). What is most important for the nurse to attempt to prevent? 1.Infection 2.Hemarthrosis 3.Contracture deformities 4.Delayed intellectual development

3.Contracture deformities

What is the most important information for the nurse to teach to a client who has had a total simple mastectomy before she leaves the hospital? 1.Why a breast prosthesis is necessary 2.Which of the more strenuous activities to curtail 3.What household tasks that require stretching to avoid 4.Why self-examination of the remaining breast is important

4.Why self-examination of the remaining breast is important

he nurse is caring for a client who is terminally ill with cancer. The health care team meets and agrees to provide the client with information to help the client make decisions regarding treatment. Which ethical principles are applied in this situation? Select all that apply. 1.Justice 2.Fidelity 3.Veracity 4.Autonomy 5.Beneficence

1.Justice 2.Fidelity 3.Veracity 4.Autonomy The nurse follows the principle of veracity by telling the truth to the client regarding his or her health status. Telling the truth helps the client in decision-making, which is in accordance with the principle of autonomy. Justice is an ethical principle that involves treating a client fairly without discrimination. Fidelity involves being loyal to the client. Beneficence involves acting in a way that causes the least harm to the client, and this principle does not apply because the team is not providing any care or making any health care decisions at this point.

A client who has undergone a mastectomy because of breast cancer is now undergoing chemotherapy, which has caused hair loss. The client states, "I feel like I've lost my sense of power." What is the nurse's best response? 1."Hair does not empower a person." 2."Losing power seems important to you." 3."Knowledge is power; I'll give you some pamphlets to read." 4."Hair loss is common; it will grow back, so you shouldn't worry."

2."Losing power seems important to you."

Aspirin is prescribed for a client with rheumatoid arthritis. Which clinical indicators of aspirin toxicity should the nurse teach the client to report? Select all that apply. 1.Bradycardia 2.Joint pain 3.Blood in the stool 4.Ringing in the ears 5.Increased urine output

3.Blood in the stool 4.Ringing in the ears

An 11-year-old child with juvenile idiopathic arthritis will be receiving continued nonsteroidal antiinflammatory drug (NSAID) therapy at home. Which important toxic effect of NSAIDs must be included in the nurse's discharge instructions to the child and family? 1.Diarrhea 2.Hypothermia 3.Blood in the urine 4.Increased irritability

3.Blood in the urine

After breast cancer is diagnosed, the client decides on a modified radical mastectomy followed by a combination therapy protocol that includes doxorubicin. What assessment finding does the nurse recognize as a toxic effect of this drug? 1.Paralytic ileus 2.Red-tinged urine 3.Cardiac dysrhythmias 4.Increased serum magnesium

3.Cardiac dysrhythmias Doxorubicin has the potential for cardiac toxicity

An infant child with juvenile idiopathic arthritis is seen in the clinic. Ibuprofen 90 mg by mouth every 6 hours is prescribed. Ibuprofen is available in a solution of 100 mg/2.5 mL. How many milliliters will the nurse instruct the parents to give with each dose? Record your answer using two decimal places. ___ mL

2.25 mL