MS1 Exam 2

A nurse is reviewing the pathophysiology of cystic fibrosis (CF) in anticipation of a new admission. The nurse should identify what characteristic aspects of CF?

Bronchial mucus plugging, inflammation, and eventual bronchiectasis

Which of the following nursing interventions is appropriate with regard to pain control in the dying client?

Give pain medications on a routine schedule.

A client with a diagnosis of gastric cancer has been unable to tolerate oral food and fluid intake and her tumor location rules out the use of enteral feeding. What intervention will best meet this client's nutritional needs?

Parenteral nutrition given via a peripherally inserted central catheter

A pediatric nurse practitioner is caring for a child who has just been diagnosed with asthma. The nurse has provided the parents with information that includes potential causative agents for an asthmatic reaction. What potential causative agent should the nurse describe?

Pets

A nurse provides care on a bone marrow transplant unit and is preparing a female client for hematopoietic stem cell transplantation (HSCT) the following day. What information should the nurse emphasize to the client's family and friends?

"Do not visit if you've had a recent infection."

The wife of a client is concerned because her husband is requiring increasingly high doses of analgesia. She states, "He was in pain long before he got cancer because he broke his back about 20 years ago. For that problem, though, his pain medicine wasn't just raised and raised." What would be the nurses' best response?

"Much cancer pain is caused by tumor involvement and needs to be treated in a way that brings the client relief."

The emergency department (ED) nurse is caring for an adult client who was in a motor vehicle accident. Radiography reveals an ulnar fracture. What type of pain is the nurse addressing with this client?

Acute

The nurse should be alert for a complication of bronchiectasis that results from a combination of retained secretions and obstrauction and leads to collapse of aveoli. What complication should the nurse monitor for?

Atelectasis

An oncology client has just returned from the postanesthesia care unit after an open hemicolectomy. This client's plan of nursing care should prioritize which of the following?

Assess the client's wound for dehiscence every 4 hours.

The nurse is conducting a health education about cancer prevention to a group of adults. What menu best demonstrates dietary choices for potentially reducing the risks of cancer?

Baked apricot chicken and steamed broccoli

A nurse is completing a focused respiratory assessment of a child with asthma. What assessment finding is most closely associated with the characteristic signs and symptoms of asthma?

Bilateral wheezes

A nurse is developing the teaching portion of a care plan for a client with COPD. What would be the most important component for the nurse to emphasize?

Chronic inhalation of indoor toxins can cause lung damage.

A clinic nurse is caring for a client who has just been diagnosed with chronic obstructive pulmonary disease (COPD). The client asks the nurse what he could have done to minimize the risk of contracting this disease. What should the nurse describe as the most significant risk factor?

Cigarette smoking

The hospice nurse is caring for a client with cancer who is living at home. The nurse has explained to the client and the family that the client is at risk for hypercalcemia and has educated them on that signs and symptoms of this health problem. What else should the nurse teach this client and family to do to reduce the client's risk of hypercalcemia?

Consume 2 to 4 L of fluid daily

A nurse is caring for a client who has been admitted with an exacerbation of chronic bronchiectasis. The nurse should expect to assess the client for which of the following clinical manifestations?

Copious sputum production

A 60-year-old client who has been fighting cancer for more than 20 years has just been diagnosed with metastases to the brain. The client finds it difficult to get out of bed in the morning, has no interest in eating, and no longer finds fulfillment in favorite hobbies. Within which emotional reaction is the client functioning?

Depression

The nurse is caring for a client whose medical history includes chronic fatigue and poorly controlled back pain. These medical diagnoses should alert the nurse to the possibility of what consequent health problem?

Depression

A nurse is preparing to care for a client with bronchiectasis. The nurse should recognize that this client is likely to experience respiratory difficulties related to what pathophysiologic process?

Dilation of bronchi and bronchioles

The nurse caring for an older adult client with osteoarthritis is reviewing the client's chart. This client is on a variety of medications prescribed by different care providers in the community. In light of the QSEN competency of safety, what is the nurse most concerned about with this client?

Drug interactions

An admitting nurse is assessing a client with COPD. The nurse auscultates diminished breath sounds. These findings indicate to the nurse to monitor the client for what?

Dyspnea and hypoxemia

A nurse is evaluating the diagnostic study data of a client with suspected cystic fibrosis (CF). Which of the following test results is associated with a diagnosis of cystic fibrosis?

Elevated sweat chloride concentration

An asthma educator is teaching a client newly diagnosed with asthma and her family about the use of a peak flow meter. The educator should teach the client that a peak flow meter measures what value?

Highest airflow during a forced expiration

A patient is diagnosed with a terminal illness and has been given less than 6 months to live. What type of referral should the nurse make to assist this patient and family at home?

Hospice

A nurse has been asked to give a workshop on COPD for a local community group. The nurse emphasizes the importance of smoking cessation because smoking has what pathophysiologic effect?

Increases mucus production

An oncology nurse educator is providing health education to a client who has been diagnosed with skin cancer. The client's wife has asked about the differences between normal cells and cancer cells. What characteristic of a cancer cell should the educator cite?

Malignant cells contain proteins called tumor-associated antigens.

A client's intractable neuropathic pain is being treated using a multimodal approach to analgesia. After administering a recently increased dose of IV morphine to the client, the nurse has returned to assess the client and finds the client unresponsive to verbal and physical stimulation with a respiratory rate of five breaths per minute. The nurse has called a code blue and should anticipate the administration of what drug?

Naloxone

A client newly diagnosed with cancer is scheduled to begin chemotherapy treatment and the nurse is providing anticipatory guidance about potential adverse effects. When addressing the most common adverse effect, what should the nurse describe?

Nausea and vomitting

The nurse is accepting care of an adult client who has been experiencing severe and intractable pain. When reviewing the client's medication administration record, the nurse notes the presence of gabapentin. The nurse is justified in suspecting what phenomenon in the etiology of the client's pain?

Neuropathy

The nurse is assessing a client's pain while the client awaits a cholecystectomy. The client is tearful, hesitant to move, and grimacing, but rates his pain as a 2 on a 0-to-10 pain scale. How should the nurse best respond to this assessment finding?

Reinforce teaching about the pain scale number system.

The nurse on a bone marrow transplant unit is caring for a client with cancer who has just begun hematopoietic stem cell transplantation (HSCT). What is the priority nursing diagnosis for this client?

Risk for infection related to altered immunologic response

A nurse is developing a teaching plan for a client with COPD. What should the nurse include as the most important area of teaching?

Setting and accepting realistic short- and long-term goals

An older adult client has been admitted to the rehabilitation facility after falling and fracturing her left hip. The client has not regained functional ability and may have to be readmitted to an acute-care facility. When planning this client's care, what should the nurse know about the negative effects of the stress associated with pain?

Stress is particularly harmful in the elderly who have been injured or who are ill.

What nursing action best demonstrates primary cancer prevention?

Teaching clients to wear sunscreen

A nurse is planning the care of a client with bronchiectasis. What goal of care should the nurse prioritize?

The client will successfully mobilize pulmonary secretions.

The nurse is creating a nursing care plan for a client with a primary diagnosis of cellulitis and a secondary diagnosis of chronic pain. What common trait of clients who live with chronic pain should be integrated into care planning?

They can experience acute pain in addition to chronic pain.

A client is asking for a breakthrough dose of analgesia. The pain-medication prescriptions are written as a combination of an opioid analgesic and a nonsteroidal anti-inflammatory drug (NSAID) given together. What is the primary rationale for administering pain medication in this manner?

To achieve better pain control than with one medication alone

The home health nurse is performing a home visit for an oncology client discharged 3 days ago after completing treatment for non-Hodgkin lymphoma. The nurse's assessment should include examination for the signs and symptoms of what complication?

Tumor lysis syndrome (TLS)

A nurse is providing discharge teaching for a client with COPD. What should the nurse teach the client about breathing exercises?

Use diaphragmatic breathing

The case manager for a group of clients with COPD is providing health education. What is most important for the nurse to assess when providing instructions on self-management to these clients?

Knowledge about self-care and their therapeutic regimen

The nurse is caring for a client who has just been told that her stage IV colon cancer has recurred and metastasized to the liver. The oncologist offers the client the option of surgery to treat the progression of this disease. What type of surgery does the oncologist offer?

Palliative

The nurse is caring for a client with bronchiectasis. Chest auscultation reveals the presence of copious secretions. What intervention should the nurse prioritize in this client's care?

Postural chest drainage

The nurse is caring for a client with an advanced stage of breast cancer and the client has recently learned that her cancer has metastasized. The nurse enters the room and finds the client struggling to breath and the nurse's rapid assessment reveals that the client's jugular veins are distended. The nurse should suspect the development of what oncologic emergency?

Superior vena cava syndrome (SVCS)