Module 4-5 Review Questions (exam 3)
A nurse teaches a client who is at risk for colon cancer. Which dietary recommendation should the nurse teach this client? a. "Eat low-fiber and low-residual foods." b. "White rice and bread are easier to digest." c. "Add vegetables such as broccoli and cauliflower to your new diet." d. "Foods high in animal fat help to protect the intestinal mucosa."
"Add vegetables such as broccoli and cauliflower to your new diet."
A client who is scheduled to undergo radiation for prostate cancer is admitted to the hospital by the nurse. Which statement by the client is most important to communicate to the health care provider? "I am allergic to iodine." "My urinary stream is very weak." "My legs are numb and weak." "I am incontinent when I cough."
"My legs are numb and weak."
A patient is receiving care to manage symptoms of a terminal illness when the disease no longer responds to treatment. What is this type of care known as? 1. Terminal care 2. Palliative care 3. Supportive care 4. Maintenance care
2. Palliative care
A nurse assesses clients at a community health center. Which client is at highest risk for the development of colorectal cancer? a. A 37-year-old who drinks eight cups of coffee daily b. A 44-year-old with irritable bowel syndrome (IBS) c. A 60-year-old lawyer who works 65 hours per week d. A 72-year-old who eats fast food frequently
A 72-year-old who eats fast food frequently
. A nurse prepares a client for a colonoscopy scheduled for tomorrow. The client states, "My doctor told me that the fecal occult blood test was negative for colon cancer. I don't think I need the colonoscopy and would like to cancel it." How should the nurse respond? a. "Your doctor should not have given you that information prior to the colonoscopy." b. "The colonoscopy is required due to the high percentage of false negatives with the blood test." c. "A negative fecal occult blood test does not rule out the possibility of colon cancer." d. "I will contact your doctor so that you can discuss your concerns about the procedure."
A negative fecal occult blood test does not rule out the possibility of colon cancer."
When caring for the client with chemotherapy-induced mucositis, which intervention will be most helpful? Administering a biological response modifier Encouraging oral care with commercial mouthwash Providing oral care with a disposable mouth swab Maintaining NPO until the lesions have resolved
Providing oral care with a disposable mouth swab
What is the effect of finasteride (Proscar) in the treatment of BPH? A. A reduction in the size of the prostate gland. B. Relaxation of the smooth muscle of the urethra C. Increased bladder tone that promotes bladder emptying D. Relaxation of the bladder detrusor muscle promoting urine flow.
A. A reduction in the size of the prostate gland.
Patients receiving chemotherapy are at risk for thrombocytopenia related to chemotherapy or disease processes. Which actions are needed for patients who must be placed on bleeding precautions? (Select all that apply). A. Provide mouthwash with alcohol for oral rinsing. B. Use paper tape on fragile skin. C. Provide a soft toothbrush or oral sponge. D. Gently insert rectal suppositories. E. Avoid aspirin or aspirin-containing products. F. Avoid over-inflation of blood pressure cuffs. G. Pad sharp corners of furniture.
A. Use paper tape on fragile skin. B. Provide a soft toothbrush or oral sponge. D. Avoid aspirin or aspirin-containing products. E. Avoid over-inflation of blood pressure cuffs. F. Pad sharp corners of furniture.
For a patient who is receiving chemotherapy, which laboratory result is of particular importance? A. White blood cell count (WBC) B. Prothrombin time and partial thromboplastin time C. Electrolyte levels D. Blood urea nitrogen level
A. White blood cell count (WBC)
A nurse assesses a client who is prescribed alosetron (Lotronex). Which assessment question should the nurse ask this client? a. "Have you been experiencing any constipation? "b. "Are you eating a diet high in fiber and fluids?" c. "Do you have a history of high blood pressure?" d. "What vitamins and supplements are you taking?"
ANS: A Ischemic colitis is a life-threatening complication of alosetron. The nurse should assess the client for constipation. The other questions do not identify complications related to alosetron.
A nurse assesses a client with irritable bowel syndrome (IBS). Which questions should the nurse include in this client's assessment? (Select all that apply.) a. "Which food types cause an exacerbation of symptoms?" b. "Where is your pain and what does it feel like?" c. "Have you lost a significant amount of weight lately?" d. "Are your stools soft, watery, and black in color?" e. "Do you experience nausea associated with defecation?"
ANS: A, B, E The nurse should ask the client about factors that may cause exacerbations of symptoms, including food, stress, and anxiety. The nurse should also assess the location, intensity, and quality of the client's pain, and nausea associated with defecation or meals. Clients who have IBS do not usually lose weight and stools are not black in color.
A nurse inserts a nasogastric (NG) tube for an adult client who has a bowel obstruction. Which actions does the nurse perform correctly? (Select all that apply.) a. Performs hand hygiene and positions the client in high-Fowler's position, with pillows behind the head and shoulders b. Instructs the client to extend the neck against the pillow once the NG tube has reached the oropharynx c. Checks for correct placement by checking the pH of the fluid aspirated from the tube d. Secures the NG tube by taping it to the client's nose and pinning the end to the pillowcase e. Connects the NG tube to intermittent medium suction with an anti-reflux valve on the air vent
ANS: A, C, E The client's head should be flexed forward once the NG tube has reached the oropharynx. The NG tube should be secured to the client's gown, not to the pillowcase, because it could become dislodged easily. All the other actions are appropriate.
A nurse assesses clients at a community health center. Which client is at highest risk for the development of colorectal cancer? a. A 37-year-old who drinks eight cups of coffee daily b. A 44-year-old with irritable bowel syndrome (IBS) C. A 60-year-old lawyer who works 65 hours per week d. A 72-year-old who eats fast food frequently
ANS: D Colon cancer is rare before the age of 40, but its incidence increases rapidly with advancing age. Fast food tends to be high in fat and low in fiber, increasing the risk for colon cancer. Coffee intake, IBS, and a heavy workload do not increase the risk for colon cancer.
A nurse cares for a client who has a new colostomy. Which action should the nurse take? a. Empty the pouch frequently to remove excess gas collection. b. Change the ostomy pouch and wafer every morning. c. Allow the pouch to completely fill with stool prior to emptying it. d. Use surgical tape to secure the pouch and prevent leakage.
ANS: AThe nurse should empty the new ostomy pouch frequently because of excess gas collection, and empty the pouch when it is one-third to one-half full of stool. The ostomy pouch does not need to be changed every morning. Ostomy wafers with paste should be used to secure and seal the ostomy appliance; surgical tape should not be used.
After teaching a client with irritable bowel syndrome (IBS), a nurse assesses the client's understanding. Which menu selection indicates that the client correctly understands the dietary teaching? a. Ham sandwich on white bread, cup of applesauce, glass of diet cola b. Broiled chicken with brown rice, steamed broccoli, glass of apple juice c. Grilled cheese sandwich, small banana, cup of hot tea with lemond. Baked tilapia, fresh green beans, cup of coffee with low-fat milk
ANS: B Clients with IBS are advised to eat a high-fiber diet (30 to 40 g/day), with 8 to 10 cups of liquid daily. Chicken with brown rice, broccoli, and apple juice has the highest fiber content. They should avoid alcohol, caffeine, and other gastric irritants.
An emergency room nurse assesses a client after a motor vehicle crash and notes ecchymotic areas across the client's lower abdomen. Which action should the nurse take first? a. Measure the client's abdominal girth. b. Assess for abdominal guarding or rigidity. c. Check the client's hemoglobin and hematocrit. d. Obtain the client's complete health history.
ANS: B On noticing the ecchymotic areas, the nurse should check to see if abdominal guarding or rigidity is present, because this could indicate major organ injury. The nurse should then notify the provider. Measuring abdominal girth or obtaining a complete health history is not appropriate at this time. Laboratory test results can be checked after assessment for abdominal guarding or rigidity.
A nurse assessing a client with colorectal cancer auscultates high-pitched bowel sounds and notes the presence of visible peristaltic waves. Which action should the nurse take? a. Ask if the client is experiencing pain in the right shoulder. b. Perform a rectal examination and assess for polyps. c. Contact the provider and recommend computed tomography. d. Administer a laxative to increase bowel movement activity.
ANS: C The presence of visible peristaltic waves, accompanied by high-pitched or tingling bowel sounds, is indicative of partial obstruction caused by the tumor. The nurse should contact the provider with these results and recommend a computed tomography scan for further diagnostic testing. This assessment finding is not associated with right shoulder pain; peritonitis and cholecystitis are associated with referred pain to the right shoulder. The registered nurse is not qualified to complete a rectal examination for polyps, and laxatives would not help this client.
A nurse assesses a client with a mechanical bowel obstruction who reports intermittent abdominal pain. An hour later the client reports constant abdominal pain. Which action should the nurse take next?a. Administer intravenous opioid medications. b. Position the client with knees to chest. c. Insert a nasogastric tube for decompression. d. Assess the client's bowel sounds.
ANS: D A change in the nature and timing of abdominal pain in a client with a bowel obstruction can signal peritonitis or perforation. The nurse should immediately check for rebound tenderness and the absence of bowel sounds. The nurse should not medicate the client until the provider has been notified of the change in his or her condition. The nurse may help the client to the knee-chest position for comfort, but this is not the priority action. The nurse need not insert a nasogastric tube for decompression.
The nurse teaches a client that intraperitoneal chemotherapy will be delivered to which part of the body? Veins of the legs Lung Heart Abdominal cavity
Abdominal cavity
A 72-year-old client recovering from lung cancer surgery asks the nurse to explain how she developed cancer when she has never smoked. Which factor may explain the possible cause? A diagnosis of diabetes treated with insulin and diet An exercise regimen of jogging 3 miles four times a week A history of cardiac disease Advancing age
Advancing age
The nurse is caring for a client who is receiving rituximab (Rituxan) for treatment of lymphoma. During the infusion, it is essential for the nurse to observe for which side effect? Alopecia Allergy Fever Chills
Allergy
When caring for the client with hyperuricemia associated with tumor lysis syndrome (TLS), for which medication does the nurse anticipate an order? Recombinant erythropoietin (Procrit) Allopurinol (Zyloprim) Potassium chloride Radioactive iodine-131 (131I)
Allopurinol (Zyloprim)
A client who is undergoing chemotherapy for breast cancer reports problems with concentration and memory. Which nursing intervention is indicated at this time? Explain that this occurs in some clients and is usually permanent. Inform the client that a small glass of wine may help her relax. Protect the client from infection. Allow the client an opportunity to express her feelings.
Allow the client an opportunity to express her feelings.
The nurse has been caring for a 65-year-old male patient who has just died. In planning for follow-up bereavement care, the nurse knows that which person is at risk for disenfranchised grief? a. A daughter who lives in a different state b. The son who was with the client when he died c. An estranged ex-wife of the patient who lives nearby d. The 16-year-old grandchild of the patient
An estranged ex-wife of the patient who lives nearby
A nurse assesses a client with a mechanical bowel obstruction who reports intermittent abdominal pain. An hour later the client reports constant abdominal pain. Which action should the nurse take next? a. Administer intravenous opioid medications. b. Position the client with knees to chest. c. Insert a nasogastric tube for decompression. d. Assess the client's bowel sounds
Assess the client's bowel sounds
Following a generalized tonic-clonic seizure, the patient is tired and sleepy. What care should the nurse provide? A. Suction the patient before allowing him to rest. B. Allow the patient to sleep as long as he feels sleepy. C. Stimulate the patient to increase his level of consciousness. D. Check the patient's level of consciousness every 15 minutes for an hour.
B. Allow the patient to sleep as long as he feels sleepy
A patient with continuous bladder irrigation following a prostatectomy tells the nurse that he has bladder spasms and leaking of urine around the catheter. What should the nurse do first? A. Slow the rate of the irrigation. B. Assess the patency of the catheter. C. Encourage the patient to try to urinate around the catheter. D. Administer a belladonna and opium (B&O) suppository as prescribed.
B. Assess the patency of the catheter.
Before undergoing a TURP, what should the patient be taught? A. Some degree of urinary incontinence is likely to occur. B. This surgery results in some degree of retrograde ejaculation. C. Erectile dysfunction is a common complication of this prostate surgery. D. An indwelling catheter will be used to maintain urinary output until healing is complete.
B. This surgery results in some degree of retrograde ejaculation
The nurse suspects metastasis from left breast cancer to the thoracic spine when the client has which symptom? Vomiting Back pain Frequent urination Cyanosis of the toes
Back pain
A client has a glioblastoma. The nurse begins to plan care for this client with which type of cancer? Liver (hepato) Smooth muscle (leiomyo) Fatty tissue (lipo) Brain
Brain
A client has a diagnosis of lung cancer. To which areas does the nurse anticipate that this client's tumor may metastasize? (Select all that apply.) Brain Bone Lymph nodes Kidneys Liver
Brain, Bone, Lymph Nodes, Liver
When teaching a patient with a seizure disorder about the medication regimen, what is to most important for the nurse to emphasize? A. The patient should increase the dosage of the medication if stress is increased. B. Most over-the-counter and prescription drugs are safe to take with antiseizure drugs. C. Stopping the medication abruptly may increase the intensity and frequency of seizures. D. If gingival hypertrophy occurs, the HCP should be notified and the drug may be changed.
C. Stopping the medication abruptly may increase the intensity and frequency of seizures.
Which finding alarms the nurse when caring for a client receiving chemotherapy who has a platelet count of 17,000/mm3? Increasing shortness of breath Diminished bilateral breath sounds Change in mental status Weight gain of 4 pounds in 1 day
Change in mental status
The oncology nurse is caring for a group of clients receiving chemotherapy. The client with which sign/symptom is displaying bone marrow suppression? Hemoglobin of 7.4 and hematocrit of 21.8 Potassium level of 2.9 mEq/L and diarrhea 250,000 platelets/mm3 5000 white blood cells/mm3
Hemoglobin of 7.4 and hematocrit of 21.8
While caring for a female patient with advanced multiple sclerosis, the nurse is discussing the difference between hospice and palliative care. Which statement by the patient indicates understanding of the difference between hospice and palliative care? a. "I will need to get hospice care if I want my symptoms controlled." b. "I can get palliative care right now— even though I am not going to die anytime soon." c. "My doctor has to make the decision if I have hospice care." d. "I can't get any other treatments, even if they are experimental, if I choose palliative care."
I can get palliative care right now— even though I am not going to die anytime soon."
The nurse is caring for a client with end-stage ovarian cancer who needs clarification on the purpose of palliative surgery. Which outcome should the nurse teach the client is the goal of palliative surgery? Cure of the cancer Relief of symptoms or improved quality of life Allowing other therapies to be more effective Prolonging the client's survival time
Relief of symptoms or improved quality of life
The process of digestion is important for every living organism for the purpose of nourishment. Where does most digestion take place in the body? 1. Large intestine 2. Small Intestines 3. Stomach 4. pancreas
Small Intestines
Which type of seizure is most likely to cause death for the patient? A. Status epilepticus B. Myoclonic seizures C. Subclinical seizures D. Psychogenic seizures
Status epilepticus
Which activity performed by the community health nurse best reflects primary prevention of cancer? Assisting women to obtain free mammograms Teaching a class on cancer prevention Encouraging long-term smokers to get a chest x-ray Encouraging sexually active women to get annual Papanicolaou (Pap) smears
Teaching a class on cancer prevention
When conducting a health history assessment, the nurse would want to know what important information about the patient's elimination status? (Select all that apply.) a. Recent changes in elimination patterns b. Changes in color, consistency, or odor of stool or urine c. Time of day patient defecates d. Discomfort or pain with elimination e. List of medications taken by patient f. Patient's preferences for toileting
a. Recent changes in elimination patterns b. Changes in color, consistency, or odor of stool or urine
A newly graduated RN has just finished a 6-week orientation to the oncology unit. Which client is most appropriate to assign to the new graduate? A 30-year-old with acute lymphocytic leukemia who will receive combination chemotherapy today A 40-year-old with chemotherapy-induced nausea and vomiting who has had no urine output for 16 hours A 45-year-old with pancytopenia who will require IV administration of erythropoietin (Procrit) A 72-year-old with tumor lysis syndrome who is receiving normal saline IV at a rate of 250 mL/hr
A 45-year-old with pancytopenia who will require IV administration of erythropoietin (Procrit)
A patient admitted to the hospital following a generalized tonic-clonic seizure asks the nurse what caused the seizure. What is the best response by the nurse? A. "So many factors can cause epilepsy that it is impossible to say what caused your seizure." B. "Epilepsy is an inherited disorder. Does anyone else in your family have a seizure disorder?" C. "In seizures, some type of trigger causes sudden, abnormal bursts of electrical discharges." D. "Scar tissue in the brain alters the chemical balance, creating uncontrolled electrical discharges."
A. "In seizures, some type of trigger causes sudden, abnormal bursts of electrical discharges."
What laboratory result would indicate that an elderly client with dementia has not been drinking enough fluids and could be at risk for AKI? A. Creatinine 1.5 mg/dL B. Hemoglobin 14 mg/dL C. Serum sodium 153 D. Urine specific gravity 1.003
A. Creatinine 1.5 mg/dL
The nurse finds a patient in bed having a generalized tonic-clonic seizure. During the seizure activity, what actions should the nurse take first (select all that apply)? A. Loosen restrictive clothing. B. Turn the patient to the side. C. Protect the patient's head from injury. D. Place a padded tongue blade between the patient's teeth. Restrain the patient's extremities to prevent soft tissue and bone injur
A. Loosen restrictive clothing. B. Turn the patient to the side. C. Protect the patient's head from injury.
43. A terminally ill patient is unresponsive and has cold, clammy skin with mottling on the extremities. The patient's husband and two grown children are arguing at the bedside about where the patient's funeral should be held. What should the nurse do first? A. Ask the family members to leave the room if they are going to argue. B. Take the family members aside and explain that the patient may be able to hear them. C. Tell the family members that this decision is premature because the patient has not yet died. D. Remind the family that this should be the patient's decision and to ask her if she regains consciousness.
A. Take the family members aside and explain that the patient may be able to hear them.
In the care of a patient with neutropenia, what tasks can be delegated to a UAP? (Select all that apply). A. Taking VS every 4 hours B. Reporting temperature of more than 100.4F. C. Assessing for sore throat, cough, or burning with urination. D. Gathering the supplies to prepare the room for protective isolation. E. Reporting superinfections, such as candidiasis. Practicing good hand-washing technique
A. Taking VS every 4 hours B. Reporting temperature of more than 100.4F C. Gathering the supplies to prepare the room for protective isolation. D. Practicing good hand-washing technique.
A nurse cares for a client who is recovering from a hemorrhoidectomy. The client states, "I need to have a bowel movement." Which action should the nurse take? a. Obtain a bedside commode for the client to use. b. Stay with the client while providing privacy. c. Make sure the call light is in reach to signal completion. d. Gather supplies to collect a stool sample for the laboratory
ANS: B The first bowel movement after hemorrhoidectomy can be painful enough to induce syncope. The nurse should stay with the client. The nurse should instruct clients who are discharged the same day to have someone nearby when they have their first postoperative bowel movement. Making sure the call light is within reach is an important nursing action too, but it does not take priority over client safety. Obtaining a bedside commode and taking a stool sample are not needed in this situation.
Which finding alarms the nurse when caring for a client receiving chemotherapy who has a platelet count of 17,000/mm3? Increasing shortness of breath Diminished bilateral breath sounds Change in mental status Weight gain of 4 pounds in 1 day
Change in mental status
In caring for a dying patient, what is an appropriate nursing action to increase family involvement? a. Insisting that all bedside care be performed by the family b. Asking family members what they would like to do for their loved one and allowing them to participate c. Expecting the family to be able to perform the patient's daily needs and to meet them consistently d. Refusing all assistance from the family, to decrease family stress
Asking family members what they would like to do for their loved one and allowing them to participate
The nurse is teaching a client who is receiving an antiestrogen drug about the side effects she may encounter. Which side effects does the nurse include in the discussion? (Select all that apply.) Heavy menses Smooth facial skin Hyperkalemia Breast tenderness Weight loss Deep vein thrombosis
Breast tenderness Deep vein thrombosis
What are the common cancers related to tobacco use? (Select all that apply.) Cardiac cancer Lung cancer Cancer of the tongue Skin cancer Cancer of the larynx
Lung cancer Cancer of the tongue Cancer of the larynx
Several theorists have identified stages of the grieving process. The nurse understands these stages and knows that people progress through them in an individualized manner. Which statement is true regarding the steps of the grieving process? a. There is a definite "timetable" or period of time specific to each stage of the grieving process. b. Nursing interventions are generalized across all stages of the grieving process. c. Tasks to be achieved at each stage have been identified by each theorist. d. There is a common stepwise progression through each stage of the grieving process.
Tasks to be achieved at each stage have been identified by each theorist.
The nurse manager in a long-term care facility is developing a plan for primary and secondary prevention of colorectal cancer. Which tasks associated with the screening plan will be delegated to nursing assistants within the facility? Testing of stool specimens for occult blood Teaching about the importance of dietary fiber Referring clients for colonoscopy procedures Giving vitamin and mineral supplements
Testing of stool specimens for occult blood
The nurse is administering finasteride (Proscar) and doxazosin (Cardura) to a 67-year-old client with benign prostatic hyperplasia. What precautions are related to the side effects of these medications? (Select all that apply.) a. Assessing for blood pressure changes when lying, sitting, and arising from the bed b. Immediately reporting any change in the alanine aminotransferase laboratory test c. Teaching the client about the possibility of increased libido with these medications d. Taking the client's pulse rate for a minute in anticipation of bradycardia e. Asking the client to report any weakness, lightheadedness, or dizziness
a. Assessing for blood pressure changes when lying, sitting, and arising from the bed b. Immediately reporting any change in the alanine aminotransferase laboratory test e. Asking the client to report any weakness, lightheadedness, or dizziness
The nurse presents a cancer prevention program to teens. Which instruction will have the greatest impact in cancer prevention? Avoid asbestos. Wear sunscreen. Get the human papilloma virus (HPV) vaccine. Do not smoke cigarettes Do not smoke cigarettes The nurse susp
Do not smoke cigarettes
The nurse is assessing a client with lung cancer. Which symptom does the nurse anticipate finding? Easy bruising Dyspnea Night sweats Chest wound
Dyspnea
Which manifestation of an oncologic emergency requires the nurse to contact the health care provider immediately? New onset of fatigue Edema of arms and hands Dry cough Weight gain
Edema of arms and hands
A client newly admitted to an in-patient psychiatric unit is diagnosed with obsessive compulsive disorder. Which behavioral symptom would the nurse expect to assess? A. The client uses excessive hand washing to relieve anxiety. B. The client rates anxiety at 8/10 C. The client uses breathing techniques to decrease anxiety. D. The client exhibits diaphoresis and tachycardia.
A. The client uses excessive hand washing to relieve anxiety.
A patient in the last stages of life is experiencing shortness of breath and air hunger. Based on practice guidelines, what is the most appropriate action by the nurse? A. Administer oxygen. B. Administer bronchodilators. C. Administer antianxiety agents. D. Use any methods that make the patient more comfortable
A. Use any methods that make the patient more comfortable.
The nurse has received in report that a client receiving chemotherapy has severe neutropenia. Which interventions does the nurse plan to implement? (Select all that apply.) Assess for fever. Observe for bleeding. Administer pegfilgrastim (Neulasta). Do not permit fresh flowers or plants in the room. Do not allow the client's 16-year-old son to visit. Teach the client to omit raw fruits and vegetables from the diet.
Assess for fever Administer pegfilgrastim (Neulasta). Do not permit fresh flowers or plants in the room. Teach the client to omit raw fruits and vegetables from the diet.
A client with a history of prostate cancer is in the clinic and reports new onset of severe low back pain. What action by the nurse is most important? a. Assess the client's gait and balance. b. Ask the client about the ease of urine flow. c. Document the report completely. d. Inquire about the client's job risks.
Assess the client's gait and balance.
4. A client is receiving chemotherapy through a peripheral IV line. What action by the nurse is most important? a. Assessing the IV site every hour b. Educating the client on side effects c. Taking the vital signs during the infusion d. Monitoring the client for nausea
Assessing the IV site every hour
The RN working on an oncology unit has just received report on these clients. Which client should be assessed first? Client with chemotherapy-induced neutropenia who has just been admitted with an elevated temperature Client with lymphoma who will need administration of an antiemetic before receiving chemotherapy Client with metastatic breast cancer who is scheduled for external beam radiation in 1 hour Client with xerostomia associated with laryngeal cancer who needs oral care before breakfast
Client with chemotherapy-induced neutropenia who has just been admitted with an elevated temperature
Which instruction is most appropriate for the nurse to convey to the client with chemotherapy-induced neuropathy? Bathe in cold water. Wear cotton gloves when cooking. Consume a diet high in fiber. Make sure shoes are snug.
Consume a diet high in fiber. A high-fiber diet will assist with constipation due to neuropathy
When caring for a client who has had a colostomy created during treatment for colon cancer, which nursing actions help support the client in accepting changes in appearance or function? (Select all that apply.) Explain to the client that the colostomy is only temporary. Encourage the client to participate in changing the ostomy. Obtain a psychiatric consultation. Offer to have a person who is coping with a colostomy visit. Encourage the client and family members to express their feelings and concerns.
Encourage the client to participate in changing the ostomy. Offer to have a person who is coping with a colostomy visit. Encourage the client and family members to express their feelings and concerns.
Which potential side effects does the nurse include in the teaching plan for a client undergoing radiation therapy for laryngeal cancer? (Select all that apply.) Fatigue Changes in color of hair Change in taste Changes in skin of the neck Difficulty swallowing
Fatigue Change in taste Changes in skin of the neck Difficulty swallowing
When monitoring a client with suspected syndrome of inappropriate antidiuretic hormone (SIADH), the nurse reviews the client's medical record, which contains the following information. The nurse notifies the health care provider for which signs and symptoms consistent with this syndrome? (Select all that apply.) Physical Assessment Findings Diagnostic Findings Medications Neuro: Episodes of confusion Cardiac: Pulse 88 and regular Musculoskeletal: Weakness, tremors Na: 115 K: 4.2 Creatinine: 0.8 ondansetron (Zofran) cyclophosphamide (Cytoxan) Hyponatremia Mental status changes Azotemia Bradycardia Weakness
Hyponatremia Mental status changes Weakness
Which medication does the nurse plan to administer to a client before chemotherapy to decrease the incidence of nausea and vomiting? Morphine Ondansetron (Zofran) Naloxone (Narcan) Diazepam (Valium)
Ondansetron (Zofran)
When caring for the client receiving cancer chemotherapy, which signs or symptoms related to thrombocytopenia should the nurse report to the health care provider? (Select all that apply.) Bruises Fever Petechiae Epistaxis Pallor
Petechiae Epistaxis Bruises
An outpatient client is receiving photodynamic therapy. Which environmental factor is a priority for the client to adjust for protection? Storing drugs in dark locations at room temperature Wearing soft clothing Wearing a hat and sunglasses when going outside Reducing all direct and indirect sources of light
Reducing all direct and indirect sources of light
The nurse corrects the nursing student when caring for a client with neutropenia secondary to chemotherapy in which circumstance? The student scrubs the hub of IV tubing before administering an antibiotic. The nurse overhears the student explaining to the client the importance of handwashing. The student teaches the client that symptoms of neutropenia include fatigue and weakness. The nurse observes the student providing oral hygiene and perineal care.
The student teaches the client that symptoms of neutropenia include fatigue and weakness. Symptoms of neutropenia include low neutrophil count, fever, and signs and symptoms of infection
When the nurse is counseling a 60-year-old African-American male client with all of these risk factors for lung cancer, teaching should focus most on which risk factor? Tobacco use Ethnicity Gender Increased age
Tobacco use
The oncology nurse should use which intervention to prevent disseminated intravascular coagulation (DIC)? Monitoring platelets Administering packed red blood cells Using strict aseptic technique to prevent infection Administering low-dose heparin therapy for clients on bedrest
Using strict aseptic technique to prevent infection
The nurse is orienting new staff to a clinical unit that provides palliative care. A new employee asks what "grief" is exactly. Which statement indicates that the nurse has correctly defined grief? a. The emotional response to a loss b. The outward, social expression of a loss c. The depression felt after a loss d. The loss of a possession or loved one
The emotional response to a loss
The nurse is teaching a 47-year-old woman about recommended screening practices for breast cancer. Which statement by the client indicates understanding of the nurse's instructions? "My mother and grandmother had breast cancer, so I am at risk." "I get a mammogram every 2 years since I turned 30." "A clinical breast examination is performed every month since I turned 40." "A computed tomography (CT) scan will be done every year after I turn 50."
"My mother and grandmother had breast cancer, so I am at risk."
The nurse reviews the chart of a client admitted with a diagnosis of glioblastoma with a T1NXM0 classification. Which explanation does the nurse offer when the client asks what the terminology means? "Two lymph nodes are involved in this tumor of the glial cells, and another tumor is present." "The brain tumor measures about 1 to 2 cm and shows no regional lymph nodes and no distant metastasis." "This type of tumor in the brain is small with some lymph node involvement; another tumor is present somewhere else in your body." "Glioma means this tumor is benign, so I will have to ask your health care provider the reason for the chemotherapy and radiation."
"The brain tumor measures about 1 to 2 cm and shows no regional lymph nodes and no distant metastasis."
The nurse caring for a dying patient understands that "nearing death awareness" is occurring when the patient asks which question. a. "Where are my shoes? I need to get ready for the trip." b. "Is my daughter from California going to come and visit before I die?" c. "When do you think that I am going to die?" d. "How much longer can I live without food or water?"
"Where are my shoes? I need to get ready for the trip."
What accurately describes prostate cancer detection and /or treatment (select all that apply)? A. The symptoms of pelvic or perineal pain, fatigue, and malaise may be present. B. Palpation of the prostate reveals hard and symmetric enlargement with areas of induration or nodules. C. Orchiectomy is a treatment option for all patients with prostatic cancer except those with stage IV tumors. D. The preferred hormonal therapy for treatment of prostate cancer includes estrogen and androgen receptor blockers. E. Early detection of cancer of the prostate is increased with annual rectal examinations and serum prostatic acid phosphatase (PAP) measurements. F. An annual prostate examination is recommended starting at age 45 for African American men with a first-degree relative with prostate cancer at an early age.
A. The symptoms of pelvic or perineal pain, fatigue, and malaise may be present. B. Palpation of the prostate reveals hard and symmetric enlargement with areas of induration or nodules. F. An annual prostate examination is recommended starting at age 45 for African American men with a first-degree relative with prostate cancer at an early age.
Which characteristics describe transurethral resection of the prostate (TURP) (select all that apply)? A. Best used for a very large prostate gland B. Inappropriate for men with rectal problems C. Involves an external incision prostatectomy D. Uses transurethral incision into the prostate E. Most common surgical procedure to treat BPH F. Resectoscope excision and cauterization of prostate tissue.
A.Best used for a very large prostate gland A. Most common surgical procedure to treat BPH B. Resectoscope excision and cauterization of prostate tissue.
A nurse cares for a client who had a colostomy placed in the ascending colon 2 weeks ago. The client states, "The stool in my pouch is still liquid." How should the nurse respond? a. "The stool will always be liquid with this type of colostomy." b. "Eating additional fiber will bulk up your stool and decrease diarrhea." c. "Your stool will become firmer over the next couple of weeks." d. "This is abnormal. I will contact your health care provider."
ANS: A The stool from an ascending colostomy can be expected to remain liquid because little large bowel is available to reabsorb the liquid from the stool. This finding is not abnormal. Liquid stool from an ascending colostomy will not become firmer with the addition of fiber to the client's diet or with the passage of time.
A nurse assesses a client who is recovering from a hemorrhoidectomy that was done the day before. The nurse notes that the client has lower abdominal distention accompanied by dullness to percussion over the distended area. Which action should the nurse take? a. Assess the client's heart rate and blood pressure. b. Determine when the client last voided. c. Ask if the client is experiencing flatus. d. Auscultate all quadrants of the client's abdomen
ANS: B Assessment findings indicate that the client may have an over-full bladder. In the immediate postoperative period, the client may experience difficulty voiding due to urinary retention. The nurse should assess when the client last voided. The client's vital signs may be checked after the nurse determines the client's last void. Asking about flatus and auscultating bowel sounds are not related to a hemorrhoidectomy
Which client problem does the nurse set as the priority for the client experiencing chemotherapy-induced peripheral neuropathy? Potential for lack of understanding related to side effects of chemotherapy Potential for injury related to sensory and motor deficits Potential for ineffective coping strategies related to loss of motor control Altered sexual function related to erectile dysfunction
Potential for injury related to sensory and motor deficits
A 55-year-old African-American client is having a visit with his health care provider. What test should the nurse discuss with the client as an option to screen for prostate cancer, even though screening is not routinely recommended? a. Complete blood count b. Culture and sensitivity c. Prostate-specific antigen d. Cystoscopy
Prostate-specific antigen
A patient with metastatic cancer of the colon experiences severe vomiting following each administration of chemotherapy. An important nursing intervention for the patient is to... A. Teach about the importance of nutrition during treatment B. Have the patient eat large meals when nausea is not present. C. Administer prescribed antiemetic 1 hour before the treatments. D. Offer dry crackers and carbonated fluids during chemotherapy.
C. Administer prescribed antiemetic 1 hour before the treatments
On admission to the ambulatory surgical center, a patient with BPH informs the nurse that he is going to have a laser treatment of his enlarged prostate. The nurse plans patients teaching with the knowledge that the patient will need to know what? A. The effects of general anesthesia B. The possibility of short-term incontinence C. Home management of an indwelling catheter D. Monitoring for postoperative urinary retention.
C. Home management of an indwelling catheter
Following a TURP, a patient has continuous bladder irrigation. Four hours after surgery, the catheter is draining thick, bright red clots and tissue. What should the nurse do? A. Release the traction on the catheter. B. Clamp the drainage tube and notify the patient's HCP. C. Manually irrigate the catheter until the drainage is clear. D. Increase the rate of the irrigation and take the patient's vital signs.
C. Manually irrigate the catheter until the drainage is clear.
A patient asks the nurse what the difference is between benign prostatic hyperplasia (BPH) and prostate cancer. The best response by the nurse includes what information about BPH. A. BPH is a benign tumor that does not spread beyond the prostate gland. B. BPH is a precursor to prostate cancer buy does not yet show any malignant changes. C. BPH is an enlargement of the gland caused by an increase in the size of existing cells. D. BPH is a benign enlargement of the gland caused by an increase in the number of normal cells.
D. BPH is a benign enlargement of the gland caused by an increase in the number of normal cells.
Which statement is true regarding advance directives? a. Advance directives apply only when the person has a chronic illness. b. Advance directives should be drawn up by family members of people who are incompetent. c. Discussion of advance directives is a nursing responsibility. d. Advance directives should be kept in a safety deposit box until the person dies.
Discussion of advance directives is a nursing responsibility.
A 52-year-old client relates to the nurse that she has never had a mammogram because she is terrified that she will have cancer. Which response by the nurse is therapeutic? "Don't worry, most lumps are discovered by women during breast self-examination." "Does anyone in your family have breast cancer?" "Finding a cancer in the early stages increases the chance for cure." "Have you noticed a lump or thickening in your breast?"
"Finding a cancer in the early stages increases the chance for cure."
The home health nurse is caring for a client who has a history of a kidney transplant and takes cyclosporine (Sandimmune) and prednisone (Deltasone) to prevent rejection. Which assessment finding is most important to communicate to the transplant team? Temperature of 96.6° F Reports of joint pain Pink and dry oral mucosa Palpable lump in the client's axilla
Palpable lump in the client's axilla
A nurse prepares a client for a colonoscopy scheduled for tomorrow. The client states, "My doctor told me that the fecal occult blood test was negative for colon cancer. I don't think I need the colonoscopy and would like to cancel it." How should the nurse respond? a. "Your doctor should not have given you that information prior to the colonoscopy." b. "The colonoscopy is required due to the high percentage of false negatives with the blood test." c. "A negative fecal occult blood test does not rule out the possibility of colon cancer." d. "I will contact your doctor so that you can discuss your concerns about the procedure."
ANS: C A negative result from a fecal occult blood test does not completely rule out the possibility of colon cancer. To determine whether the client has colon cancer, a colonoscopy should be performed so the entire colon can be visualized and a tissue sample taken for biopsy. The client may want to speak with the provider, but the nurse should address the client's concerns prior to contacting the provider.
A nurse teaches a client who is recovering from a colon resection. Which statement should the nurse include in this client's plan of care? a. "You may experience nausea and vomiting for the first few weeks." b. "Carbonated beverages can help decrease acid reflux from anastomosis sites." c. "Take a stool softener to promote softer stools for ease of defecation." d. "You may return to your normal workout schedule, including weight lifting."
ANS: C Clients recovering from a colon resection should take a stool softener as prescribed to keep stools a soft consistency for ease of passage. Nausea and vomiting are symptoms of intestinal obstruction and perforation and should be reported to the provider immediately. The client should be advised to avoid gas-producing foods and carbonated beverages, and avoid lifting heavy objects or straining on defecation.
A nurse teaches a client who is at risk for colon cancer. Which dietary recommendation should the nurse teach this client? a. "Eat low-fiber and low-residual foods." b. "White rice and bread are easier to digest." c. "Add vegetables such as broccoli and cauliflower to your new diet." d. "Foods high in animal fat help to protect the intestinal mucosa."
ANS: C The client should be taught to modify his or her diet to decrease animal fat and refined carbohydrates. The client should also increase high-fiber foods and Brassica vegetables, including broccoli and cauliflower, which help to protect the intestinal mucosa from colon cancer.
The nurse has been caring for a patient who has just died. What is the preferred outcome in caring for the body after death? a. Make sure the body is sent to the morgue within an hour after death. b. Have the family members participate in the bathing and dressing of the deceased. c. Notify in person or by phone all family and team members immediately after the patient's death. d. Demonstrate respect for the body and provide a clean, peaceful impression of the deceased for the family.
Demonstrate respect for the body and provide a clean, peaceful impression of the deceased for the family.
Which type of cancer has been associated with Down syndrome? Breast cancer Colorectal cancer Malignant melanoma Leukemia
Leukemia
A client with cancer is admitted to a short-term rehabilitation facility. The nurse prepares to administer the client's oral chemotherapy medications. What action by the nurse is most appropriate? a. Crush the medications if the client cannot swallow them. b. Give one medication at a time with a full glass of water. c. No special precautions are needed for these medications. d. Wear personal protective equipment when handling the medications
Wear personal protective equipment when handling the medications
The mother of two children, 8 and 10 years of age, has just experienced the death of her mother, the children's grandmother. The mother is concerned about the emotional impact attending the funeral may have on her children. She asks the nurse what she should do in relation to her children attending the funeral. What is the nurse's best response? a. "Take them to the funeral—they need closure, and seeing their grandma in the casket will assist them in knowing that she has died and will not return. Many children attend funerals in today's society." b. "Do not take them to the funeral—they are too young to be exposed to the emotions that are demonstrated at funerals. Many children who attend funerals have adverse psychological reactions." c. "Talk to your children about how they feel about attending the funeral and encourage them to ask questions and talk about their concerns. If they want to go, they will need to be prepared for what will happen at the funeral." d. "Talk to your children about what your mother meant to you and how much she cared for them as her grandchildren and then see if they really want to attend the funeral. If they want to go it is okay to take them."
c. "Talk to your children about how they feel about attending the funeral and encourage them to ask questions and talk about their concerns. If they want to go, they will need to be prepared for what will happen at the funeral."
Which information must the organ transplant nurse emphasize before a client is discharged? "Taking immunosuppressant medications increases your risk for cancer and the need for screenings." "You are at increased risk for cancer when you reach 60 years of age." "Immunosuppressant medications will decrease your risk for developing cancers." "After 6 months, you may stop immunosuppressant medications, and your risk for cancer will be the same as that of the general population.
"Taking immunosuppressant medications increases your risk for cancer and the need for screenings."
A nurse cares for a client who has a family history of colon cancer. The client states, "My father and my brother had colon cancer. What is the chance that I will get cancer?" How should the nurse respond? a. "If you eat a low-fat and low-fiber diet, your chances decrease significantly." b. "You are safe. This is an autosomal dominant disorder that skips generations." c. "Preemptive surgery and chemotherapy will remove cancer cells and prevent cancer." d. "You should have a colonoscopy more frequently to identify abnormal polyps early."
"You should have a colonoscopy more frequently to identify abnormal polyps early."
The nurse is caring for a client receiving chemotherapy who reports anorexia. Which measure does the nurse use to best monitor for cachexia? Monitor weight Trend red blood cells and hemoglobin and hematocrit Monitor platelets Observe for motor deficits
Monitor weight
The nurse explains to a client that which risk factor of those listed most likely contributed to the client's primary liver carcinoma? Infection with hepatitis B virus Consuming a diet high in animal fat Exposure to radon Familial polyposis
Infection with hepatitis B virus
Which statement about the process of malignant transformation is correct? Mutation of genes is an irreversible event that always leads to cancer development in the initiation phase. Insulin and estrogen enhance the division of an initiated cell during the promotion phase. Tumors form when carcinogens invade the gene structure of the cell in the latency phase. Nutrition of cancer cells is provided by tumor angiogenesis factor (TAF) in the promotion stage.
Nutrition of cancer cells is provided by tumor angiogenesis factor (TAF) in the promotion stage.
The nurse is preparing to admit a newly diagnosed patient experiencing tonic-clonic seizures. What could the nurse delegate to unlicensed assistive personnel (UAP)? A. Complete the admission assessment. B. Assess the details of the seizure event. C. Obtain the suction equipment from the supply cabinet. D. Place a padded tongue blade on the wall above the patient's bed.
Obtain the suction equipment from the supply cabinet.
When taking a nursing history from a patient with BPH, the nurse would expect the patient to report A. Nocturia, dysuria, and bladder spasms. B. Urinary frequency, hematuria, and perineal pain. C. Urinary hesitancy, post void dribbling, and weak urinary stream. D. Urinary urgency with a forceful urinary stream and cloudy urine.
C. Urinary hesitancy, post void dribbling, and weak urinary stream.
. A client is interested in learning about the risk factors for prostate cancer. Which factors does the nurse include in the teaching? (Select all that apply.) a. Family history of prostate cancer b. Smoking c. Obesity d. Advanced age e. Eating too much red meat f. Race
Family history of prostate cancer Eating too much red meat Race
In which scenario is hospice care provided? a. Only in the homes of the terminally ill b. For any terminal illness that requires symptom control c. For cancer patients only in their last weeks of life d. In hospital settings based on the seriousness of the illness
For any terminal illness that requires symptom control
The nurse is giving a group presentation on cancer prevention and recognition. Which statement by an older adult client indicates understanding of the nurse's instructions? "Cigarette smoking always causes lung cancer." "Taking multivitamins will prevent me from developing cancer." "If I have only one shot of whiskey a day, I probably will not develop cancer." "I need to report the pain going down my legs to my health care provider."
"I need to report the pain going down my legs to my health care provider."
Which statement made by a client allows the nurse to recognize whether the client receiving brachytherapy for ovarian cancer understands the treatment plan? "I may lose my hair during this treatment." "I must be positioned in the same way during each treatment." "I will have a radioactive device in my body for a short time." "I will be placed in a semiprivate room for company."
"I will have a radioactive device in my body for a short time."
A client is diagnosed with metastatic prostate cancer. The client asks the nurse the purpose of his treatment with the luteinizing hormone-releasing hormone (LH-RH) agonist leuprolide (Lupron) and the bisphosphonate pamidronate (Aredia). Which statement by the nurse is most appropriate? a. "The treatment reduces testosterone and prevents bone fractures." b. "The medications prevent erectile dysfunction and increase libido." c. "There is less gynecomastia and osteoporosis with this drug regimen." d. "These medications both inhibit tumor progression by blocking androgens."
"The treatment reduces testosterone and prevents bone fractures."
The nurse is conducting a community health education class on diet and cancer risk reduction. What should be included in the discussion? (Select all that apply.) Limit sodium intake. Avoid beef and processed meats. Increase consumption of whole grains. Eat "colorful fruits and vegetables," including greens. Avoid gas-producing vegetables such as cabbage.
Avoid beef and processed meats. Increase consumption of whole grains. Eat "colorful fruits and vegetables," including greens.
The nurse provided discharge teaching to a patient following a TURP and determines that the patient understands the instructions when he makes which statement? A. "I should use daily enemas to avoid straining until healing is complete." B. "I will avoid heavy lifting, climbing, and driving until my follow-up visit." C. "At least I don't have to worry about developing cancer of the prostate now." D. "Every day I should drink 10 to 12 glasses of liquids such as coffee, tea, or soft drinks."
I will avoid heavy lifting, climbing, and driving until my follow-up visit."
When caring for a client receiving chemotherapy, the nurse plans care during the nadir of bone marrow activity to prevent which complication? Drug toxicity Polycythemia Infection Dose-limiting side effects
Infection
The nurse includes which factors in teaching regarding the typical warning signs of cancer? (Select all that apply.) Persistent constipation Scab present for 6 months Curdlike vaginal discharge Axillary swelling Headache
Persistent constipation Scab present for 6 months Axillary swelling
