AH2 RESPIRATORY & ONCOLOGY PQS (that I got wrong!!)

When developing a discharge plan to manage the care of a client with COPD, the nurse should anticipate that the client will do which of the following? A. Develop infections easily B. Maintain current status C. Require less supplemental oxygen D. Show permanent improvement

A A client with COPD is at high risk for development of respiratory infections. COPD is a slowly progressive; therefore, maintaining current status and establishing a goal that the client will require less supplemental oxygen are unrealistic expectations. Treatment may slow progression of the disease, but permanent improvement is highly unlikely.

The nurse is reviewing the laboratory results of a client receiving chemotherapy. The platelet count is 10,000 cells/mm. Based on this laboratory value, the priority nursing assessment is which of the following? A. Assess level of consciousness B. Assess temperature C. Assess bowel sounds D. Assess skin turgor

A A high risk of hemorrhage exists when the platelet count is fewer than 20,000. Fatal central nervous system hemorrhage or massive gastrointestinal hemorrhage can occur when the platelet count is fewer than 10,000. The client should be assessed for changes in levels of consciousness, which may be an early indication of an intracranial hemorrhage. Option 2 is a priority nursing assessment when the white blood cell count is low and the client is at risk for an infection.

Which of the following substances has abnormal values early in the course of multiple myeloma (MM)? A. Immunoglobulins B. Platelets C. Red blood cells D. White blood cells

A MM is characterized by malignant plasma cells that produce an increased amount of immunoglobulin that isn't functional. As more malignant plasma cells are produced, there's less space in the bone marrow for RBC production. In late stages, platelets and WBC's are reduced as the bone marrow is infiltrated by malignant plasma cells.

The nurse in charge is teaching a client with emphysema how to perform pursed-lip breathing. The client asks the nurse to explain the purpose of this breathing technique. Which explanation should the nurse provide? A. It helps prevent early airway collapse B. It increases inspiratory muscle strength C. It decreases use of accessory breathing muscles D. It prolongs the inspiratory phase of respiration

A Pursed-lip breathing helps prevent early airway collapse. Learning this technique helps the client control respiration during periods of excitement, anxiety, exercise, and respiratory distress. To increase inspiratory muscle strength and endurance, the client may need to learn inspiratory resistive breathing. To decrease accessory muscle use and thus reduce the work of breathing, the client may need to learn diaphragmatic (abdominal) breathing. In pursed-lip breathing, the client mimics a normal inspiratory-expiratory (I:E) ratio of 1:2. (A client with emphysema may have an I:E ratio as high as 1:4.)

A cervical radiation implant is placed in the client for treatment of cervical cancer. The nurse initiates what most appropriate activity order for this client? A. Bed rest B. Out of bed ad lib C. Out of bed in a chair only D. Ambulation to the bathroom only

A The client with a cervical radiation implant should be maintained on bed rest in the dorsal position to prevent movement of the radiation source. The head of the bed is elevated to a maximum of 10 to 15 degrees for comfort. The nurse avoids turning the client on the side. If turning is absolutely necessary, a pillow is placed between the knees and, with the body in straight alignment, the client is logrolled.

An oxygenated delivery system is prescribed for a client with COPD to deliver a precise oxygen concentration. Which of the following types of oxygen delivery systems would the nurse anticipate to be prescribed? A. Venturi mask B. Aerosol mask C. Face tent D. Tracheostomy collar

A The venture mask delivers the most accurate oxygen concentration. The Venturi mask is the best oxygen delivery system for the client with chronic airflow limitation because it delivers a precise oxygen concentration. The face tent, the aerosol mask, and the tracheostomy collar are also high-flow oxygen delivery systems but most often are used to administer high humidity.

A nurse is teaching a community program on nutritional guidelines for cancer prevention. Which of the following instructions should the nurse include? (Select All that Apply) A. Eat foods high in vitamin A B. Add cruciferous vegetables C. Increase intake of red meats D. Use saturated cooking oil E. Consume refined grains

A,B consume foods high in Vitamin A (apricots, carrots, leafy green vegetables) & cruciferous vegetables (broccoli, cabbage) reduces the risk of cancer D. use polyunsaturated & monounsaturated fats instead E. consume whole grains

A nurse in an oncology clinic is caring for a client who is undergoing treatment for cancer and reports difficulty eating due to inability to taste food. Which of the following interventions should the nurse recommend? A. Avoid Citrus Juice B. Use plastic utensils to eat C. Eat foods that are warm D. Increase foods high in pectin

B use of plastic utensils when eating can enhance taste sensations for the pt undergoing cancer treatment & reduce the occurrence of a metallic taste

The nurse in charge formulates a nursing diagnosis of Activity intolerance related to inadequate oxygenation and dyspnea for a client with chronic bronchitis. To minimize this problem, the nurse instructs the client to avoid conditions that increase oxygen demands. Such conditions include: A. Drinking more than 1,500 ml of fluid daily B. Being overweight C. Eating a high-protein snack at bedtime D. Eating more than three large meals a day

B Conditions that increase oxygen demands include obesity, smoking, exposure to temperature extremes, and stress. A client with chronic bronchitis should drink at least 2,000 ml of fluid daily to thin mucus secretions; restricting fluid intake may be harmful. The nurse should encourage the client to eat a high-protein snack at bedtime because protein digestion produces an amino acid with sedating effects that may ease the insomnia associated with chronic bronchitis. Eating more than three large meals a day may cause fullness, making breathing uncomfortable and difficult; however, it doesn't increase oxygen demands. To help maintain adequate nutritional intake, the client with chronic bronchitis should eat small, frequent meals (up to six a day).

The nurse is developing a plan of care for the client with multiple myeloma. The nurse includes which priority intervention in the plan of care? A. Coughing and deep breathing B. Encouraging fluids C. Monitoring red blood cell count D.Providing frequent oral care

B Hypercalcemia caused by bone destruction is a priority concern in the client with multiple myeloma. The nurse should administer fluids in adequate amounts to maintain and output of 1.5 to 2 L a day. Clients require about 3 L of fluid pre day. The fluid is needed not only to dilute the calcium overload but also to prevent protein from precipitating in renal tubules. Options 1, 3, and 4 may be components in the plan of care but are not the priority in this client.

Which of the following is the primary goal for surgical resection of lung cancer? A. To remove the tumor and all surrounding tissue. B. To remove the tumor and as little surrounding tissue as possible. C. To remove all of the tumor and any collapsed alveoli in the same region. D. To remove as much as the tumor as possible, without removing any alveoli.

B The goal of surgical resection is to remove the lung tissue that has a tumor in it while saving as much surrounding tissue as possible. It may be necessary to remove alveoli and bronchioles, but care is taken to make sure only what's absolutely necessary is removed.

A nurse is preparing to obtain a sputum specimen from a client. Which of the following nursing actions will facilitate obtaining the specimen? A. Limiting fluids B. Having the client take 3 deep breaths C. Asking the client to spit into the collection container D. Asking the client to obtain the specimen after eating

B To obtain a sputum specimen, the client should rinse the mouth to prevent contamination, breathe deeply, and then cough unto a sputum specimen container. The client should be encouraged to cough and not spit so as to obtain sputum. Sputum can be thinned by fluids or by a respiratory treatment such as inhalation of nebulized saline or water. The optimal time to obtain a specimen is on arising in the morning.`

A nurse is preparing to obtain a sputum specimen from a male client. Which of the following nursing actions will facilitate obtaining the specimen? A. Limiting fluid B. Having the client take deep breaths C. Asking the client to spit into the collection container D. Asking the client to obtain the specimen after eating

B To obtain a sputum specimen, the client should rinse the mouth to reduce contamination, breathe deeply, and then cough into a sputum specimen container. The client should be encouraged to cough and not spit so as to obtain sputum. Sputum can be thinned by fluids or by a respiratory treatment such as inhalation of nebulized saline or water. The optimal time to obtain a specimen is on arising in the morning.

A nurse is teaching a client who is undergoing cancer treatment about interventions to manage stomatitis. Which of the following statements by the client indicates understanding of the teaching? A. "I will try chewing larger pieces of food" B. "I will avoid toasting my bread" C. "I will consume more food in the morning" D. "I will add more citrus foods to my diet"

B dry, coarse foods such as toast can worsen the s/s of stomatitis

A client with a positive Mantoux test result will be sent for a chest x-ray. For which of the following reasons is this done? A. To confirm the diagnosis B. To determine if a repeat skin test is needed C. To determine the extent of the lesions D. To determine if this is a primary or secondary infection

C If the lesions are large enough, the chest x-ray will show their presence in the lungs. Sputum culture confirms the diagnosis. There can be false-positive and false-negative skin test results. A chest x-ray can't determine if this is a primary or secondary infection.

A male client with chronic obstructive pulmonary disease (COPD) is recovering from a myocardial infarction. Because the client is extremely weak and can't produce an effective cough, the nurse should monitor closely for: A. Pleural effusion B. Pulmonary edema C. Atelectasis D. Oxygen toxicity

C In a client with COPD, an ineffective cough impedes secretion removal. This, in turn, causes mucus plugging, which leads to localized airway obstruction — a known cause of atelectasis. An ineffective cough doesn't cause pleural effusion (fluid accumulation in the pleural space). Pulmonary edema usually results from left-sided heart failure, not an ineffective cough. Although many noncardiac conditions may cause pulmonary edema, an ineffective cough isn't one of them. Oxygen toxicity results from prolonged administration of high oxygen concentrations, not an ineffective cough.

According to a standard staging classification of Hodgkin's disease, which of the following criteria reflects stage II? A. Involvement of extralymphatic organs or tissues B. Involvement of single lymph node region or structure C. Involvement of two or more lymph node regions or structures. D. Involvement of lymph node regions or structures on both sides of the diaphragm.

C Stage II involves two or more lymph node regions. Stage I only involves one lymph node region; stage III involves nodes on both sides of the diaphragm; and stage IV involves extralymphatic organs or tissues.

For a patient with advance chronic obstructive pulmonary disease (COPD), which nursing action best promotes adequate gas exchange? A. Encouraging the patient to drink three glasses of fluid daily B. Keeping the patient in semi-fowler's position C. Using a high-flow venturi mask to deliver oxygen as prescribe D. Administering a sedative, as prescribe

C The patient with COPD retains carbon dioxide, which inhibits stimulation of breathing by the medullary center in the brain. As a result, low oxygen levels in the blood stimulate respiration, and administering unspecified, unmonitored amounts of oxygen may depress ventilation. To promote adequate gas exchange, the nurse should use a Venturi mask to deliver a specified, controlled amount of oxygen consistently and accurately. Drinking three glasses of fluid daily would not affect gas exchange or be sufficient to liquefy secretions, which are common in COPD. Patients with COPD and respiratory distress should be places in high-Fowler's position and should not receive sedatives or other drugs that may further depress the respiratory center.

Nurse April is teaching a group of women to perform breast self-examination. The nurse should explain that the purpose of performing the examination is to discover: A. cancerous lumps. B. areas of thickness or fullness. C. changes from previous self-examinations. D. fibrocystic masses.

C Women are instructed to examine themselves to discover changes that have occurred in the breast. Only a physician can diagnose lumps that are cancerous, areas of thickness or fullness that signal the presence of a malignancy, or masses that are fibrocystic as opposed to malignant.

The nurse is caring for a client following a modified radical mastectomy. Which assessment finding would indicate that the client is experiencing a complication related to this surgery? A. Sanguineous drainage in the Jackson-Pratt drain B. Pain at the incisional site C. Complaints of decreased sensation near the operative site D. Arm edema on the operative sid

D Arm edema on the operative side (lymphedema) is a complication following mastectomy and can occur immediately postoperatively or may occur months or even years after surgery. The other options are expected occurrences.

A nurse is caring for a client after a bronchoscopy and biopsy. Which of the following signs if noted in the client should be reported immediately to the physician? A. Blood-streaked sputum B. Dry cough C. Hematuria D. Bronchospasm

D If a biopsy was performed during a bronchoscopy, blood-streaked sputum is expected for several hours. Frank blood indicates hemorrhage. A dry cough may be expected. The client should be assessed for signs of complications, which would include cyanosis, dyspnea, stridor, bronchospasm, hemoptysis, hypotension, tachycardia, and arrhythmias. Hematuria is unrelated to this procedure.

Warning signs and symptoms of lung cancer include persistent cough, bloody sputum, dyspnea, and which of the other following symptoms? A. Dizziness B. Generalized weakness C. Hypotension D. Recurrent pleural effusion

D Recurring episodes of pleural effusions can be caused by the tumor and should be investigated. Dizziness, generalized weakness, and hypotension aren't typically considered warning signals, but may occur in advanced stages of cancer.term-11

A male client is asking the nurse a question regarding the Mantoux test for tuberculosis. The nurse should base her response on the fact that the: A. Area of redness is measured in 3 days and determines whether tuberculosis is present. B. Skin test doesn't differentiate between active and dormant tuberculosis infection. C. Presence of a wheal at the injection site in 2 days indicates active tuberculosis. D. Test stimulates a reddened response in some clients and requires a second test in 3 months.

The Mantoux test doesn't differentiate between active and dormant infections. If a positive reaction occurs, a sputum smear and culture as well as a chest X-ray are necessary to provide more information. Although the area of redness is measured in 3 days, a second test may be needed; neither test indicates that tuberculosis is active. In the Mantoux test, an induration 5 to 9 mm in diameter indicates a borderline reaction; a larger induration indicates a positive reaction. The presence of a wheal within 2 days doesn't indicate active tuberculosis.

https://nurseslabs.com/nclex-cancer-oncology-nursing-3-25-items/

start from Q. 1

https://nurseslabs.com/nclex-exam-pneumonia-tuberculosis-60-items/

start from Q.21