ACM SAUNDERS EXAM 5

A client is receiving intravesical chemotherapy for cancer of the bladder. The nurse should plan to take which action after the completion of each treatment? 1. Encourage increased intake of oral fluids. 2. Provide increased doses of opioid analgesics. 3. Place the client on strict contact isolation for 24 hours. 4. Keep the client on nothing by mouth (NPO) status for 6 hours.

1. Encourage increased intake of oral fluids.

A client with liver cancer who is receiving chemotherapy tells the nurse that some foods taste bitter. The nurse would try to limit which food that is most likely to cause this bitter taste for the client? 1. Pork 2.Custard 3.Potatoes 4.Cantaloupe

1. Pork

The nurse is reviewing the record of a client admitted to the nursing unit and notes that the client has a history of Laënnec's cirrhosis. Which question related to the client's history would be most important to ask? 1."Do you abuse alcohol?" 2."Do you have any known cardiac disease?" 3."Does your type of employment cause you to have exposure to chemicals?" 4."Have you ever been told that you have had obstruction to your biliary ducts?"

1."Do you abuse alcohol?"

The nurse is performing an assessment on a client with acute pancreatitis who was admitted to the hospital. Which assessment question would most specifically elicit information regarding the pain that is associated with acute pancreatitis? 1."Does the pain in your stomach radiate to your back?" 2."Does the pain in your lower abdomen radiate to your hip?" 3."Does the pain in your lower abdomen radiate to your groin?" 4."Does the pain in your stomach radiate to your lower middle abdomen?"

1."Does the pain in your stomach radiate to your back?"

The nurse has taught the client with chronic pancreatitis about risk factor modification to reduce the incidence of recurrences. The nurse determines that teaching was effective if the client states that it will be necessary to control which factor? 1.Alcohol intake 2.Ulcer 3.Crohn's disease 4.Diabetes mellitus

1.Alcohol intake

A client with viral hepatitis states, "I am so yellow." What is the most appropriate nursing action? 1. Assist the client in expressing feelings. 2. Restrict visitors until the jaundice subsides. 3. Perform most of the activities of daily living for the client. 4. Provide information to the client only when he or she requests it.

1.Assist the client in expressing feelings.

A client who is receiving chemotherapy for breast cancer develops myelosuppression. Which instructions should the nurse include in the client's discharge teaching plan? Select all that apply. 1.Avoid contact sports. 2.Wash hands frequently. 3.Increase intake of fresh fruits and vegetables. 4.Avoid crowded places such as shopping malls. 5.Treat a sore throat with over-the-counter products. 6.Avoid people who have received live attenuated vaccines.

1.Avoid contact sports. 2.Wash hands frequently. 4.Avoid crowded places such as shopping malls. 6.Avoid people who have received live attenuated vaccines.

A cervical radiation implant is placed in a client who is undergoing treatment of cervical cancer. The nurse should initiate which activity prescription as the most appropriate for this client? 1.Bed rest 2.Out of bed ad lib 3.Out of bed in a chair only 4.Ambulation to the bathroom only

1.Bed rest

The nurse is caring for a client with a low thrombin level as a result of liver dysfunction. Based on this finding it is most important for the nurse to monitor the client for signs and symptoms of which potential complication? 1.Bleeding 2.Infection 3.Dehydration 4.Malnutrition

1.Bleeding

A Penrose drain is in place on the first postoperative day in a client who has undergone a cholecystectomy procedure. Serosanguineous drainage is noted on the dressing covering the drain. Which nursing intervention is most appropriate? 1.Change the dressing. 2.Continue to monitor the drainage. 3.Notify the primary health care provider (PHCP). 4.Use a pen to circle the amount of drainage on the dressing.

1.Change the dressing.

The nurse is providing dietary instructions to a client hospitalized for pancreatitis. Which food should the nurse instruct the client to avoid? 1.Chili 2.Bagel 3.Lentil soup 4.Watermelon

1.Chili

A client is admitted to the nursing unit after undergoing radical prostatectomy for cancer. The nurse anticipates that which problem would be of most concern to the client in the immediate postoperative period? 1.Concern about the outcome of surgery 2.Continuous pain because of the effects of cancer 3.Appearance disturbance as a result of the presence of a suprapubic catheter 4.Concern about caring for self at home because of insufficient help after discharge

1.Concern about the outcome of surgery

The nurse is caring for a client with biliary obstruction. The nurse interprets that obstruction of which passage is related to the client's condition? 1.Cystic duct 2.Liver canaliculi 3.Common bile duct 4.Right hepatic duct

1.Cystic duct

The nurse is caring for a hospitalized client with pancreatitis. Which findings should the nurse look for and expect to note when reviewing the laboratory results? Select all that apply. 1.Elevated lipase level 2.Elevated lactase level 3.Elevated trypsin level 4.Elevated amylase level 5.Elevated sucrase level

1.Elevated lipase level 3.Elevated trypsin level 4.Elevated amylase level

The nurse is reviewing the results of serum laboratory studies for a client admitted for suspected hepatitis. Which laboratory finding is most associated with hepatitis, requiring the nurse to contact the primary health care provider? 1.Elevated serum bilirubin level 2.Below normal hemoglobin concentration 3.Elevated blood urea nitrogen (BUN) level 4.Elevated erythrocyte sedimentation rate (ESR)

1.Elevated serum bilirubin level

The nurse is caring for a client with acute pancreatitis. Which finding should the nurse expect to note when reviewing the laboratory results? 1.Elevated serum lipase level 2.Elevated serum bilirubin level 3.Decreased serum trypsin level 4.Decreased serum amylase level

1.Elevated serum lipase level

The nurse is caring for a client with lung cancer and bone metastasis. What signs and symptoms would the nurse recognize as indications of a possible oncological emergency? Select all that apply. 1.Facial edema in the morning 2.Weight loss of 20 lb (9 kg) in 1 month 3.Serum calcium level of 12 mg/dL (3.0 mmol/L) 4.Serum sodium level of 136 mg/dL (136 mmol/L) 5.Serum potassium level of 3.4 mg/dL (3.4 mmol/L) 6.Numbness and tingling of the lower extremities

1.Facial edema in the morning 3.Serum calcium level of 12 mg/dL (3.0 mmol/L) 6.Numbness and tingling of the lower extremities

A client with chronic pancreatitis needs information on dietary modification to manage the health problem. Which item in the diet should the nurse teach the client to limit? 1.Fat 2.Protein 3.Carbohydrate 4.Water-soluble vitamins

1.Fat

A client is admitted to the hospital with acute viral hepatitis. Which sign or symptom should the nurse expect to note based on this diagnosis? 1.Fatigue 2.Pale urine 3.Weight gain 4.Spider angiomas

1.Fatigue

A woman has just been told by the primary health care provider that she has breast cancer. The woman responds, "Oh, no! Does this mean I'm going to die?" The nurse interprets the woman's initial reaction as which response? 1.Fear 2.Rage 3.Denial 4.Anxiety

1.Fear

The nurse is assessing a client who is experiencing an acute episode of cholecystitis. Which of these clinical manifestations support this diagnosis? Select all that apply. 1.Fever 2.Positive Cullen's sign 3.Complaints of indigestion 4.Palpable mass in the left upper quadrant 5.Pain in the upper right quadrant after a fatty meal 6.Vague lower right quadrant abdominal discomfort

1.Fever 3.Complaints of indigestion 5.Pain in the upper right quadrant after a fatty meal

The nurse is reviewing the primary health care provider's prescriptions written for a client admitted to the hospital with acute pancreatitis. Which prescription requires follow-up by the nurse? 1.Full liquid diet 2.Morphine sulfate for pain 3.Nasogastric tube insertion 4.An anticholinergic medication

1.Full liquid diet

The nurse has been caring for a client who required a Sengstaken-Blakemore tube because other treatment measures for esophageal varices were unsuccessful. The primary health care provider (PHCP) arrives on the nursing unit and deflates the esophageal balloon. Which assessment finding by the nurse is the most important and should be reported to the PHCP immediately? 1.Hematemesis 2.Bloody diarrhea 3.Swelling of the abdomen 4.An elevated temperature and a rise in blood pressure

1.Hematemesis

The nurse is caring for a client with acute pancreatitis and is monitoring the client for paralytic ileus. Which assessment data would alert the nurse to this occurrence? 1.Inability to pass flatus 2.Loss of anal sphincter control 3.Severe, constant pain with rapid onset 4.Firm, nontender mass palpable at the lower right costal margin

1.Inability to pass flatus

The nurse is caring for a client with acute pancreatitis and is monitoring the client for paralytic ileus. Which piece of assessment data should alert the nurse to this occurrence? 1.Inability to pass flatus 2.Loss of anal sphincter control 3.Severe, constant pain with rapid onset 4.Firm, nontender mass palpable at the lower right costal margin

1.Inability to pass flatus

The nurse is teaching the client with viral hepatitis about the stages of the disease. The nurse should explain to the client that the second stage of this disease is characterized by which specific assessment findings? Select all that apply. 1.Jaundice 2.Flu-like symptoms 3.Clay-colored stools 4.Elevated bilirubin levels 5.Dark or tea-colored urine

1.Jaundice 3.Clay-colored stools 4.Elevated bilirubin levels 5.Dark or tea-colored urine

The nurse is caring for a client with common bile duct obstruction. The nurse should anticipate that the primary health care provider (PHCP) will prescribe which diet for this client? 1.Low fat 2.High protein 3.High carbohydrate 4.Low in water-soluble vitamins

1.Low fat

The nurse is reviewing the prescription for a client admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions would the nurse expect to be prescribed for the client? Select all that apply. 1.Maintain NPO (nothing by mouth) status. 2.Encourage coughing and deep breathing. 3.Give small, frequent high-calorie feedings. 4.Maintain the client in a supine and flat position. 5.Give hydromorphone intravenously as prescribed for pain. 6.Maintain intravenous fluids at 10 mL/hr to keep the vein open.

1.Maintain NPO (nothing by mouth) status. 2.Encourage coughing and deep breathing. 5.Give hydromorphone intravenously as prescribed for pain.

The nurse is reviewing a plan of care for a client with cancer of the cervix who is undergoing treatment with a cesium (radiation) implant. Which nursing interventions are most appropriate for this client? Select all that apply. 1.Maintain the client on bed rest. 2.Place the client on a low-fiber diet. 3.Keep the head of the bed flat at all times. 4.Restrict visitors to visiting for 60 minutes per day. 5.Stand at the entrance of the room to communicate with the client when possible.

1.Maintain the client on bed rest. 2.Place the client on a low-fiber diet. 5.Stand at the entrance of the room to communicate with the client when possible.

A client has developed hepatitis A after eating contaminated oysters. The nurse assesses the client for which expected assessment finding? 1.Malaise 2.Dark stools 3.Weight gain 4.Left upper quadrant discomfort

1.Malaise

The nurse is creating a plan of care for a client with cirrhosis and ascites. Which nursing actions should be included in the care plan for this client? Select all that apply. 1.Monitor daily weight. 2.Measure abdominal girth. 3.Monitor respiratory status. 4.Place the client in a supine position. 5.Assist the client with care as needed.

1.Monitor daily weight. 2.Measure abdominal girth. 3.Monitor respiratory status. 5.Assist the client with care as needed.

A client with cirrhosis has ascites and excess fluid volume. Which assessment findings does the nurse anticipate to note as a result of increased abdominal pressure? Select all that apply. 1.Orthopnea and dyspnea 2.Petechiae and ecchymosis 3.Inguinal or umbilical hernia 4.Poor body posture and balance 5.Abdominal distention and tenderness

1.Orthopnea and dyspnea 2.Petechiae and ecchymosis 3.Inguinal or umbilical hernia 5.Abdominal distention and tenderness

A client with cirrhosis is beginning to show signs of hepatic encephalopathy. The nurse should plan a dietary consultation to limit the amount of which ingredient in the client's diet? 1.Protein 2.Calories 3.Minerals 4.Carbohydrates

1.Protein

A client with carcinoma of the lung develops syndrome of inappropriate antidiuretic hormone (SIADH) as a complication of the cancer. The nurse anticipates that the oncologist will request which prescriptions? Select all that apply. 1.Radiation 2.Chemotherapy 3.Increased fluid intake 4.Decreased oral sodium intake 5.Serum sodium level determination 6.Medication that is antagonistic to antidiuretic hormone

1.Radiation 2.Chemotherapy 5.Serum sodium level determination 6.Medication that is antagonistic to antidiuretic hormone

A client with a medical diagnosis of breast cancer is undergoing chemotherapy. The client complains to the nurse about losing her hair and severe fatigue from the treatment. Which interventions should the nurse implement for this client? Select all that apply. 1.Review side effects of chemotherapy and treatment with the client. 2.Teach the client how to resolve specific concerns of her personal life. 3.Teach the client to pace activities with rest so as to maintain strength. 4.Offer information on available counseling services and support groups. 5.Tell the client about some other clients who have had breast cancer treatment. 6.Inquire how the cancer diagnosis and treatment affect the client's normal routine.

1.Review side effects of chemotherapy and treatment with the client. 3.Teach the client to pace activities with rest so as to maintain strength. 4.Offer information on available counseling services and support groups. 6.Inquire how the cancer diagnosis and treatment affect the client's normal routine.

The nurse is monitoring the intravenous (IV) infusion of an antineoplastic medication to treat breast cancer. During the infusion, the client complains of pain at the insertion site. On inspection of the site, the nurse notes redness and swelling and that the infusion of the medication has slowed in rate. The nurse suspects extravasation and should take which actions? Select all that apply. 1.Stop the infusion. 2.Prepare to apply ice or heat to the site. 3.Notify the primary health care provider (PHCP). 4.Restart the IV at a distal part of the same vein. 5.Prepare to administer a prescribed antidote into the site. 6.Increase the flow rate of the solution to flush the skin and subcutaneous tissue.

1.Stop the infusion. 2.Prepare to apply ice or heat to the site. 3.Notify the primary health care provider (PHCP). 5.Prepare to administer a prescribed antidote into the site.

The nurse is assessing a client with liver disease for signs and symptoms of low albumin. Which sign or symptom should the nurse expect to note? 1. Weight loss 2. Peripheral edema 3.Capillary refill of 5 seconds 4. Bleeding from previous puncture sites

2. Peripheral edema

The primary health care provider has determined that a client has contracted hepatitis A based on flu-like symptoms and jaundice. Which statement made by the client supports this medical diagnosis? 1."I have had unprotected sex with multiple partners." 2."I ate shellfish about 2 weeks ago at a local restaurant." 3."I was an intravenous drug abuser in the past and shared needles." 4."I had a blood transfusion 30 years ago after major abdominal surgery."

2."I ate shellfish about 2 weeks ago at a local restaurant."

A sexually active young adult client has developed viral hepatitis. Which client statement indicates the need for further teaching? 1."I should avoid drinking alcohol." 2."I can go back to work right away." 3."My partner should get the vaccine." 4."A condom should be used for sexual intercourse."

2."I can go back to work right away."

The nurse is providing teaching to a client who will undergo chemotherapy for cancer, and alopecia is expected from the chemotherapeutic agent. Which statement made by the client indicates a need for further teaching? 1."Excessive hair brushing should be avoided." 2."I can't believe my hair loss will be permanent." 3."I guess I'll have to stop using my electric hair dryer and curling rod." 4."I will have my hair stylist cut my hair short just before I start my treatments."

2."I can't believe my hair loss will be permanent."

A home care nurse visits a client who was recently diagnosed with cirrhosis. The nurse provides home care management instructions to the client. Which client statement indicates a need for further instruction? 1."I will obtain adequate rest." 2."I will take acetaminophen if I get a headache." 3."I should monitor my weight on a regular basis." 4."I need to include sufficient amounts of carbohydrates in my diet.

2."I will take acetaminophen if I get a headache."

The nurse is reviewing the preoperative prescriptions for a client with a colon tumor who is scheduled for abdominal perineal resection and notes that the primary health care provider has prescribed neomycin for the client. After discussing a prescription for neomycin with the nursing student who is caring for the client, the nurse determines that the student understands the rationale for administration if which statement is made? 1."The client is allergic to penicillin." 2."It will help to decrease the bacteria in the bowel." 3."It is given to prevent an immune dysfunction postoperatively." 4."It is given because the client has an infection that must be treated prior to surgery."

2."It will help to decrease the bacteria in the bowel."

The nurse who is caring for a client with a diagnosis of cirrhosis is monitoring the client for signs of portal hypertension. Which finding should the nurse interpret as a sign or symptom of portal hypertension? 1.Flat neck veins 2.Abdominal distention 3.Hemoglobin of 14.2 g/dL (142 mmol/L) 4.Platelet count of 600,000 mm3 (600 × 109/L)

2.Abdominal distention

The nurse is caring for a client with leukemia. In assessing the client for signs of leukemia, the nurse determines that what should be monitored? 1.Platelet count 2.Bone marrow biopsy 3.White blood cell count 4.Complete blood cell count

2.Bone marrow biopsy

The nurse is giving instructions to a client with cholecystitis about food to exclude from the diet. Which food item identified by the client indicates that the educational session was successful? 1.Fresh fruit 2.Brown gravy 3.Fresh vegetables 4.Poultry without skin

2.Brown gravy

The nurse should incorporate which in the dietary plan to ensure optimal nutrition for the client during the acute phase of hepatitis? Select all that apply. 1.Select foods high in protein content. 2.Consume multiple small meals throughout the day. 3.Select foods low in carbohydrates to prevent nausea. 4.Allow the client to select foods that are most appealing. 5.Eliminate fatty foods from the meal trays until nausea subsides. 6.Eat a nutritious dinner because it is typically the best tolerated meal of the day.

2.Consume multiple small meals throughout the day. 4.Allow the client to select foods that are most appealing. 5.Eliminate fatty foods from the meal trays until nausea subsides.

For the client with stomatitis resulting from chemotherapy, the care plan should include which intervention? 1.Inspect the mouth every week for fungus. 2.Encourage foods with neutral or cool temperatures. 3.Give the client spicy foods to stimulate the sense of taste. 4.Perform frequent oral hygiene using a commercial alcohol-based mouthwash.

2.Encourage foods with neutral or cool temperatures.

A client is diagnosed with viral hepatitis, complaining of "no appetite" and "losing my taste for food." What instruction should the nurse give the client to provide adequate nutrition? 1.Select foods high in fat. 2.Increase intake of fluids, including juices. 3.Eat a good supper when anorexia is not as severe. 4.Eat less often, preferably only 3 large meals daily.

2.Increase intake of fluids, including juices.

A client with acute pancreatitis is experiencing severe pain from the disorder. The nurse determines that education about positioning to reduce pain was effective if the client avoids which action? 1.Sitting up 2.Lying flat 3.Leaning forward 4.Drawing the legs to the chest

2.Lying flat

A hospitalized client with liver disease has a dietary protein restriction. The nurse encourages intake of which source of complete proteins to maximize the availability of essential amino acids? 1.Nuts 2.Meats 3.Cereals 4.Vegetables

2.Meats

Cholestyramine resin is prescribed for a client with an elevated serum cholesterol level. The nurse should instruct the client to take the medication in which way? 1.After meals 2.Mixed with fruit juice 3.Via a rectal suppository 4.At least 3 hours before meals

2.Mixed with fruit juice

The nurse is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the nurse specifically note as a result of the massive cell destruction that occurred from the chemotherapy? 1.Anemia 2.Decreased platelets 3.Increased uric acid level 4.Decreased leukocyte count

3.Increased uric acid level

A client with viral hepatitis has no appetite, and food makes the client nauseated. Which nursing intervention is appropriate? 1.Encourage foods that are high in protein. 2.Monitor for fluid and electrolyte imbalance. 3.Explain that high-fat diets usually are better tolerated. 4.Explain that most daily calories need to be consumed in the evening hours.

2.Monitor for fluid and electrolyte imbalance.

The nurse is caring for a client with acute pancreatitis. Which medications should the nurse expect to be prescribed for treatment of this problem? Select all that apply. 1.Insulin 2.Morphine 3.Dicyclomine 4.Pancrelipase 5.Pantoprazole 6.Acetazolamide

2.Morphine 3.Dicyclomine 5.Pantoprazole 6.Acetazolamide

The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis who is scheduled for surgery in 2 hours. The client begins to complain of increased abdominal pain and begins to vomit. On assessment, the nurse notes that the abdomen is distended and bowel sounds are diminished. Which is the most appropriate nursing intervention? 1.Administer the prescribed pain medication. 2.Notify the primary health care provider (PHCP). 3.Call and ask the operating room team to perform surgery as soon as possible. ' 4.Reposition the client and apply a heating pad on the warm setting to the client's abdomen.

2.Notify the primary health care provider (PHCP).

The nurse is caring for a client with leukemia who is receiving intravenous chemotherapy. The nurse reviews the laboratory results and notes that the white blood cell count is 2000 mm3 (2 × 109/L), the platelet count is 150,000 mm3 (150 × 109/L), the clotting time is 10 minutes, and the ammonia level is 20 mcg/dL (12 mcmol/L). Which nursing action would be appropriate? 1.Place the client on bleeding precautions. 2.Place the client on neutropenic precautions. 3.Remove the rectal thermometer from the client's room. 4.Instruct the dietary department to eliminate all proteins from the client's diet.

2.Place the client on neutropenic precautions.

The nurse is monitoring a client with cirrhosis of the liver for signs of hepatic encephalopathy. Which assessment finding would the nurse note as an early sign of hepatic encephalopathy? 1. Restlessness 2.Presence of asterixis 3.Complaints of fatigue 4. Decreased serum ammonia levels

2.Presence of asterixis

The nurse is reviewing the laboratory test results for a client with a diagnosis of leukemia who is receiving chemotherapy. The nurse notes that the client's platelet count is 20,000 mm3 (200 × 109/L). The nurse should prepare to implement which action based on this finding? 1.Remove the fresh flowers from the client's room. 2.Remove the rectal thermometer from the client's room. 3.Instruct family members to wear a mask when entering the client's room. 4.Call the dietary department to report that the client will be on a low-bacteria diet.

2.Remove the rectal thermometer from the client's room.

The nurse is reviewing the laboratory test results for a client receiving chemotherapy. The nurse notes that the white blood cell count is extremely low and places the client on neutropenic precautions. Which interventions are components of these types of precautions? Select all that apply. 1.Allowing only fresh fruits in the client's room 2.Removing fresh-cut flowers from the client's room 3.Encouraging the client to eat any types of fresh vegetables 4.Instructing family members on the proper technique for hand washing 5.Instructing family members to wear a mask when entering the client's room

2.Removing fresh-cut flowers from the client's room 4.Instructing family members on the proper technique for hand washing 5.Instructing family members to wear a mask when entering the client's room

A client with laryngeal cancer has undergone laryngectomy and is now receiving external radiation therapy to the head and neck. The nurse should monitor the client for which side and adverse effects of external radiation? Select all that apply. 1.Cystitis 2.Stomatitis 3.Dysgeusia 4.Leukopenia 5.Xerostomia 6.Thrombocytopenia

2.Stomatitis 3.Dysgeusia

The nurse is preparing to care for a client with a diagnosis of metastatic cancer. The nurse notes documentation in the client's chart that the client is experiencing cachexia. Which should the nurse expect to note on assessment of the client? 1.Elevated blood pressure and ascites 2.Sunken eyes and a hollow cheek appearance 3.Periorbital edema and swelling around the ears 4.Generalized edema and the presence of weight gain

2.Sunken eyes and a hollow cheek appearance

A client who has been receiving radiation therapy for bladder cancer tells the nurse that it feels as if she is voiding through the vagina. The nurse interprets that the client may be experiencing which condition? 1.Rupture of the bladder 2.The development of a vesicovaginal fistula 3.Extreme stress caused by the diagnosis of cancer 4.Altered perineal sensation as a side effect of radiation therapy

2.The development of a vesicovaginal fistula

Lactulose is prescribed for a hospitalized client with a diagnosis of hepatic encephalopathy. Which assessment finding indicates that the client is responding to this medication therapy as anticipated? 1.Vomiting occurs. 2.The fecal pH is acidic. 3.The client experiences diarrhea. 4.The client is able to tolerate a full diet.

2.The fecal pH is acidic.

A client is admitted to the hospital with a diagnosis of acute pancreatitis. Which would the nurse expect the client to report about the pain? 1.Eating helps to decrease the pain. 2.The pain usually increases after vomiting. 3.The pain is mostly around the umbilicus and comes and goes. 4.The pain increases when the client sits up and bends forward.

2.The pain usually increases after vomiting.

The nurse is providing discharge instructions to a client who has undergone treatment of cervical cancer with a radiation (cesium) implant. Which instruction should the nurse provide to the client? 1.Avoid douching for at least 1 year. 2.Use a vaginal dilator 3 times a week. 3.Sexual activity can be resumed in about 2 months. 4.Bed rest is recommended for at least 1 week after discharge.

2.Use a vaginal dilator 3 times a week.

The nurse is obtaining a health history for a client with chronic pancreatitis. The health history is most likely to include which as a most common causative factor in this client's disorder? 1.Weight gain 2.Use of alcohol 3.Exposure to occupational chemicals 4.Abdominal pain relieved with food or antacids

2.Use of alcohol

The health education nurse provides instructions to a group of clients regarding measures that will assist in preventing skin cancer. Which instructions should the nurse provide? Select all that apply. 1.Sunscreen should be applied every 8 hours. 2.Use sunscreen when participating in outdoor activities. 3.Wear a hat, opaque clothing, and sunglasses when in the sun. 4.Avoid sun exposure in the late afternoon and early evening hours. 5.Examine your body monthly for any lesions that may be suspicious.

2.Use sunscreen when participating in outdoor activities. 3.Wear a hat, opaque clothing, and sunglasses when in the sun. 5.Examine your body monthly for any lesions that may be suspicious.

The nurse in the ambulatory care unit is providing home care instructions to a client after cryotherapy for the treatment of malignant skin lesions. Which statement would be most appropriate for the nurse to include in the home care instructions for this client? 1."Apply ice to the site to prevent swelling." 2."Clean the site with alcohol 3 times daily." 3."Apply a warm, damp washcloth if discomfort occurs." 4."Avoid showering or taking baths until seen by the primary health care provider in 1 week."

3."Apply a warm, damp washcloth if discomfort occurs."

A client with viral hepatitis is having difficulty coping with the disorder. Which question by the nurse is the most appropriate in identifying the client's coping problem? 1."Do you have a fever?" 2."Are you losing weight?" 3."Have you enjoyed having visitors?" 4."Do you rest sometime during the day?"

3."Have you enjoyed having visitors?"

The nurse has given instructions to a client with hepatitis about postdischarge management during convalescence. The nurse determines that further teaching is needed if the client makes which statement? 1."I need to avoid alcohol and aspirin." 2."I should eat a high-carbohydrate, low-fat diet." 3."I can resume a full activity level within 1 week." 4."I need to take the prescribed amounts of vitamin K."

3."I can resume a full activity level within 1 week."

The nurse is providing instructions to the client who is receiving external radiation therapy. Which statement, if made by the client, indicates the need for further instruction? 1."I will dry affected areas with patting motions." 2."I will wear soft clothing over the affected site." 3."I will use a washcloth to wash the affected area." 4."I need to make sure I carry my purse on the unaffected side."

3."I will use a washcloth to wash the affected area."

As part of chemotherapy education, the nurse teaches a female client about the risk for bleeding and self-care during the period of greatest bone marrow suppression (the nadir). The nurse understands that further teaching is needed if the client makes which statement 1."I should avoid blowing my nose." 2."I may need a platelet transfusion if my platelet count is too low." 3."I'm going to take aspirin for my headache as soon as I get home." 4."I will count the number of pads and tampons I use when menstruating."

3."I'm going to take aspirin for my headache as soon as I get home."

A client with viral hepatitis is discussing with the nurse the need to avoid alcohol and states, "I'm not sure I can avoid alcohol." What is the most appropriate nursing response? 1."I don't believe that." 2."Everything will be all right." 3."I'm not sure that I understand. Would you please explain?" 4."I think you should talk more with the primary health care provider about this."

3."I'm not sure that I understand. Would you please explain?"

The nurse is caring for a client undergoing external radiation. The client has developed a dry desquamation of the skin in the treatment area, and the nurse is teaching about management of the skin reaction. Which comment made by the client suggests understanding of the instructions? 1."I don't need to stay out of the sun or put on sunscreen." 2."I can use ice packs to relieve itching in the treatment area." 3."When bathing I will use lukewarm water on the affected area." 4."I can lubricate the irritated area with an ointment like bacitracin."

3."When bathing I will use lukewarm water on the affected area."

A clinic nurse prepares a teaching plan for a client receiving an antineoplastic medication. When implementing the plan, the nurse should make which statement to the client? 1."You can take aspirin as needed for headache." 2."You can drink beverages containing alcohol in moderate amounts each evening." 3."You need to consult with the primary health care provider (PHCP) before receiving immunizations." 4."It is fine to receive a flu vaccine at the local health fair without PHCP approval because the flu is so contagious."

3."You need to consult with the primary health care provider (PHCP) before receiving immunizations."

A client seen in the ambulatory care clinic has ascites and slight jaundice. The nurse should assess the client for a history of chronic use of which medication? 1.Ibuprofen 2.Ranitidine 3.Acetaminophen 4.Acetylsalicylic acid

3.Acetaminophen

The nurse is developing a teaching plan for a client with viral hepatitis. The nurse should plan to include which information in the teaching session? 1.The diet should be low in calories. 2.Meals should be large to conserve energy. 3.Activity should be limited to prevent fatigue. 4.Alcohol intake should be limited to 2 ounces per day.

3.Activity should be limited to prevent fatigue.

The nurse is reviewing the record of a client with a diagnosis of cirrhosis and notes that there is documentation of the presence of asterixis. How should the nurse assess for its presence? 1.Dorsiflex the client's foot. 2.Measure the abdominal girth. 3.Ask the client to extend the arms. 4.Instruct the client to lean forward.

3.Ask the client to extend the arms.

The nurse is caring for a client after intravesical instillation of an alkylating chemotherapeutic agent for the treatment of bladder cancer. What should the nurse instruct the client to do after the instillation? 1.Urinate immediately. 2.Maintain strict bed rest. 3.Change position every 15 minutes. 4.Retain the instillation fluid for 30 minutes.

3.Change position every 15 minutes.

Which interventions are the most appropriate for a client who is experiencing thrombocytopenia? Select all that apply. 1.Use a straight-edge razor for shaving. 2.Obtain a rectal temperature every 8 hours. 3.Check secretions for frank or occult blood. 4.Give vitamin K by the intramuscular route. 5.Encourage fluid intake to avoid constipation. 6.Provide oral sponges or a soft toothbrush for oral care.

3.Check secretions for frank or occult blood. 5.Encourage fluid intake to avoid constipation. 6.Provide oral sponges or a soft toothbrush for oral care.

The nurse is assessing a client 24 hours following a cholecystectomy. The nurse notes that the T-tube has drained 750 mL of green-brown drainage since the surgery. Which nursing intervention is most appropriate? 1.Clamp the T-tube. 2.Irrigate the T-tube. 3.Document the findings. 4.Notify the primary health care provider.

3.Document the findings.

The nurse is caring for a client with pancreatitis. Which finding should the nurse expect to note when reviewing the client's laboratory results? 1.Elevated level of pepsin 2.Decreased level of lactase 3.Elevated level of amylase 4.Decreased level of enterokinase

3.Elevated level of amylase

The nurse manager is providing an educational session to nursing staff members about the phases of viral hepatitis. The nurse manager tells the staff that which clinical manifestation(s) are primary characteristics of the preicteric phase? 1.Pruritus 2.Right upper quadrant pain 3.Fatigue, anorexia, and nausea 4.Jaundice, dark-colored urine, and clay-colored stools

3.Fatigue, anorexia, and nausea

The nurse is assigned to care for a client with a Sengstaken-Blakemore tube. Which laboratory result is most focused on evaluating the effectiveness of this tube? 1.Sodium 2.Creatinine 3.Hemoglobin 4.Ammonia

3.Hemoglobin

The nurse is caring for a client with altered protein metabolism as a result of liver dysfunction. Which finding should the nurse expect to note when reviewing the client's laboratory results? 1.Increased lactase level 2.Decreased albumin level 3.Increased ammonia level 4.Decreased lactic acid level

3.Increased ammonia level

Chemotherapy dosage is frequently based on total body surface area (BSA), so it is important for the nurse to perform which assessment before administering chemotherapy? 1.Measure the client's abdominal girth. 2.Calculate the client's body mass index. 3.Measure the client's current weight and height. 4.Ask the client about his or her weight and height.

3.Measure the client's current weight and height.

The nurse is reviewing the laboratory results for a client with cirrhosis and notes that the ammonia level is 85 mcg/dL (51 mcmol/L). Which dietary selection does the nurse suggest to the client? 1.Roast pork 2.Cheese omelet 3.Pasta with sauce 4.Tuna fish sandwich

3.Pasta with sauce

The nurse is monitoring a client for signs and symptoms related to superior vena cava syndrome. Which is an early sign of this oncological emergency? 1.Cyanosis 2.Arm edema 3.Periorbital edema 4.Mental status changes

3.Periorbital edema

The clinic nurse prepares instructions for a client diagnosed with leukemia who developed stomatitis after the administration of a course of antineoplastic medications. The nurse should provide the client with which instruction? 1.Avoid foods and fluids for the next 12 to 24 hours. 2.Swab the mouth with lemon and glycerin 4 times a day. 3.Rinse the mouth with a diluted solution of baking soda or saline. 4.Brush the teeth with a stiff-bristled toothbrush, and use dental floss 3 times a day.

3.Rinse the mouth with a diluted solution of baking soda or saline.

A client is receiving external radiation to the neck for cancer of the larynx. Which is the most likely expected effect? 1.Dyspnea 2.Diarrhea 3.Sore throat 4.Constipation

3.Sore throat

A client has been hospitalized for removal of a cervical radiation implant used to treat cancer. The implant is removed, and the nurse provides home care instructions to the client. Which statement made by the client indicates a need for further instruction? 1."Cream may be used to relieve dryness or itching." 2."Some vaginal bleeding is expected for 1 to 3 months." 3."Sexual intercourse may be resumed after 7 to 10 days." 4."Foul-smelling vaginal discharge is a sign of an infection."

4."Foul-smelling vaginal discharge is a sign of an infection."

The nurse has provided instructions to a client receiving external radiation therapy. Which client statement would indicate a need for further instruction regarding self-care related to the radiation therapy? 1."I need to eat a high-protein diet." 2."I need to avoid exposure to sunlight." 3."I need to wash my skin with a mild soap and pat dry." 4."I need to apply pressure on the irritated area by wearing snug clothing to prevent bleeding."

4."I need to apply pressure on the irritated area by wearing snug clothing to prevent bleeding."

The nurse teaches skin care to a client receiving external radiation therapy. Which client statement indicates the need for further instruction? 1."I will handle the area gently." 2."I will wear loose-fitting clothing." 3."I will avoid the use of deodorants." 4."I will limit sun exposure to 1 hour daily."

4."I will limit sun exposure to 1 hour daily."

The nurse is performing an assessment on a client with suspected acute pancreatitis. Which complaint made by the client supports the diagnosis? 1."I have epigastric pain radiating to my neck." 2."I have severe abdominal pain that is relieved after vomiting." 3."My temperature has been running between 96º F (35.5º C) and 97º F (36.1º C)." 4."I've been experiencing constant, severe abdominal pain that is unrelieved by vomiting."

4."I've been experiencing constant, severe abdominal pain that is unrelieved by vomiting."

A client with cirrhosis complicated by ascites is admitted to the hospital. The client reports a 10-lb weight gain over the past 1½ weeks. The client has edema of the feet and ankles, and his abdomen is distended, taut, and shiny with striae. Which client problem is most appropriate at this time? 1. Difficulty with sleeping 2. Risk for skin breakdown 3. Difficulty with breathing 4.Excessive body fluid volume

4.Excessive body fluid volume

A client admitted to the hospital with a suspected diagnosis of acute pancreatitis is being assessed by the nurse. Which assessment findings would be consistent with acute pancreatitis? Select all that apply. 1.Diarrhea 2.Black, tarry stools 3.Hyperactive bowel sounds 4.Gray-blue color at the flank 5.Abdominal guarding and tenderness 6.Left upper quadrant pain with radiation to the back

4.Gray-blue color at the flank 5.Abdominal guarding and tenderness 6.Left upper quadrant pain with radiation to the back

A client with leukemia is receiving busulfan and allopurinol. The nurse should tell the client that the purpose of the allopurinol is to prevent which symptom? 1.Nausea 2.Alopecia 3.Vomiting 4.Hyperuricemia

4.Hyperuricemia

The nurse assists a primary health care provider in performing a liver biopsy. After the procedure, the nurse should place the client in which position? 1.Prone 2.Supine 3.Left side 4.Right side

4.Right side

A 67-year-old man is receiving outpatient radiation treatments for carcinoma of the oropharynx and has developed dysphagia. The nurse develops a teaching plan regarding dysphagia and includes which interventions in the plan? Select all that apply. 1.Teach the man to speak slowly. 2.Teach the man to enunciate clearly. 3.Encourage the man to drink only thin liquids. 4.Teach the man to examine his oral mucosa daily. 5.Encourage the man to use artificial saliva to manage dryness.

4.Teach the man to examine his oral mucosa daily. 5.Encourage the man to use artificial saliva to manage dryness.

A client receiving chemotherapy is experiencing mucositis. The nurse should advise the client to use which item as the best substance to rinse the mouth? 1.Alcohol-based mouthwash 2.Hydrogen peroxide mixture 3.Lemon-flavored mouthwash 4.Weak salt and bicarbonate mouth rinse

4.Weak salt and bicarbonate mouth rinse