NP3-MS Unit 2

You're patient is scheduled for an EEG (electroencephalogram). As the nurse you will:* A. Keep the patient nothing by mouth. B. Hold seizure medications until after the test. C. Allow the patient to have coffee, milk, and juice only. D. Wash the patient's hair prior to the test. E. Administer a sedative prior to the test.

B & D

A client is diagnosed as having a bowel tumor. The nurse should monitor the client for which complications of this type of tumor? Select all that apply. a.Flatulence b.Peritonitis c.Hemorrhage d.Fistula formation e.Bowel perforation f.Lactose intolerance

B, C, D, E

You're educating a 25-year-old female about possible triggers for seizures. Which statement requires you to re-educate the patient about the triggers?* A. "I'm at risk for seizure activity during my menstrual cycle." B. "I will limit my alcohol intake to 2 glasses of wine per day." C. "It's important I get plenty of sleep." D. "I will be sure to stay hydrated, especially during hot weather."

B. "I will limit my alcohol intake to 2 glasses of wine per day."

A patient who uses a fentanyl (Duragesic) patch for control of chronic cancer pain complains of a rapid onset of pain rated at 9 of 10. The patient asks the nurse to provide "something that works fast" for pain relief. What is the best action by the nurse? A.Provide the patient with a new fentanyl patch and remove the old one. B.Encourage the client to use additional oral narcotics as needed. C.Alternately apply hot and cold compresses to the painful area. D.Massage the area where the patch is located to release more medication.

B.Encourage the client to use additional oral narcotics as needed.

Which descriptions are characteristic of iron-deficiency anemia (select all that apply)? a.Lack of intrinsic factor b.Autoimmune-related disease c.Most common type of anemia d.Associated with chronic blood loss e.May occur with removal of the stomach f.May occur with removal of the duodenum

C, D, F

Your patient has a history of epilepsy. While helping the patient to the restroom, the patient reports having this feeling of déjà vu and seeing spots in their visual field. Your next nursing action is to?* A. Continue assisting the patient to the restroom and let them sit down. B. Initiate the emergency response system. C. Lay the patient down on their side with a pillow underneath the head. D. Assess the patient's medication history.

C. Lay the patient down on their side with a pillow underneath the head.

Your patient has entered the post ictus stage for seizures. The patient's seizure presented with an aura followed by body stiffening and then recurrent jerking. The patient had incontinence and bleeding in the mouth from injury to the tongue. What is an expected finding in this stage based on the type of seizure this patient experienced?* A. Crying and anxiety B. Immediate return to baseline behavior C. Sleepy, headache, and soreness D. Unconsciousness

C. Sleepy, headache, and soreness

What are the types of generalized seizures? Select all that apply 1. Tonic-Clonic 2. Ischemic 3. Absence 4. Myoclonic 5. Epileptic 6. Atonic/Akinetic (Drop Attacks)

1,3,4,6

The nurse is caring for a client who is postoperative following a pelvic exenteration, and the surgeon changes the client's diet from NPO (nothing by mouth) status to clear liquids. The nurse should check which priority item before administering the diet? 1. Bowel sounds 2. Ability to ambulate 3. Incision appearance 4. Urine specific gravity

1. Bowel sounds

When caring for a client with an internal radiation implant, the nurse should observe which principles? Select all that apply. 1. Limiting the time with the client to 1 hour per shift. 2. Keeping pregnant women out of the client's room. 3. Placing the client in a private room with a private bath. 4. Wearing a lead shield when providing direct client care. 5. Removing the dosimeter film badge when entering the client's room. 6. Allowing individuals younger than 16 years old in the room as long as they are 6 feet away from the client.

2. Keeping pregnant women out of the client's room. 3. Placing the client in a private room with a private bath. 4. Wearing a lead shield when providing direct client care.

The nurse is instructing a client to perform a testicular self-examination (TSE). The nurse should provide the client with which information about the procedure? 1. To examine the testicles while lying down 2. That the best time for the examination is after a shower 3. To gently feel the testicle with one finger to feel for a growth 4. That TSEs should be done at least every 6 months

2. That the best time for the examination is after a shower

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

The nurse is assessing a client who has a new ureterostomy. Which statement by the client indicates the need for more education about urinary stoma care? 1. "I change my pouch every week." 2. "I change the appliance in the morning." 3. "I empty the urinary collection bag when it is two-thirds full." 4. "When I'm in the shower I direct the flow of water away from my stoma."

3. "I empty the urinary collection bag when it is two-thirds full."

A gastrectomy is performed on a client with gastric cancer. In the immediate postoperative period, the nurse notes bloody drainage from the nasogastric tube. The nurse should take which most appropriate action? 1. Measure abdominal girth. 2. Irrigate the nasogastric tube. 3. Continue to monitor the drainage. 4. Notify the primary health care provider (PHCP).

3. Continue to monitor the drainage.

The nurse should plan to implement which intervention in the care of a client experiencing neutropenia as a result of chemotherapy? 1. Restrict all visitors. 2. Restrict fluid intake. 3. Teach the client and family about the need for hand hygiene. 4. Insert an indwelling urinary catheter to prevent skin breakdown.

3. Teach the client and family about the need for hand hygiene.

During the admission assessment of a client with advanced ovarian cancer, the nurse recognizes which manifestation as typical of the disease? 1. Diarrhea 2. Hypermenorrhea 3. Abnormal bleeding 4. Abdominal distention

4. Abdominal distention

The nurse is reviewing a health care provider's prescriptions for a child with sickle cell anemia who was admitted to the hospital for the treatment of vaso-occlusive crisis. Which prescriptions documented in the child's record should the nurse question? a.Restrict fluid intake b.Position for comfort c.Avoid strain on painful joints d.Apply nasal oxygen at 2L/minute e.Provide a high-calorie, high-protein diet. f.Give merperidine, 25 mg intravenously, every 4 hours for pain

A & F

When staging Hodgkin's lymphoma, which features should the nurse evaluate? (Select all that apply.) A.Tumor B.Nodes C.Metasteses D.Mitotic Rate E.Neoplasms

A, B, & C

You're assessing your patient load for the patients who are at MOST risk for seizures. Select all the patients below that are at risk:* A. A 32-year-old with a blood glucose of 20 mg/dL. B. A 63-year-old whose CT scan shows an ischemic stroke. C. A 72-year-old who is post opt day 5 from open heart surgery. D. A 16-year-old with bacterial meningitis. E. A 58-year-old experiencing ETOH withdrawal.

A, B, D, E

A client with carcinoma of the lungs develops syndrome of inappropriate antidiuretic hormone as a complication of the cancer. The nurse anticipates that he health care provider will request which prescriptions? Select all that apply. a.Radiation b.Chemotherapy c.Increased fluid intake d.Decreased oral sodium intake e.Serum sodium level determination f.Medication that is antagonistic to antidiuretic hormone

A, B, E, F

The nurse is caring for a patient with bladder cancer and bone metastasis. What signs/symptoms would the nurse recognize as indications of a possible oncological emergency? a.Facial edema in the morning b.Serum calcium level of 12 c.Weight loss of 20 lbs in 1 month d.Serum sodium level of 136 e.Serum potassium level of 3.4 f.Numbness and tingling of the lower extremities

A, B, F

Cancer cells go through stages of development. What accurately describes the stage of promotion? Select all that apply. a.Obesity is an example of a promoting factor b.The stage is characterized by increased growth rate and metastasis c.Withdrawal of promoting factors will reduce the risk of cancer development d.Tobacco smoke is a complete carcinogen that is capable of both initiation and promotion e.Promotion is the stage of cancer development in which there is an irreversible alteration in the cell's DNA

A, C, D

A patient with aplastic anemia has a nursing diagnosis of impaired oral mucous membrane. The etiology of this diagnosis can be related to the effects of what deficiencies (select all that apply)? a.RBCs b.Ferritin c.Platelets d.Coagulation factor VIII e.White blood cells (WBCs)

A,C,E

A nursing student is assigned to care for a client with an internal radiation applicator in place. Which statement by the student indicates an understanding of the necessary nursing considerations? A."I must work efficiently in giving care and medications." B."This client's personal belongings must be wrapped in plastic." C."This client should not eat any fresh fruits or vegetables." D."This client will not be allowed to have any visitors."

A."I must work efficiently in giving care and medications."

The nurse is caring for a client who is concerned about developing bladder cancer. Which modifiable risk factor for bladder cancer should the nurse discuss with the patient? A.cigarette smoking B.history of sexually transmitted disease C.urinary retention D.use of caffeine

A.cigarette smoking

A client newly diagnosed with small cell lung cancer states, "I have heard that if the cancer doesn't kill you, the treatment will." Which sign of complications is most important for the nurse to teach. A.Heart palpitations B.Dependent edema C.Fever greater than 100.1 D.Dry mouth

C.Fever greater than 100.1

A nurse is caring for a client with metastatic bone cancer. The client is complaining of increased thirst, headache, and muscle cramps. Which complication should the nurse suspect? A.hyperkalemia B.primary diabetes insipidus C.hypercalcemia D.diabetes mellitus

C.hypercalcemia

The nurse understands that chemotherapy for the treatment of cancer would be most effective in which type of cells? A.Cells with a large nucleus B.Cells with a slow mitotic rate C.Cells with a small nucleus D.Cells with a rapid mitotic rate

D.Cells with a rapid mitotic rate

A client undergoing chemotherapy has a platelet count of 20,000 microliters. Which nursing intervention is most important for this client? A.Prepare the client for a bone marrow transplant. B.Monitor the client's temperature at least every 4 hours. C.Encourage fluid intake of 4 liters per day. D.Check the client's stools for occult blood.

D.Check the client's stools for occult blood.

True or False: A patient who is experiencing a tonic-clonic seizure is experiencing a focal (partial) seizure.* True False

False

Number in sequence the events that occur in disseminated intravascular coagulation (DIC). a.____ activation of fibrinolytic system b.____ uncompensated hemorrhage c.____ widespread fibrin and platelet deposition in capillaries and arterioles d.____ release of fibrin-split products e.____ fibrinogen converted to fibrin f.____ Inhibition of normal blood clotting g.____ productionof intravascular thrombin h.____ depletion of platelets and coagulation factors

G, E, C, H, A D, F, B

a patient has a WBC count of 2300 and a neutrophil percentage of 40%. a.Does the patient have leukopenia? b.What is the patient's neutrophil count? c.Does the patient have neutropenia? d.Is the patient at risk for developing a bacterial infection? If so, why?

Yes WBC <4000 920 Yes Neutrophils <1000 Yes due to risk from opportunistic pathogens in normal body flora

A patient has recently been diagnosed with early stages of breast cancer. What is most appropriate for the nurse to focus on? a. Maintaining the patient's hope b. Preparing a will and advance directives c. Discussing replacement child care for the patient's children d. Discussing the patient's past experiences with her grandmother's cancer

a. Maintaining the patient's hope

While receiving a unit of packed RBCs, the patient develops chills and a temperature of 102.2*F. What is the priority action for the nurse to take? a.Stop the transfusion and instill normal saline b.Notify the health care provider and the blood bank c.Add a leukocyte reduction filter to the blood administration set d.Recognize this as a mild allergic transfusion reaction and slow the transfusion

a.Stop the transfusion and instill normal saline

A patient on chemotherapy and radiation for head and neck cancer has a WBC count of 1.9 × 103/μL, hemoglobin of 10.8 g/dL, and a platelet count of 99 × 103/μL. Based on the CBC results, what is the most serious clinical finding? a. Cough, rhinitis, and sore throat b. Fatigue, nausea, and skin redness at site of radiation c. Temperature of 101.9° F, fatigue, and shortness of breath d. Skin redness at site of radiation, headache, and constipation

c. Temperature of 101.9° F, fatigue, and shortness of breath

A patient is admitted to the hospital for evaluation and treatment of thrombocytopenia Which action is most important for the nurse to implement? a.Taking the temperature every 4 hours to assess for fever b.Maintaining the patient on strict bed rest to prevent injury c.Monitoring the patient for headaches, vertigo, or confusion d.Removing the oral crusting and scabs with a soft brush four times a day

c.Monitoring the patient for headaches, vertigo, or confusion

During the assessment of a patient with cobalamin deficiency, what manifestation would the nurse expect to find in the patient? a.Icteric sclera b.Hepatomegaly c.Paresthesia of the hands and feet d.Intermittent heartburn with acid reflux

c.Paresthesia of the hands and feet

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? a.Cyanosis b.Arm edema c.Periorbital edema d.Mental status changes

c.Periorbital edema

In providing care for a patient hospitalized with an acute exacerbation of polycythemia vera, the nurse gives priority to which activity? a.Maintaining protective isolation b.Promoting hydration with a large oral fluid intake c.Promoting leg exercises and ambulation d.Protecting the patient from injury or falls

c.Promoting leg exercises and ambulation

While caring for a patient who is at the nadir of chemotherapy, the nurse establishes the highest priority for nursing actions related to a.Diarrhea b.Grieving c.Risk for infection d.Inadequate nutritional intake

c.Risk for infection

In reviewing the laboratory results of a patient with hemophila A, what would the nurse expect to find? a.An absence of factor IX b.A decreased platelet count c.A prolonged bleeding time d.A prolonged partial thromboplastin time (PTT)

d.A prolonged partial thromboplastin time (PTT)

During the admission assessment of a patient with advanced ovarian cancer, the nurse recognizes which symptom as typical of the disease? a.Diarrhea b.Hypermenorrhea c.Abnormal bleeding d.Abdominal distention

d.Abdominal distention

What is a nursing intervention that is indicated for a patient during sickle cell crisis? a.Frequent ambulation b.Application of antiembolism hose c.Restriction of sodium and oral fluids d.Administration of large doses of continuous opioid analgesics

d.Administration of large doses of continuous opioid analgesics

A patient is admitted with acute myelogenous leukemia and a history of Hodgkin's lymphoma. What is the nurse likely to find in the patient's history? a.Work as a radiation chemist b.Epstein-barr virus diagnosed in vitro c.Intense tanning throughout the lifetime d.Alkylating agents for treating the Hodgkin's lymphoma

d.Alkylating agents for treating the Hodgkin's lymphoma

That patient is learning about skin care related to the external radiation that he is receiving. Which instructions should the nurse include in this teaching? a.Moisturize with lotion b.Keep the area covered if it is sore c.Dry the skin thoroughly after cleansing it d.Avoid extreme temperatures to the area

d.Avoid extreme temperatures to the area

The strict vegetarian is at highest risk for the development of which anemia? a.Thalassemia b.Iron-deficiency anemia c.Folic acid deficiency anemia d.Cobalamin deficiency anemia

d.Cobalamin deficiency anemia

The nurse is counseling a group of individuals over the age of 50 with average risk for cancer about screening tests for cancer. Which screening recommendation should be performed to screen for colorectal cancer? a.Barium enema every year b.Fecal occult blood every 5 years c.Annual prostate-specific antigen (PSA) and digital rectal exam d.Colonoscopy every 10 years

d.Colonoscopy every 10 years

Aclient with non-Hodgkin's lymphoma is receiving daunorubicin. Which finding would indicate to the nurse that the client is experiencing an adverse effect related to the medication? a.Fever b.Sore in the mouth and throat c.Complaints of nausea and vomiting d.Crackles on auscultation of the lungs

d.Crackles on auscultation of the lungs

A child with beta-thalassemia is receiving long-term blood transfusion therapy for the treatment of the disorder. Chelation therapy is prescribed as a result of too much iron from the transfusions. Which medication should the nurse anticipate to be prescribed? a.Fragmin b.Meropenem c.Metoprolol d.Deferoxamine

d.Deferoxamine

During the physical assessment of the patient with severe anemia, which finding is of the most concern to the nurse? a.Anorexia b.Bone pain c.Hepatomegaly d.Dyspnea at rest

d.Dyspnea at rest

A client is admitted to the hospital with a suspected diagnosis of Hodgkin's disease. Which assessment finding would the nurse expect to note specifically in the client? a.Fatigue b.Weakness c.Weight gain d.Enlarged lymph nodes

d.Enlarged lymph nodes

The clinic nurse instructs parents of a child with sickle cell anemia about the precipitating factors related to sickle cell crisis. Which, if identified by the parents as a precipitating factor, indicates the need for further instructions? a.Stress b.Trauma c.Infection d.Fluid overload

d.Fluid overload

A 20-year-old female patient is in the emergency department for anorexia and fatigue. She takes phenytoin (Dilantin) for a seizure disorder and oral contraceptives. Which type of anemia is the patient most at risk for? a.Aplastic anemia b.Hemolytic anemia c.Iron-deficiency anemia d.Folic acid deficiency anemia

d.Folic acid deficiency anemia

What defect in cellular proliferation is involved in the development of cancer? a.A rate of cell proliferation that is more rapid than that of normal body cells b.Shortened phases of cell life cycles with occasional skipping of GI or S phases c.Rearrangement of stem cell RNA that causes abnormal cellular protein synthesis d.Indiscriminate and continuous proliferation of cells with loss of contact inhibition

d.Indiscriminate and continuous proliferation of cells with loss of contact inhibition

Which delivery system would be used to deliver regional chemotherapy for metastasis from a primary colorectal cancer? a.Intrathecal b.Intraarterial c.Intravenous d.Intraperitoneal

d.Intraperitoneal

Tamoxifen citrate isprescribed for a client with metastatic breast carcinoma The nurse administering the medication understands that which is the primary action of this medication? a.It increases DNA and RNA synthesis b.It promotes the biosynthesis of nucleic acids c.It increases estrogen concentration and estrogen response d.It competitively binds to estrogen receptors on tumors and other tissue targets

d.It competitively binds to estrogen receptors on tumors and other tissue targets

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? a.Measure the client's abdominal girth b.Calculate the client's body mass index c.Ask the client about hisor her weight and height d.Measure the client's current weight and height

d.Measure the client's current weight and height

The patient with advanced cancer is having difficulty controlling her pain. She says she is afraid she will become addicted to the opioids. What is the first thing the nurse should do for this patient? a.Administer a non-steroidal anti-inflammatory drug b.Assess the patient's vital signs and behavior to determine the medication to use c.Have the patient keep a pain diary to better assess the patient's potential addiction d.Obtain a detailed pain history including quality, location, intensity, duration, and type of pain

d.Obtain a detailed pain history including quality, location, intensity, duration, and type of pain

The nurse analyzes the laboratory results of a child with hemophilia. The nurse understands that which result will most likely be abnormal in this child? a.Platelet count b.Hematocrit level c.Hemoglobin level d.Partial thromboplastin time

d.Partial thromboplastin time

While giving care to a patient with an internal cervical radiation implant, the nurse findsthe implant in the bed. The nurse should take which initial action? a.Call the health care provider b.Reinsert the implant into the vagina c.Pick up the implant with gloved hands and flush it down the toilet d.Pick up the implant with long-handled forceps and place it in a lead container

d.Pick up the implant with long-handled forceps and place it in a lead container

During discharge teaching of a patient with newly diagnosed sickle cell disease, what should the nurse teach the patient to do? a.Limit fluid intake b.Avoid humid weather c.Eliminate exercise from the lifestyle d.Seek early medical intervention for upper respiratory infections

d.Seek early medical intervention for upper respiratory infections

What is a major method of preventing infection in the patient with neutropenia? a.Prophylactic antibiotics b.A diet that eliminates fresh fruits and vegetables c.High-efficiency particulate air (HEPA) filtration rooms d.Strict hand washing by all persons in contact with the patient

d.Strict hand washing by all persons in contact with the patient

Which bleeding disorder affects both genders, is autosomal dominant, and will have laboratory resultsshowing prolonged bleeding time? a.Hemophilia A b.Hemophilia B c.Thrombocytopenia d.von Willebrand's disease

d.von Willebrand's disease

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."

Which statements accurately describe chronic lymphocytic leukemia? Select all that apply. a.most common leukemia of adults b.only cure is bone marrow transplant c.neoplasm activated B lymphocytesd.increase d incidence in survivors of atomic bombs e.Philadelphiachromosomes is a diagnostic hallmark f.Mature-appearing but functionally inactive lymphocytes

A, C, F

Which statements describe anemia related to blood loss (Select all that apply)? a.A major concern is prevention of shock b.This anemia is most frequently treated with increased dietary iron intake c.In addition to the general symptoms of anemia, this patient also manifests jaundice d.Clinical symptoms are the most reliable way to evaluate the effect and degree of blood loss e.A patient who has acute blood loss may have postural hypotension and increased heart rate

A, D, E

You have a patient who has a brain tumor and is at risk for seizures. In the patient's plan of care you incorporate seizure precautions. Select below all the proper steps to take in initiating seizure precautions:* A. Oxygen and suction at bedside B. Bed in highest position C. Remove all pillows from the patient's head D. Have restraints on stand-by E. Padded bed rails F. Remove restrictive objects or clothing from patient's body G. IV access

A, E, F, G

When teaching a patient with breast cancer about the drug tamoxifen citrate, which information should the nurse include? A.Use a lubricant to relieve vaginal dryness. B.Take a home pregnancy test on the first day of a missed menstrual cycle. C.Blocked estrogen receptors may induce hot flashes. D.Notify the physician if you experience edema in the legs.

C.Blocked estrogen receptors may induce hot flashes.

A client who is receiving chemotherapy develops stomatitis. Which action would be appropriate for the nurse to incorporate into the plan of care? A.Encourage the client to rinse their mouth with salt water following each meal B.Place the client NPO until condition is resolved C.Encourage the client to use a soft-bristle tooth brush or oral sponges during oral care D.Offer the client hot liquids such as tea and coffee

C.Encourage the client to use a soft-bristle tooth brush or oral sponges during oral care

The nurse is explaining the benefits of intrathecal administration of chemotherapy. Which teaching should the nurse include? A.Intrathecal chemotherapy can be administered in the home setting by a home health nurse. B.Intrathecal chemotherapy is a less invasive route of chemotherapy treatment. C.Intrathecal chemotherapy may be used in treating clients with brain tumors. D.Intrathecal chemotherapy has fewer complications then traditional IV chemotherapy.

C.Intrathecal chemotherapy may be used in treating clients with brain tumors.

A client is receiving treatment for multiple myeloma. Which nursing interventions are most important? A.Administering antiemetics prior to meals and antidiarrheals following meals to aid nutritional efforts. B.Maintaining strict reverse isolation protocols and aseptic technique. C.Maintaining hydration to attain 1.5-2 L of urine per day and caution when moving the client. D.Pain control and monitoring of liver function tests.

C.Maintaining hydration to attain 1.5-2 L of urine per day and caution when moving the client.

During administration of the first dose of an alkylating agent, which nursing intervention ismostimportant? A.Measure vital signs before and after each administration of the drug. B.Give the client a prophylactic antiemetic. C.Monitor the client frequently for symptoms of extravasation. D.Monitor the patient for symptoms of metabolic alkalosis.

C.Monitor the client frequently for symptoms of extravasation.

A 70-year-old male patient has multiple myeloma. His wife calls to report that he sleeps most of the day, is confused when awake, and reports nausea and constipation. Which complication of cancer is this most likely caused by? a. Hypercalcemia b. Tumor lysis syndrome c. Spinal cord compression d. Superior vena cava syndrome

a. Hypercalcemia

To prevent the debilitating cycle of fatigue-depression-fatigue in patients receiving radiation therapy, what should the nurse encourage the patient to do? a.Implement a walking program b.Ignore the fatigue as much as possible c.Do the most stressful activities when fatigue is tolerable d.Schedule rest periods throughout the day whether fatigue is present or not

a.Implement a walking program

When teaching the patient about a new prescription for oral iron supplements, what does the nurse instruct the patient to do? a.Increase the fluid and dietary fiber intake b.Take the iron preparations with meals c.Use enteric-coated preparations with meals d.Report the presence of black stools to the health care provider

a.Increase the fluid and dietary fiber intake

During initial chemotherapy a patient with leukemia develops hyperkalemia and hyperuricemia. The nurse recognizes these symptoms as an oncologic emergency and anticipates that the priority treatment will be to a.Increase urine output with hydration therapy b.Establish electrocadiographic (ECG) monitoring c.Administer a bisphosphonate such as pamidronate (Aredia) d.Restrict fluids and administer hypertonic sodium chloride solution

a.Increase urine output with hydration therapy

A patient with a genetic mutation of BRCA1 and afamily history of breast cancer is admitted to the surgical unit where she is scheduled that day for a bilateral simple mastectomy. What is the reason for this procedure? a.Prevent breast cancer b.Diagnose breast cancer c.Cure or control breast cancer d.Provide palliative care for untreated breast cancer

a.Prevent breast cancer

The nurse is presenting a community education program related to cancer prevention. Based on current cancer death rates, the nurse emphasizes what as the most important preventive action for both women and men? a.Smoking cessation b.Routine colonoscopies c.Protection from ultraviolet light d.Regular examination of reproductive organs

a.Smoking cessation

The home health nurse is caring for a patient with cancer who is complaining of acute pain. The most appropriate determination of the patient's pain should include which assessment? a.The client's pain rating b.Nonverbal cues from the client c.The nurse's impression of the client's pain d.Pain relief after appropriate nursing intervention

a.The client's pain rating

The nurse is assessing the colostomy of a patient who has had an abdominal perineal resection for a bowel tumor. Which assessment finding indicates that the colostomy is beginning to function? a.The passage of flatus b.Absent bowel sounds c.The client's ability to tolerate food d.Bloody drainage from the colostomy

a.The passage of flatus

The nurse is caring for a client following a mastectomy. Which nursing intervention would assist in preventing lymphedema of the affected arm? a.Placing cool compresses on the affected arm b.Elevating the affected arm on a pillow above heart level c.Avoiding arm exercises in the immediate post-operative period d.Maintaining an intravenous site below the antecubital area on the affected side

b.Elevating the affected arm on a pillow above heart level

The most effective method of administering a chemotherapy agent that is a vesicant is to a. give it orally. b. give it intraarterially. c. use an Ommaya reservoir. d. use a central venous access device.

d. use a central venous access device.

The community health nurse is instructing a group of young female clients about breast self-examination. The nurse should instruct the clients to perform the examination at which time? a.At the onset of menstruation b.Every month during ovulation c.Weekly at the same time of day d.1 week after menstruation begins

d.1 week after menstruation begins

The nurse is instituting seizure precautions for a client who is being admitted from the emergency department. Which measures should the nurse include in planning for the client's safety? Select all that apply. 1. Padding the side rails of the bed. 2. Placing an airway at the bedside. 3. Placing the bed in the high position. 4. Putting a padded tongue blade at the head of the bed. 5. Placing oxygen and suction equipment at the bedside. 6. Flushing the intravenous catheter to ensure that the site is patent.

1,2,5,6

The nurse is providing dietary teaching for a client who underwent a partial gastrectomy to treat gastric cancer about foods high in vitamin B12. The nurse would instruct the client to include which food items in the diet that are high in this vitamin? Select all that apply. 1. Milk 2. Fish 3. Beef 4. Apples 5. Turkey 6. Bananas

1, 2, 3, 5

The nurse is conducting a history and monitoring laboratory values on a client with multiple myeloma. What assessment findings should the nurse expect to note? Select all that apply. 1. Pathological fracture 2. Urinalysis positive for Bence Jones protein 3. Hemoglobin level of 15.5 g/dL (155 mmol/L) 4. Calcium level of 8.6 mg/dL (2.15 mmol/L) 5. Serum creatinine level of 2.0 mg/dL (176.6 mcmol/L)

1, 2, 5

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 primary health care provider 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, 2, 5, 6

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, 3, 6

The nurse is caring for a client who begins to experience seizure activity while in bed. Which actions should the nurse take? Select all that apply. 1. Loosening restrictive clothing. 2. Restraining the client's limbs. 3. Removing the pillow and raising padded side rails. 4. Positioning the client to the side, if possible, with the head flexed forward. 5. Keeping the curtain around the client and the room door open so when help arrives they can quickly enter to assist.

1,3,4

The nurse is teaching a client about the risk factors associated with colorectal cancer. The nurse determines that further teaching is necessary related to colorectal cancer if the client identifies which item as an associated risk factor? 1. Age younger than 50 years 2. History of colorectal polyps 3. Family history of colorectal cancer 4. Chronic inflammatory bowel disease

1. Age younger than 50 years

The nurse is creating a plan of care for the client with multiple myeloma and includes which priority intervention in the plan? 1. Encouraging fluids 2. Providing frequent oral care 3. Coughing and deep breathing 4. Monitoring the red blood cell count

1. Encouraging fluids

The nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which would the nurse expect to note specifically in this disorder? 1. Increased calcium level 2. Increased white blood cells 3. Decreased blood urea nitrogen level 4. Decreased number of plasma cells in the bone marrow

1. Increased calcium level

The home health care nurse is caring for a client with cancer who is complaining of acute pain. The most appropriate determination of the client's pain should include which assessment? 1. The client's pain rating 2. Nonverbal cues from the client 3. The nurse's impression of the client's pain 4. Pain relief after appropriate nursing intervention

1. The client's pain rating

The nurse is assessing the colostomy of a client who has had an abdominal perineal resection for a bowel tumor. Which assessment finding indicates that the colostomy is beginning to function? 1. The passage of flatus 2. Absent bowel sounds 3. The client's ability to tolerate food 4. Bloody drainage from the colostomy

1. The passage of flatus

A client is diagnosed as having a intestinal tumor. The nurse should monitor the client for which complications of this type of tumor? Select all that apply. 1. Flatulence 2. Peritonitis 3. Hemorrhage 4. Fistula formation 5. Bowel perforation 6. Lactose intolerance

2, 3, 4, 5

The nurse is instructing a client with iron deficiency anemia regarding the administration of a liquid oral iron supplement. Which instruction should the nurse tell the client? 1. Administer the iron at mealtimes. 2. Administer the iron through a straw. 3. Mix the iron with cereal to administer. 4. Add the iron to apple juice for easy administration.

2. Administer the iron through a straw.

The nurse is assessing the perineal wound in a client who has returned from the operating room following an abdominal perineal resection and notes serosanguineous drainage from the wound. Which nursing intervention is most appropriate? 1. Clamp the surgical drain. 2. Change the dressing as prescribed. 3. Notify the surgeon. 4. Remove and replace the perineal packing.

2. Change the dressing as prescribed.

The nurse is caring for a client following a mastectomy. Which nursing intervention would assist in preventing lymphedema of the affected arm? 1. Placing cool compresses on the affected arm 2. Elevating the affected arm on a pillow above heart level 3. Avoiding arm exercises in the immediate postoperative period 4. Maintaining an intravenous site below the antecubital area on the affected side

2. Elevating the affected arm on a pillow above heart level

The nurse is reviewing the history of a client with bladder cancer. The nurse expects to note documentation of which most common sign or symptom of this type of cancer? 1. Dysuria 2. Hematuria 3. Urgency on urination 4. Frequency of urination

2. Hematuria

What features of cancer cells distinguish them from normal cells (select all that apply)? a. Cells lack contact inhibition. b. Cells undergo rapid proliferation. c. Cells return to a previous undifferentiated state. d. Proliferation occurs when there is a need for more cells. e. New proteins characteristic of embryonic stage emerge on cell membrane.

A, C, E

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 nurse manager is teaching the nursing staff about signs and symptoms related to hypercalcemia in a client with metastatic prostate cancer and tells the staff that which is a late sign or symptom of this oncological emergency? 1. Headache 2. Dysphagia 3. Constipation 4. Electrocardiographic changes

4. Electrocardiographic changes

A client is admitted to the hospital with a suspected diagnosis of Hodgkin's disease. Which assessment finding would the nurse expect to note specifically in the client? 1. Fatigue 2. Weakness 3. Weight gain 4. Enlarged lymph nodes

4. Enlarged lymph nodes

The community health nurse is instructing a group of young female clients about breast self-examination. The nurse should instruct the clients to perform the examination at which time? 1. At the onset of menstruation 2. Every month during ovulation 3. Weekly at the same time of day 4. One week after menstruation begins

4. One week after menstruation begins

While giving care to a client with an internal cervical radiation implant, the nurse finds the implant in the bed. The nurse should take which initial action? 1. Call the primary health care provider (PHCP). 2. Reinsert the implant into the vagina. 3. Pick up the implant with gloved hands and flush it down the toilet. 4. Pick up the implant with long-handled forceps and place it in a lead container.

4. Pick up the implant with long-handled forceps and place it in a lead container.

Laboratory studies are performed for a client suspected to have iron deficiency anemia. The nurse reviews the laboratory results, knowing that which result indicates this type of anemia? 1. Elevated hemoglobin level 2. Decreased reticulocyte count 3. Elevated red blood cell count 4. Red blood cells that are microcytic and hypochromic

4. Red blood cells that are microcytic and hypochromic

When administering alkylating or cytotoxic medications to a client, which assesment findings indicate that the client is experiencing early signs of extravasation? A.Pain and redness. B.Swelling and a rash. C.Muscle spasms. D.Change in level of consciousness.

A.Pain and redness.

A patient who is having a tonic-clonic seizure is prescribed Phenobarbital. During administration of this drug, it is important the nurse monitors for:* A. Respiratory depression B. Hypertension C. Disseminated intravascular clotting D. Hypotension E. Fever

A & D

The nurse is preparing to administer a blood transfusion. Number the actions in order of priority. ( 1 is first priority; 10 is last priority action) a.____ verify the order for the transfusion b.____ ensurethat the patient has a patent 18-gauge IV c.____ prime the transfusion tubing and filter with normal saline d.____ verify that the physician has discussed risks, benefits, and alternatives with the patient e.____ obtain the blood product from the blood bank f.____ ask another licensed person (nurse or MD) to assist in verifying the product identification and the patient identification g.____ document outcomes in the patient record. Document vital sings, names of personnel, and starting and product is infused. h.____ adjust the infusion rate and continue to monitor the patient every 30 minutes for up to an hour after the product is infused i.____ infuse the first 50 mL over 15 minutes, staying with the patient j.____ obtainthe patient's vital signs before starting the transfusion

A D B C E F J I H G

The nurse is teaching a group of patients about the warning signs of cancer. Which symptoms should the nurse include? (Select all that apply) A.Unusual bleeding B.Nagging cough or hoarseness C.Change in bowel habits D.Unexplained weight gain E.A mole that does not change

A, B, C

The nurse is conducting staff in-service training on von Willebrand's disease. Which should the nurse include as characteristics of von Willebrand's disease? Select all that apply. a.Easy bruising occurs b.Gum bleeding occurs c.It is a hereditary bleeding disorder d.Treatment and care are similar to that for hemophilia e.It is characterized by extremely high creatinine levels f.The disorder causes platelets to adhere to damaged endothelium.

A, B, C, D, F

The nurse is monitoring the intravenous infusion of an antineoplastic medication. 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. a.Stop the infusion b.Notify the health care provider c.Prepare to apply ice or heat to the site d.Restart the IV at a distal part of the same vein e.Prepare to administer a prescribed antidote into the site f.Increase the flow rate of the solution to flush the skin and subcutaneous tissue

A, B, C, E

A client has been receiving biologic therapy for the treatment of cancer. The nurse should assess for which common side effects? (Select all that apply). A.Fever B.Chills C.Candidiasis D.Muscle aches E.Hirsutism

A, B, D

Which factors will assist a patient in coping positively with having cancer? Select all that apply. a.Feeling of control b.Strong support system c.Internalization of feelings d.Possibility of cure or control e.A young person will adapt more easily f.Not having had to cope with previous stressful events

A, B, D

Which statements accurately describe thrombocytopenia (Select all that apply)? a.Patients with platelet deficiencies can have internal or external hemorrhage b.The most common acquired thrombocytopenia is thrombotic thrombocytopenia purpura (TTP) c.Immune thrombocytopenia purpura(ITP) is characterized by increased platelet destruction by the spleen d.TTP is characterized by decreased platelets, decreased RBCs, and enhanced aggregation of platelets e.A classic clinical manifestation of thrombocytopenia that the nurse would expect to find on physical examination of the patient is ecchymosis

A,C,D

Match the surgical procedures with their primary purposes in cancer treatment (answers may be used more than once) 1. Cure, control, or both 2. Supportive care 3. Palliation 4. Rehabilitation a._____ mammoplasty b._____ bowel resection c._____ cordotomy for pain control d._____ insertion of feeding tube into stomach e._____ colostomy to bypass bowel obstruction f._____ placement of a central venous catheter g._____ debulking procedure to enhance radiation therapy h._____ surgical fixation of bones at risk for pathologic fracture

A-4 B-1 C-3 D-2 E-3 F-2 G-1 H-2

Indicate whether the following characteristics are associated with Hodgkin's lymphoma (HL), non-Hodgkin's lymphoma (NHL) or both (B). a.____affects all ages b.____presence of Reed-Stenberg cells c.____associated with Epstein-Barr virus d.____multiple histopathologic classifications e.____treated with radiation and chemotherapy f.____originates in lymph nodes in most patients g.____greater than 85% cure rate in stage I disease h.____often widely disseminated at time of diagnosis i.____ingested alcohol-induced pain at the site of disease j.____primary initial clinical manifestation is painless lymph node enlargement

A-NHL B-HL C-B D-NHL

A patient is taking Phenytoin for treatment of seizures. Which statement by the patient requires you to re-educate the patient about this medication?* A. "Every morning I take this medication with a full glass of milk with my breakfast." B. "I know it is important to have my drug levels checked regularly." C. "I will report a skin rash immediately to my doctor." D. "This medication can lower my body's ability to clot and fight infection."

A. "Every morning I take this medication with a full glass of milk with my breakfast."

You're assessing a patient who recently experienced a focal type seizure (partial seizure). As the nurse, you know that which statement by the patient indicates the patient may have experienced a focal impaired awareness (complex partial) seizure? A. "My friend reported that during the seizure I was staring off and rubbing my hands together, but I don't remember doing this." B. "I remember having vision changes, but it didn't last long." C. "I woke up on the floor with my mouth bleeding." D. "After the seizure I was very sleepy, and I had a headache for several hours."

A. "My friend reported that during the seizure I was staring off and rubbing my hands together, but I don't remember doing this."

A 45-year-old patient has breast cancer that has spread to the liver and spine. The patient has been taking oxycodone (OxyContin) and amitriptyline (Elavil) for pain control at home but now has constant severe pain and is hospitalized for pain control and development of a pain-management program. When doing the initial assessment, which question will be most appropriate to askfirst? A."How would you describe your pain?" B."What relieves your pain?" C."How long have you had this pain?" D."How many times a day do you take medication for pain?"

A."How would you describe your pain?"

Morphine 10 mg IV every 4 to 6 hours prn is ordered for a client with multiple myeloma who has a history of alcohol abuse. After 3 days of receiving the morphine every 6 hours, the patient tells the nurse that the medication is needed more frequently to control the pain. What is the bestaction by the nurse? A.Administer the morphine every 4 hours as needed. B.Recommend taking 15 mg of morphine every 6 hours. C.Assess for signs and symptoms of addiction. D.Use alternative therapies such as heat or cold.

A.Administer the morphine every 4 hours as needed.

The client is receiving chemotherapy for a large tumor of the colon. When teaching the client about the expected outcome of chemotherapy, what limitations of the treatment should the nurse explain? A.Large tumors contain more drug-resistant resting and non-cycling cells. B.Large tumors become encapsulated, preventing response to drug therapy. C.The client's own immune system is overwhelmed by the number of cancer cells. D.Large tumors usually do not respond to radiation.

A.Large tumors contain more drug-resistant resting and non-cycling cells.

A client with squamous cell lung carcinoma arrives in the emergency room complaining of nausea/vomiting, extreme thirst, fatigue, and weakness, and says "my heart keeps skipping beats." Which interventions should the nurse anticipate initially? A.Placing client on a continuous cardiac monitor and drawing electrolyte levels. B.Cardiac enzyme studies and administration of antiemetics. C.Administration of IV calcium gluconate (10%). D.Oral rehydration efforts and continuous electrocardiogram.

A.Placing client on a continuous cardiac monitor and drawing electrolyte levels.

A bone marrow transplant is being considered for the treatment of a client with acute leukemia that has not responded to chemotherapy. The client has many questions and concerns regarding the procedure. In discussing the treatment with the client, what should the nurse explain? A.Protective isolation will be used for several weeks after the procedure to help prevent infection. B.The bone marrow cells are transplanted into the client's bone marrow under general anesthesia. C.The donor marrow cells will begin functioning immediately after transplanted. D.Tissue matching requirements are not as strict for bone marrow transplants as for transplantation of other organs.

A.Protective isolation will be used for several weeks after the procedure to help prevent infection.

The nurse is caring for a client who has a WBC of 900. The client has a temperature of 100.5 F. The physician has ordered a sputum culture, blood cultures, and urine culture along with IV Rocephin. The blood cultures and urine culture have been obtained. The client cannot produce a sputum specimen. What action should the nurse take? A.Start the Rocephin without obtaining the sputum specimen. B.Wait until the client produces a sputum specimen. C.Encourage the client to turn, cough, and deep breath. D.Call physician to find out if the sputum specimen is needed.

A.Start the Rocephin without obtaining the sputum specimen.

The nurse is caring for a client undergoing brachytherapy with a temporary vaginal implant. The nurse should plan care for this client based on which factor? A.The client is emitting ionizing radiation. B.The client's source of radioactivity is low and not a hazard to others C.Radioactive precautions are used only for the first 24 hours of treatment D.Radioactive precautions are only needed for the client's body fluids

A.The client is emitting ionizing radiation.

The physician orders a blood test for prostate specific antigen (PSA) when an enlarged prostate is palpated on a 57 year old male. Which teaching should the nurse provide about testing of PSA levels? A.The test is combined with a digital rectal exam to monitor for the presence of prostate cancer. B.Elevated PSA levels always indicate prostate cancer. C.The test is used after a biopsy to confirm prostate cancer. D.The test is used to determine the stage and grade prostatic tumors.

A.The test is combined with a digital rectal exam to monitor for the presence of prostate cancer.

A client in the terminal stage of cancer is cared for by her family at home with the assistance of visiting hospice nurses. She is in continuous pain, and the physician has left orders to administer morphine at a rate to control her pain. When the nurse visits the client, she is awake but moaning with severe pain and asks for an increase in her morphine dosage. Her respirations are 10 per minute. What should the nurse do? A.Titrate the morphine dose upward until the patient has adequate pain relief. B.Suggest to the family that they give the patient additional nonnarcotic analgesics, such as ibuprofen. C.Tell the patient that she cannot have additional morphine until her respirations are at least 16 per minute. D.Inform the patient that increasing her dose of morphine will only increase the side effects and will not further control her pain.

A.Titrate the morphine dose upward until the patient has adequate pain relief.

A client admitted for a breast biopsy asks that nurse, "Where is cancer usually found in the breast?". The nurse should answer based on the understanding that most tumors occur where? A.near the axilla B.the circumareolar region C.within the nipple D.under the breast

A.near the axilla

A client has a small cell carcinoma of the lung that is causing syndrome of inappropriate antidiuretic hormone (SIADH). Which symptom supports this diagnosis? A.unexplained weight loss B.increased urine osmolality C.elevated ketones in the urine D.increased serum osmolality

B.increased urine osmolality

When assessing a client with suspected cervical cancer, which assessment finding should the nurse identify an important risk factor for this cancer? A.prolonged use of birth control pills B.multiple sex partners C.obesity D.fibrocystic disease

B.multiple sex partners

When assessing a patient, which symptom should the nurse recognize as an early symptom of Hodgkin's lymphoma? A.difficulty swallowing B.swollen cervical lymph nodes C.rapid, shallow respirations D.a feeling of stomach fullness

B.swollen cervical lymph nodes

While administering an infusion of packed RBCs, which actions can the RN delegate to unlicensed assistive personnel (UAP)? Select all that apply. a.Verify that the IV is patent. b.Obtain the blood products from the blood bank. c.Obtain vital signs before and after the first 15 minutes. d.Monitor the blood transfusion rate and adjust as needed. e.Assist the RN with checking patient identification and blood product identification data.

B & C

When caring for a patient with an internal radiation implant, the nurse should observe which principles? Select all that apply. a.Limiting the time with the client to 1 hour per shift b.Keeping pregnant women out of the client's room c.Placing the client in a private room with a private bath d.Wearing a lead shield when providing direct client care e.Removing the dosimeter film badge when entering the client's room f.Allowing individuals younger than 16 years old in the room as long as they are 6 feet away from the client

B, C, D

You're developing discharge instructions to the parents of a child who experiences atonic seizures. What information below is important to include in the teaching?* A. "This type of seizure is hard to detect because the child may appear like he or she is daydreaming." B. "Be sure your child wears a helmet daily." C. "It is common for the child to feel extremely tired after experiencing this type of seizure." D. "Avoid high fat and low carbohydrate diets."

B. "Be sure your child wears a helmet daily."

The nurse is ordered to administer Lorazepam to a patient experiencing status epilepticus. As a precautionary measure, the nurse will also have what reversal agent on standby?* A. Narcan B. Flumazenil C. Calcium Chloride D. Idarucizumab

B. Flumazenil

A patient with a history of epilepsy is taking Phenytoin. The patient's morning labs are back, and the patient's Phenytoin level is 7 mcg/mL. Based on this finding, the nurse will?* A. Assess the patient for a rash B. Initiate seizure precautions C. Hold the next dose of Phenytoin D. Continue to monitor the patient

B. Initiate seizure precautions

While receiving chemotherapy for leukemia a client asks the nurse how this medication will affect his ability to have children in the future. The best reply from the nurse would be A."Chemotherapy has no effect on fertility." B."You should use birth control while on this therapy and wait about 2years after the end of the treatment to try to conceive." C."Birth control does not need to be used while you are receiving this drug, you can't conceive during treatment." D."Chemotherapy always results in permanent sterility."

B."You should use birth control while on this therapy and wait about 2years after the end of the treatment to try to conceive."

When teaching family members about gifts to bring to a neutropenic patient, what information should the nurse include? A.Avoid latex balloons. B.Avoid fresh fruit. C.Avoid silk flowers D.Avoid chocolate.

B.Avoid fresh fruit.

When educating people about modifiable risk factors related to the most common cancers, which teaching should the nurse provide? A.Avoid saturated fats. B.Avoid smoking. C.Avoid alcohol. D.Avoid radiation exposure

B.Avoid smoking.

A patient receiving radiation therapy develops a dry desquamation of the skin in the treatment area. Which nursing intervention is appropriate? A.Exfoliate the dead skin with a very soft brush. B.Cleanse the area with mild soap and water. C.Apply ice packs to decrease pain and itching. D.Cover the area with an occlusive dressing

B.Cleanse the area with mild soap and water.

Twelve hours after an operation to remove an esophageal tumor, the nurse's assessment findings include: Pulse 92 regular Blood pressure 120/88 Respirations 24 shallow Rectal temp 99.4 F NG tube draining blood with greenish/yellow tinge Which finding should the nurse investigate first? A.Client's pulse. B.Client's respirations. C.Client's temperature. D.Client's NG drainage

B.Client's respirations.

A client with leukemia has severe neutropenia. Which nursing intervention is most importantto prevent transmission of harmful pathogens to the client? A.Administer prophylactic antibiotics as ordered. B.Enforce strict hand washing by staff and visitors. C.Wear a mask when providing care. D.Avoid serving any fruits or vegetables

B.Enforce strict hand washing by staff and visitors.

The patient is receiving an IV vesicant chemotherapy drug. The nurse notices redness and swelling at the site. What should the nurse do first? A.Flush the line with normal saline. B.Turn off the chemotherapy infusion. C.Apply an ice pack to the site. D.Remove the IV catheter.

B.Turn off the chemotherapy infusion.

The nurse is reviewing the lab results of a client who is receiving chemotherapy. Which lab result should be reported to the physician immediately? A.Hemoglobin 10.0 B.WBC count 1400 C.Platelet count 78,000 D.Serum creatinine 1.2

B.WBC count 1400

A client has been receiving a biologic response modifier for treatment of cancer. The nurse should assess for which common side effects? A.nausea, vomiting, and diarrhea B.fever, chills, and muscle aches C.opportunistic infections such as candidisis D.renal damage with increased serum BUN and creatinine

B.fever, chills, and muscle aches

Neurons in the brain are tasked with handling and transmitting information. There are different types of neurons, such as excitatory and inhibitory. Excitatory neurons release the neurotransmitter _____________, while inhibitory neurons release the neurotransmitter ________________.* A. GABA, glutamate B. Norepinephrine, GABA C. Glutamate, GABA D. Dopamine, glutamate

C. Glutamate, GABA

An 8-year-old child, who is not responding to anti-seizure medications, is prescribed to start a ketogenic diet. This diet will include:* A. High carbohydrates and high fat B. Low fat, high salt, and high carbohydrates C. High fat and low carbohydrates D. High glucose, high fat, and low carbohydrates

C. High fat and low carbohydrates

Keeping the previous question in mind, the patient is now experiencing characteristics of a tonic-clonic seizure. The seizure started at 1402 and it is now 1408, and the patient is still experiencing a seizure. The nurse should?* A. Continue to monitor the patient B. Suction the patient C. Initiate the emergency response system D. Restrain the patient to prevent further injury

C. Initiate the emergency response system

A patient with metastatic cancer of the colon experiences severe vomiting following each administration of chemotherapy. Which intervention is most important? A.Monitor electrolyte levels daily. B.Provide frequent, gentle oral care. C.Administer prescribed antimetics 1 hour before the treatments. D.Offer high-calorie snacks between treatments.

C.Administer prescribed antimetics 1 hour before the treatments.

A 64 year old female has undergone a modified radical mastectomy for a breast tumor. The pathology identifies the tumor as stage II, estrogen receptor positive adenocarcinoma. The nurse would expect which treatment for thisclient? A.Chemotherapy of CHOP B.Radiation therapy of 12 weeks in duration C.Administration of a hormone receptor agonist D.Interferon therapy

C.Administration of a hormone receptor agonist

A 7-year-old male patient is being evaluated for seizures. While in the child's room talking with the child's parents, you notice that the child appears to be daydreaming. You time this event to be 10 seconds. After 10 seconds, the child appropriately responds and doesn't recall the event. This is known as what type of seizure?* A. Focal Impaired Awareness (complex partial) B. Atonic C. Tonic-clonic D. Absence

D. Absence

A client has terminal renal cancer and is being cared for by his wife at home. His abdominal pain has become increasingly severe, and he now says it is intense most of the time. Which action by the client indicates that teaching regarding pain management has been effective? A.The client only takes narcotics when pain levels reach 7/10.. B.The client realizes that unrelieved pain is an inevitable effect of cancer. C.The client uses pain medication if NSAIDS are not effective.. D.The client takes analgesics on a regular schedule and uses additional doses if needed.

D.The client takes analgesics on a regular schedule and uses additional doses if needed.

A chemotherapy client has an absolute neutrophil count (ANC) of 550 microliters. Which dietary choice is contraindicatedfor this client? A.Canned pears in a heavy sugar syrup B.Fruit gelatinwith non-dairy cream topping C.Roast turkey sandwich with mustard D.Vegetable salad with grilled chicken

D.Vegetable salad with grilled chicken

When evaluating a tumor, the nurse understands that activation of which component within the cell may initiate the cell's transformation from normal to malignant? A.morphogene B.tumor suppressor gene C.maligenesis gene D.oncogene.

D.oncogene.

The primary protective role of the immune system related to malignant cells is a. surveillance for cells with tumor-associated antigens. b. binding with free antigens released by all cancer cells. c. producing blocking factors that immobilize cancer cells. d. reacting to a new set of antigenic determinants on cancer cells.

a. surveillance for cells with tumor-associated antigens.

The nurse is teaching a patient about the risk factors associated with colorectal cancer. The nurse determines that further teaching is necessary related to colorectal cancer if the patient identifies which item as an associated risk factor? a.Age younger than 50 years b.History of colorectal polyps c.Family history of colorectal cancer d.Chronic inflammatory bowel disease

a.Age younger than 50 years

For which type of malignancy should the nurse expect the use of the intravesical route of regional chemotherapy delivery? a.Bladder b.Leukemia c.Osteogenic sarcoma d.Metastasis to the brain

a.Bladder

The nurse determines that teaching about pernicious anemia has been effective when the patient says a.This condition can kill me unless I take injections of the vitamin for the rest of my life. b.My symptoms can be completely reversed if I take cobalamin (Vit B12) supplements. c.Ifmy anemia does not respond to cobalamin therapy, my only other alternative is a bone marrow transplant. d.The least expensive and most convenient treatment of pernicious anemia is to use a diet with foods high in cobalamin.

a.This condition can kill me unless I take injections of the vitamin for the rest of my life.

A patient has a platelet count of 50,000 and is diagnosed with ITP. What does the nurse anticipate that initial treatment will include? a.corticosteroids b.Splenectomy c.Administration of platelets d.Immunosuppressive therapy

a.corticosteroids

Nursing interventions for the patient with aplastic anemia are directed toward the prevention of which complications? a.Fatigue and dyspnea b.Hemorrhage and infection c.Thromboemboli and gangrene d.Cardiac dysrhythmias and heart failure

b. Hemorrhage and infection

To prevent fever and shivering during an infusion of rituximab (Rituxan), the nurse should premedicate the patient with a. aspirin. b. acetaminophen. c. sodium bicarbonate. d. meperidine (Demerol).

b. acetaminophen.

The nursing student is presenting a clinical conference and discusses the cause of Beta-thalassemia. The nursing student informs the group that a child at greatest risk of developing this disorder is which one? a.A child of Mexican descent. b.A child of Mediterranean descent. c.A child whose intake of iron is extremely poor. d.A breast-fed child of a mother with chronic anemia.

b.A child of Mediterranean descent.

What causes the anemia of sickle cell disease? a.Intracellular hemolysis of sickled RBCs b.Accelerated breakdown of normal RBCs c.Autoimmune antibody destruction of RBCs d.Isoimmune antibody-antigen reactions with RBCs

b.Accelerated breakdown of normal RBCs

The nurse is instructing the parent's of a child with iron deficiency anemia regarding the administration of liquid oral iron supplement. Which instruction should the nurse tell the parents? a.Administer the iron at mealtimes b.Administer the iron through a straw c.Mix the iron with cereal to administer d.Add the iron to formula for easy administration

b.Administer the iron through a straw

A patient with thrombocytopenia with active bleeding is to receive two units of platelets. To administer the platelets, what should the nurse do? a.Check for ABO compatibility b.Agitate the bag periodically during the transfusion c.Take vital sings every 15 minutes during the procedure d.Refrigerate the second unit until the first unit has transfused

b.Agitate the bag periodically during the transfusion

Which anemia is manifested with pancytopenia? a.Thalassemia b.Aplastic anemia c.Megaloblastic anemia d.Anemia of chronic disease

b.Aplastic anemia

The nurse is caring for a patient who is postoperative following a pelvic exenteration and the health care provider changes the client's diet from NPO status to clear liquids. The nurse should check which priority item before administering thediet? a.Ability to ambulate b.Bowel sounds c.Incision appearance d.Urine specific gravity

b.Bowel sounds

A client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication? a.Glucose level b.Calcium level c.Potassium level d.Prothrombin time

b.Calcium level

The nurse is assessing the perineal wound in a patient who has returned from the operating room following an abdominal perineal resection and notes serosanguineous drainage from the wound. Which nursing intervention is most appropriate? a.Clamp the penrose drain b.Change the dressing as prescribed c.Notify the health care provider d.Remove and replace the perineal packing

b.Change the dressing as prescribed

A patient with a hemoglobin level of 7.8 g/dLhas cardiac palpitations, a heart rate of 102 bpm, and an increased reticulocyte count. At this severity of anemia, what other manifestations would the nurse expect the patient to exhibit? a.Pallor b.Dyspnea c.A smooth tongue d.Sensitivity to cold

b.Dyspnea

When teaching the patient with cancer about chemotherapy, which approach should the nurse take? a.Avoid telling the patient about possible side effects of the drugs to prevent anticipatory anxiety b.Explain that antiemetics, antidiarrheals, and analgesics will be provided as needed to control side effects c.Assure the patient that the side effects from chemotherapy are uncomfortable but never life threatening d.Inform he patient that chemotherapy-related alopecia is usually permanent but can be managed with lifelong use of wigs

b.Explain that antiemetics, antidiarrheals, and analgesics will be provided as needed to control side effects

What is the most important method for identifying the presence of infection in a neutropenic patient? a.Routine blood and sputum cultures b.Frequent temperature monitoring c.Assessing for redness and swelling d.Monitoring white blood cell count

b.Frequent temperature monitoring

A 45-year-old patient has symptoms including arthralgia, impotence, weight loss, and liver enlargement. His laboratory results include an elevated serum iron, total iron binding capacity (TIBC), and serum ferritin levels. Which disorder does this describe and which treatment will be used? (L; 122; 22) a.Thalassemia; combination chemotherapy b.Hemochromatosis; deferoxamine c.Myelodysplastic syndrome; filgastim d.Delayed transfusion reaction; deferasirox

b.Hemochromatosis; deferoxamine

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 need if the client makes which statement? a.I should avoid blowing my nose. b.I'm going to take aspirin for my headache as soon as I get home. c.I may need a platelet transfusion if my platelet count is too low. d.I will count the number of pads and tampons I use when menstruating.

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

The nurse is providing medication instructions to a client with breast cancer who is receiving cyclophosphamide. The nurse should tell the client to take which action? a.Take the medication with food b.Increase fluid intake to 2000 to 3000 mL daily c.Decrease sodium intake while taking the medication d.Increase potassium intake while taking the medication

b.Increase fluid intake to 2000 to 3000 mL daily

In teaching the patient with pernicious anemia about the disease, the nurse explains that it results from a lack of a.Folic acid b.Intrinsic factor c.Extrinsic factor d.Cobalamin intake

b.Intrinsic factor

The patient was told she has carcinoma in situ, and the student nurse wonders what that is. How should the nurse explain this to the student nurse? a.Evasion of the immune system by cancer cells b.Lesion with histologic features of cancer except invasion c.Capable of causing cellular alterations associated with cancer d.Tumor cell surface antigens that stimulate an immune response

b.Lesion with histologic features of cancer except invasion

Which patient would be most likely to be cured with chemotherapy as a treatment measure? a.Small cell lung cancer b.New neuroblastoma c.Small tumor of the bone d.Large hepatocellular carcinoma

b.New neuroblastoma

What characteristics should the nurse be aware of in planning care of a patient with Hodgkin's lymphoma? a.Staging Hodgkin's lymphoma is not important to predict prognosis b.Nursing management of the patient undergoing treatment for Hodgkin's lymphoma includes measure to prevent infection. c.Hodgkin's lymphoma is characterized by proliferation of malignant activated B cells that destroy the kidneys. d.An important nursing intervention in the care of patients with Hodgkin's lymphoma is increasing fluids to manage hypercalcemia.

b.Nursing management of the patient undergoing treatment for Hodgkin's lymphoma includes measure to prevent infection.

A patient with hemophilia is hospitalized with acute knee pain and swelling. What is an appropriate nursing intervention for the patient? a.Wrapping the knee with an elastic bandage b.Placing the patient on bed rest and applying ice to the joint c.Administering nonsteroidal anti-inflammatory drugs (NSAIDs) as needed for pain d.Gently performing range-of-motion (ROM) exercises to the knee and to prevent adhesions

b.Placing the patient on bed rest and applying ice to the joint

When the patient asks about the late effects of chemotherapy and high-dose radiation, what areas of teaching should the nurse plan to include when describing these effects? a.Third space syndrome b.Secondary malignancies c.Chronic nausea and vomiting d.Persistent myelosuppression

b.Secondary malignancies

The nurse is instructing a patient to perform a testicular self-examination (TSE). The nurse should provide the patient with which information about the procedure? a.To examine the testicles while lying down b.That the best time for the examination is after a shower c.To gently feel the testicle with one finger to feel for a growth d.That testicular self-examinations should be done at least every 6 months

b.That the best time for the examination is after a shower

A patient who has been receiving radiation therapy for bladder cancer tells the nurse that it feels as if she is voidingthrough the vagina. The nurse interprets that the patient may be experiencing which condition? a.Rupture of the bladder b.The development of a vesicovaginal fistula c.Extreme stress caused by the diagnosis of cancer d.Altered perineal sensation as a side effect of radiation therapy

b.The development of a vesicovaginal fistula

When a patient is undergoing brachytherapy, what is it important for the nurse to be aware of when caring for this patient? a.The patient will undergo simulation to identify and mark the field of treatment. b.The patient is a source of radiation and personnel must wear film badges during care. c.The goal of this treatment is only palliative and the patient should be aware of the expected outcome. d.Computerized dosimetry is used to determine the maximum dose of radiation to the tumor within an acceptable dose to normal tissue.

b.The patient is a source of radiation and personnel must wear film badges during care.

Asmall lesion is discovered in a patient's lung when an x-ray is performed for cervical spine pain. What is the most definitive method of determining if the lesion is malignant? a.Lung scan b.Tissue biopsy c.Oncofetal antigens in the blood d.CT or positron emission tomography (PET) scan

b.Tissue biopsy

A patient with sickle cell anemia asks the nurse why the sickling crisis does not stop when oxygen therapy is started. Which explanation should the nurse give to the patient? a.Sickling occurs in response to decreased blood viscosity, which is not affectedby oxygen therapy b.When RBCs sickle, they occlude small vessels, which causes more local hypoxia and more sickling c.The primary problem during a sickle cell crisis is destruction of the abnormal cells, resulting in fewer RBCs to carry oxygen d.Oxygen therapy does not alter the shape of the abnormal erythrocytes but only allows for increased oxygen concentration in hemoglobin

b.When RBCs sickle, they occlude small vessels, which causes more local hypoxia and more sickling

The goals of cancer treatment are based on the principle that a. surgery is the single most effective treatment for cancer. b. initial treatment is always directed toward cure of the cancer. c. a combination of treatment modalities is effective for controlling many cancers. d. although cancer cure is rare, quality of life can be increased with treatment modalities.

c. a combination of treatment modalities is effective for controlling many cancers.

Trends in the incidence and death rates of cancer include the fact that a. a higher percent of women than men have lung cancer. b. lung cancer is the most common type of cancer in men. c. blacks have a higher death rate from cancer than whites. d. breast cancer is the leading cause of cancer deaths in women.

c. blacks have a higher death rate from cancer than whites.

A characteristic of the stage of progression in cancer development is a. oncogenic viral transformation of target cells. b. a reversible steady growth facilitated by carcinogens. c. a period of latency before clinical detection of cancer. d. proliferation of cancer cells despite host control mechanisms.

d. proliferation of cancer cells despite host control mechanisms.

The nurse is monitoring the laboratory results of a client receiving an antineoplastic medication by the intravenous route. The nurse plans to initiate bleeding precautions if which laboratory result is noted? a.A clotting time of 10 minutes b.An ammonia level of 20 c.A platelet count of 50,000 d.A white blood cell count of 5000

c.A platelet count of 50,000

Which leukemia is seen in 80% of adults with acute leukemia and exhibits proliferation of precursors of granulocytes? a.Acute lymphocytic leukemia (ALL) b.Chronic lymphocytic leukemia (CLL) c.Acute myelogenous leukemia (AML) d.Chronic myelogenous leukemia (CML)

c.Acute myelogenous leukemia (AML)

Which normal tissues manifest early, acute responses to radiation therapy? a.Spleen and liver b.Kidney and nervous tissue c.Bone marrow and gastrointestinal mucosa d.Hollow organs such as the stomach and bladder

c.Bone marrow and gastrointestinal mucosa

A gastrectomy is performed on apatient with gastric cancer. In the immediate postoperative period, the nurse notes bloody drainage form the nasogastric tube. The nurse should take which most appropriate action? a.Measure abdominal girth b.Irrigate the nasogastric tube c.Continue to monitor the drainage d.Notify the health care provider

c.Continue to monitor the drainage

What describes a primary use of biologic therapy in cancer treatment? a.Protect normal, rapidly reproducing cells of the GI system from damage during chemotherapy b.Prevent the fatigue associated with chemotherapy and high-dose radiation as seen with bone marrow depression c.Enhance or supplement the effects of the host's immune response to tumor cells that produce flu-like symptoms d.Depress the immune system and circulating lymphocytes as well as increase a sense of well-being by replacing central nervous system deficits

c.Enhance or supplement the effects of the host's immune response to tumor cells that produce flu-like symptoms

The nurse uses many precautions during IV administration of vesicant chemotherapeutic agents, primarily to prevent a.Septicemia b.Catheter occlusion c.Extravasation d.Anaphylactic shock

c.Extravasation

A patient with hemophilia comes to the clinic for treatment. What should the nurse anticipates that he or she will need to administer? a.Whole blood b.Thromboplastin c.Factor concentrates d.Fresh frozen plasma

c.Factor concentrates

The nurse is reviewing the history of a patient with bladder cancer. The nurse expects to note documentation of which most common symptom of this type of cancer? a.Dysuria b.Urgency on urination c.Hematuria d.Frequency of urination

c.Hematuria

The nurse is assessing a patient who has a new ureterostomy. Which statement by the patient indicates the need for more education about urinary stoma care? a.I change my pouch every week. b.I change the appliance in the morning. c.I empty the urinary collection bag when it is two-thirds full. d.When I'm in the shower I direct the flow of water away from my stoma.

c.I empty the urinary collection bag when it is two-thirds full.

Following a splenectomy for the treatment of ITP, the nurse would expect the patient's laboratory test results to reveal which of the following? a.Decreased RBCs b.Decreased WBCs c.Increased platelets d.Increased immunoglobulins

c.Increased platelets

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 a.Anemia b.Decreased platelets c.Increased uric acid levels d.Decreased leukocyte count

c.Increased uric acid levels

What is the underlying cause of lymphadenopathy, splenomegaly, and hepatomegaly in leukemia? a.The development of infection at these sites b.Increased compensatory production of blood cells by these organs c.Infiltration of the organs by increased numbers of WBC in the blood d.Normal hypertrophy of the organs in an attempt to destroy abnormal cells

c.Infiltration of the organs by increased numbers of WBC in the blood

A 10-year old child with hemophilia A has slipped on the ice and bumped his knee. The nurse should prepare to administer which prescription? a.Injection of factor X b.Intravenous infusion of iron c.Intravenous infusion of factor VIII d.Intramuscular injection of iron using the Z-track method

c.Intravenous infusion of factor VIII

What factor differentiates a malignant tumor from a benign tumor? a.It causes death b.It grows at a faster rate c.It invades and metastasizes d.It is often encapsulated.

c.It invades and metastasizes

A 76-year-old woman has a Hgb of 7.3 and is experiencing ataxia and confusion on admission to the hospital. What is a priority nursing intervention for this patient? a.Provide a darkened, quiet room b.Have the family stay with the patient c.Keep top bedside rails up and call bell in close reach d.Question the patient about possible causes of anemia

c.Keep top bedside rails up and call bell in close reach

The nurse explains to a patient undergoing brachytherapy of the cervix that she a. must undergo simulation to locate the treatment area. b. requires the use of radioactive precautions during nursing care. c. may have desquamation of the skin on the abdomen and upper legs. d. requires shielding of the ovaries during treatment to prevent ovarian damage.

d. requires shielding of the ovaries during treatment to prevent ovarian damage.

A patient with acute myelogenous leukemia is considering a hematopoietic stem cell transplant and asks the nurse what is involved. What is the best response the nurse can give the patient? a.Your bone marrow is destroyed by radiation and new bone marrow cells from a matched donor we injected into your bones. b.A specimen of your bone marrow may be aspirated and treated to destroy any leukemic cells and then re-infused when your disease becomes worse. c.Leukemic cells and bone marrow stem cells are eliminated with chemotherapy and/or total body radiation and new bone marrow cells from a donor are infused. d.During chemotherapy and/or total body irradiation to destroy all of your blood cells, you may be given transfusions of red blood cells and platelets to prevent complications

c.Leukemic cells and bone marrow stem cells are eliminated with chemotherapy and/or total body radiation and new bone marrow cells from a donor are infused.

The nurse is providing home care instructions to the parents of a 10-year-old child with hemophilia. Which sport activity should the nurse suggest for this child? a.Soccer b.Basketball c.Swimming d.Field hockey

c.Swimming

The nurse should plan to implement which intervention in the care of a patient experiencing neutropenia as a result of chemotherapy? a.Restrictall visitors b.Restrict fluid intake c.Teach the client and family about the need for hand hygiene d.Insert an indwelling urinary catheter to prevent skin breakdown

c.Teach the client and family about the need for hand hygiene

A patient on chemotherapy for 10 weeks started at a weight of 121 lb. She now weighs 118 lb and has no sense of taste. Which nursing intervention would be a priority? a. Discuss with the provider the need for parenteral nutrition. b. Teach the patient to eat foods that are fatty, fried, or high in calories. c. Tell the patient to drink a nutritional supplement beverage three times a day. d. Have the patient try various spices and seasonings to enhance the flavor of food.

d. Have the patient try various spices and seasonings to enhance the flavor of food.

Laboratory studies are performed for a child suspected to have iron deficiency anemia. The nurse reviews the laboratory results, knowing that which result indicates this type of anemia? a. Elevated hemoglobin level b. Decreased reticulocyte count c. Elevated red blood cell count d. Red blood cells that are microcytic and hypochromic

d. Red blood cells that are microcytic and hypochromic

The nurse is caring for a 59-year-old woman who had surgery 1 day ago to remove an ovarian cancer mass. The patient is awaiting the pathology report. She is tearful and says that she is scared to die. The most effective nursing intervention at this point is to use this opportunity to a. motivate change in an unhealthy lifestyle. b. teach her about the 7 warning signs of cancer. c. discuss healthy stress relief and coping practices. d. let her communicate about the meaning of this experience.

d. let her communicate about the meaning of this experience.

The nurse counsels the patient receiving radiation therapy or chemotherapy that a. effective birth control methods should be used for the rest of the patient's life. b. after successful treatment, patients can expect a return to their previous level of function. c. the cycle of fatigue-depression-fatigue that may occur during treatment may be reduced by restricting activity. d. nausea and vomiting can usually be managed with antiemetic drugs, diet modification, and other interventions.

d. nausea and vomiting can usually be managed with antiemetic drugs, diet modification, and other interventions.