theory 3 practice questions

Which nursing goal is appropriate for a client with multiple myeloma? A) Achieve effective management of bone pain. B) Recover from the disease with minimal disabilities. C) Decrease episodes of nausea and vomiting. D) Avoid hyperkalemia.

A) Achieve effective management of bone pain. In multiple myeloma, neoplastic plasma cells invade the bone marrow and begin to destroy the bone. As a result of this skeletal destruction, pain can be significant. There is no cure for multiple myeloma. Nausea and vomiting are not characteristics of the disease, although the client may experience anorexia. The client should be monitored for signs of hypercalcemia resulting from bone destruction, not for hyperkalemia.

The nurse is providing health education about injury and poisoning prevention to a group of young mothers at a health fair. What type of prevention is the nurse conduction? a) primary prevention b) secondary prevention c) tertiary prevention d) limited prevention

a) primary prevention generalized health promotion and specific protection against diseases or specific accidents targeted to a specific group. This intervention precedes disease or dysfunction and is applied to generally health group

A client had a surgery for gastrointestinal cancer and required a colostomy from the surgery. What type of preventative care would this client need at the stage a) tertiary b) limited c) secondary b) primary

a) tertiary

the nurse is assessing a woman who is receiving the second administration of chemotherapy for breast cancer. When obtaining this client's health history, the nurse should ask the client which question? a) "Has your hair been falling out in clumps?" b) "Have you had nausea or vomiting?" c) "Have you been sleeping at night?" d) "Do you have your usual energy level?"

b) "Have you had nausea or vomiting?" Chemotherapy agents typically cause nausea and vomiting when not controlled by antiemetic drugs. Antineoplastic drugs attack rapidly growing normal cells, such as in the gastrointestinal tract. These drugs also stimulate the vomiting center in the brain. Hair loss, loss of energy, and sleep are important aspects of the health history, but are not as critical as the potential for dehydration and electrolyte imbalance caused by nausea and vomiting.

During a breast examination, which finding most strongly suggests that a client has breast cancer? a) Slight asymmetry of the breasts b) A fixed nodular mass with dimpling of the overlying skin c) Bloody discharge from the nipple d)Multiple firm, round, freely movable masses that change with the menstrual cycle

b) A fixed nodular mass with dimpling of the overlying skin A fixed nodular mass with dimpling of the overlying skin is common during late stages of breast cancer. Many women have slightly asymmetrical breasts. Bloody nipple discharge is a sign of intraductal papilloma, a benign condition. Multiple firm, round, freely movable masses that change with the menstrual cycle indicate fibrocystic breasts, a benign condition.

potassium - 4 sodium -142 chloride - 100 calcium 12.4 The nurse is reviewing the lab report for a client in hospice care with breast cancer and brain metastasis. According to the information in the chart, what should the nurse do next? a) Document these results on the medical record. b) Report the elevated potassium level immediately. c) Report the elevated calcium level immediately. d) Refrain from reporting the results because the client is in hospice care.

c) Report the elevated calcium level immediately. The normal calcium level is 9.0 to 10.5 mg/dL. Hypercalcemia is commonly seen with malignant disease and metastases. The other laboratory values are normal. Hypercalcemia can be treated with fluids, furosemide, or administration of calcitonin. Failure to treat hypercalcemia can cause muscle weakness, changes in level of consciousness, nausea, vomiting, abdominal pain, and dehydration. Although the client is on hospice care, she will still need palliative treatment. Comfort and risk reduction are components of hospice care.

After a mastectomy for breast cancer, the nurse teaches the client how to avoid the development of lymphedema. The nurse should teach the client to: a) apply an elastic bandage to the affected extremity. b) limit range-of-motion exercises in the shoulder and elbow. c) elevate the affected arm on a pillow. d) use diuretics as necessary to decrease swelling.

c) elevate the affected arm on a pillow The client should be taught to elevate the affected arm on a pillow to promote venous return and lymphatic drainage of the area.

Which statement by a client undergoing external radiation therapy indicates the need for further teaching? a) "I'll wash my skin with mild soap and water only." b) "I'll not use my heating pad during my treatment." c) "I'll wear protective clothing when outside." d) "I'm worried I'll expose my family members to radiation."

d) "I'm worried I'll expose my family members to radiation." The client undergoing external radiation therapy requires further teaching when he voices a concern that he might expose his family to radiation. Internal radiation, not external radiation, poses a risk to the client's family. The client requires no further teaching if he states that he should wash his skin with mild soap and water, wear protective clothing when outside, and avoid using a heating pad.

A nurse is caring for a client who is receiving chemotherapy for lung cancer. During the hand-off report, the nurse from the previous shift states that the client has been placed on neutropenic precautions. Which laboratory value supports this nursing action? a) A red blood cell count of 3.5 million/mm3 b) A platelet count of 90,000 per microliter c) A retculocyte count of 1% d) A white blood cell count of 2200/mm3

d) A white blood cell count of 2200/mm3 The normal number of WBCs in the blood is 4,500-10,000 white blood cells per microliter (mcL). Less than 4,500 is considered neutropenia and places the client at risk for infection. The platelet count ranges from 150,000 to 450,000/mcL. Platelets are responsible for blood clotting. The nurse needs to institute bleeding precautions for this, not neutropenic precautions. Red blood cells are responsible for oxygen transport. The reticulocyte count is normal.

A female client undergoes a yearly mammography. The nurse understands this to be what level of prevention. a) tertiary b) limited c) secondary b) primary

secondary - mammograms are apart of early detection

The client with Hodgkin's disease undergoes an excisional cervical lymph node biopsy under local anesthesia. After the procedure, what does the nurse assess first? a) vital signs b) the incision c) the airway d) neurologic signs

c) the airway Assessing for an open airway is always first. The procedure involves the neck; the anesthesia may have affected the swallowing reflex, or the inflammation may have closed in on the airway, leading to ineffective air exchange. Once a patent airway is confirmed and an effective breathing pattern established, the circulation is checked. Vital signs and the incision are assessed as soon as possible, but only after it is established that the airway is patent and the client is breathing normally. A neurologic assessment is completed as soon as possible after other important assessments.

A client at risk for lung cancer asks about the reason for having a computed tomography (CT) scan as part of the initial exam. What is the nurse's best response? "A CT scan is: a) far superior to magnetic resonance imaging for evaluating lymph node metastasis." b) noninvasive and readily available." c) useful for distinguishing small differences in tissue density and detecting nodal involvement." d) used to distinguish a malignant from a nonmalignant adenopathy."

c) useful for distinguishing small differences in tissue density and detecting nodal involvement." CT scanning is the standard noninvasive method used in a workup for lung cancer because it can distinguish small differences in tissue density and can detect nodal involvement. CT is comparable to magnetic resonance imaging in evaluating lymph node metastasis. CT is noninvasive and usually available, but these are not the main reasons for its use. CT can distinguish malignancy in some situations only.