Cancer/Nutrition/Upper GI quiz

The nurse reviews the laboratory results of a patient who is receiving chemotherapy. Which laboratory result is most important to report to the health care provider? Select one: a. Platelets 95,000/µL b. White blood cells (WBC) 2700/µL c. Hemoglobin 10 g/L d. Hematocrit 30%

White blood cells (WBC) 2700/µL

The nurse will instruct the patient with a fractured left radius that the cast will need to remain in place Select one: a. for at least 3 weeks. b. until x-rays show complete bony union. c. until swelling of the wrist has resolved. d. for several months.

for at least 3 weeks.

What is the priority nursing diagnosis for a patient experiencing chemotherapy-induced anemia? Select one: a. Imbalanced nutrition, less than body requirements related to anorexia b. Disturbed body image related to skin color changes c. Fatigue related to decreased cellular oxygenation d. Risk for injury related to poor blood clotting

Fatigue related to decreased cellular oxygenation

While collecting a health history on a patient admitted for colon cancer, which of the following questions would be a priority to ask this patient? Select one: a. "Have you noticed any swelling in your abdomen?" b. "Have you noticed any blood in your stool?" c. "Have you been experiencing nausea?" d. "Do you have back pain?"

Have you noticed any blood in your stool?"

After the nurse has taught a 28-yr-old with fibromyalgia, which statement by the patient indicates a good understanding of effective self-management? Select one: a. "I will need to stop drinking so much coffee and soda." b. "I will call the doctor every time my symptoms get worse." c. "I am going to join a soccer team to get more exercise." d. "I should avoid using over-the-counter medications for pain."

"I will need to stop drinking so much coffee and soda."

The nurse is caring for a postoperative patient who has just vomited yellow green liquid and reports nausea. Which action would be an appropriate nursing intervention? Select one: a. Discontinue any medications that may cause nausea or vomiting. b. Take the patient for a walk in the hallway to promote peristalsis. c. Apply a cool washcloth to the forehead and provide mouth care. d. Offer the patient an herbal supplement such as ginseng.

Apply a cool washcloth to the forehead and provide mouth care.

A patient develops neutropenia after receiving chemotherapy. Which information about ways to prevent infection will the nurse include in the teaching plan (select all that apply)? Select one or more: a. Cook food thoroughly before eating. b. Use rectal suppositories if needed for constipation. c. Talk to the oncologist before having any dental work. d. Choose low fiber, low residue foods. e. Avoid public transportation such as buses.

Avoid public transportation such as buses. Cook food thoroughly before eating. Talk to the oncologist before having any dental work

Which information will the nurse include when teaching adults to decrease the risk for cancers of the tongue and buccal mucosa? Select one: a. Avoid use of cigarettes and smokeless tobacco. b. Use antivirals to treat herpes simplex virus (HSV) infections. c. Use sunscreen when outside even on cloudy days. d. Complete antibiotic courses used to treat throat infections.

Avoid use of cigarettes and smokeless tobacco.

A patient is being discharged after 1 week of IV antibiotic therapy for acute osteomyelitis in the right leg. Which information will be included in the discharge teaching? Select one: a. The reason for taking oral antibiotics for 7 to 10 days after discharge b. How to monitor and care for a long-term IV catheter c. How to apply warm packs to the leg to reduce pain d. The need for daily aerobic exercise to help maintain muscle strength

How to monitor and care for a long-term IV catheter

The nurse at the clinic is interviewing a 64-yr-old woman who is 5 feet, 3 inches tall and weighs 125 lb (57 kg). The patient has not seen a health care provider for 20 years. She walks 5 miles most days and has a glass of wine two or three times a week. Which topics will the nurse plan to include in patient teaching about cancer screening and decreasing cancer risk (select all that apply)? Select one or more: a. Colorectal screening b. Sunscreen use c. Pap testing d. Tobacco use e. Mammography

Mammography Colorectal screening Sunscreen use Pap testing

An 80-yr-old patient who is hospitalized with peptic ulcer disease develops new-onset auditory hallucinations. Which prescribed medication will the nurse discuss with the health care provider before administration? Select one: a. Aluminum hydroxide b. Omeprazole (Prilosec) c. Sucralfate (Carafate) d. Metoclopramide (Reglan)

Metoclopramide (Reglan)

The nurse is preparing to hang fat emulsion (lipids) and notes that fat globules are visible at the top of the solution. The nurse should take what action? Select one: a. Obtain a different bottle of solution b. Roll the bottle of solution gently c. run the bottle of solution under warm water d. shake the bottle of solution vigorously

Obtain a different bottle of solution

During assessment of the patient with fibromyalgia, the nurse would expect the patient to report which of the following (select all that apply)? Select one or more: a. Sleep disturbances b. Multiple tender points c. Cardiac palpitations and dizziness d. Widespread bilateral, burning musculoskeletal pain e. Multijoint inflammation and swelling

Sleep disturbances Multiple tender points Widespread bilateral, burning musculoskeletal pain

A hospitalized patient who has received chemotherapy for leukemia develops neutropenia. Which observation by the nurse would indicate a need for further teaching? Select one: a. The patient's visitors bring in fresh peaches. b. The patient cleans with a warm washcloth after having a stool. c. The patient ambulates around the room. d. The patient uses soap and shampoo to shower every other day.

The patient's visitors bring in fresh peaches.

A patient vomiting blood-streaked fluid is admitted to the hospital with acute gastritis. To determine possible risk factors for gastritis, the nurse will ask the patient about Select one: a. use of nonsteroidal antiinflammatory drugs (NSAIDs). b. a family history of gastric or colon cancer. c. the amount of saturated fat in the diet. d. a history of a large recent weight gain or loss.

use of nonsteroidal antiinflammatory drugs (NSAIDs).

Which information about dietary management should the nurse include when teaching a patient with peptic ulcer disease (PUD)? Select one: a. "Avoid foods that cause pain after you eat them." b. "You will need to remain on a bland diet." c. "High-protein foods are least likely to cause you pain." d. "You should avoid eating any raw fruits and vegetables."

"Avoid foods that cause pain after you eat them."

Which statement by the patient indicates a good understanding of the nurse's teaching about a new short-arm synthetic cast? Select one: a. "I can get the cast wet as long as I dry it right away with a hair dryer." b. "I can use a cotton-tipped applicator to rub lotion on any dry areas under the cast." c. "I will apply an ice pack to the cast over the fracture site off and on for 24 hours." d. "I should avoid moving my fingers and elbow until the cast is removed."

"I will apply an ice pack to the cast over the fracture site off and on for 24 hours."

A female patient complains of a "scab that just won't heal" under her left breast. During your conversation, she also mentions chronic fatigue, loss of appetite, and slight cough, attributed to allergies. What is the nurse's best action? Select one: a. Tell her to put a bandage on the scab and set a follow-up appointment in one week. b. Suggest further testing with a cancer specialist and provide the appropriate literature. c. End the appointment and tell the patient to use skin protection during sun exposure. d. Continue to conduct a symptom analysis to better understand the patient's symptoms and concerns.

Continue to conduct a symptom analysis to better understand the patient's symptoms and concerns.

The nurse notes crackling sounds and a grating sensation with palpation of an older patient's elbow. How will this finding be documented? Select one: a. Subluxation b. Epicondylitis c. Crepitation d. Torticollis

Crepitation

Interleukin-2 (IL-2) is used as adjuvant therapy for a patient with metastatic renal cell carcinoma. Which information should the nurse include when explaining the purpose of this therapy to the patient? Select one: a. IL-2 enhances the body's immunologic response to tumor cells. b. IL-2 prevents bone marrow depression caused by chemotherapy. c. IL-2 protects normal cells from harmful effects of chemotherapy. d. IL-2 stimulates malignant cells in the resting phase to enter mitosis.

IL-2 enhances the body's immunologic response to tumor cells.

A patient with prostate cancer is taking estrogen daily to control tumor growth. He reports that his left calf is swollen and painful. Which of the following would be the nurse's best action? Select one: a. Instruct the client to keep the leg elevated. b. Document assessment findings as an expected response with estrogen therapy. c. Measure the calf circumference and compare the measurement with the right calf circumference measurement. d. Apply ice to the calf after a 10-minute massage of the area.

Measure the calf circumference and compare the measurement with the right calf circumference measurement.

A patient receiving head and neck radiation for larynx cancer has ulcerations over the oral mucosa and tongue and thick, ropey saliva. Which instructions should the nurse give to this patient? Select one: a. Use cotton-tipped applicators dipped in hydrogen peroxide to clean the teeth. b. Gargle and rinse the mouth several times a day with an antiseptic mouthwash. c. Rinse the mouth before and after each meal and at bedtime with a saline solution. d. Remove food debris from the teeth and oral mucosa with a stiff toothbrush.

Rinse the mouth before and after each meal and at bedtime with a saline solution.

The nurse is instructing a client with hypertension on the importance of choosing foods low in sodium. The nurse should teach the client to limit intake of which food? Select one: a. Steamed vegetables b. Bananas c. Smoked Sausage d. Apples

Smoked Sausage

The nurse administers an IV vesicant chemotherapeutic agent to a patient. Which action is most important for the nurse to take? Select one: a. Infuse the medication over a short period of time. b. Administer the chemotherapy through a small-bore catheter. c. Hold the medication unless a central venous line is available. d. Stop the infusion if swelling is observed at the site.

Stop the infusion if swelling is observed at the site.

A patient who had arthroscopic surgery of the right knee 7 days ago is admitted with a red, swollen, hot knee. Which assessment finding by the nurse should be reported to the health care provider immediately? Select one: a. The blood pressure is 86/50 mm hg. b. The patient is taking ibuprofen (Motrin). c. The white blood cell count is 11,500/µL. d. The patient says the knee pain is severe.

The blood pressure is 86/50 mm hg.

Which discharge instruction will the emergency department nurse include for a patient with a sprained ankle? Select one: a. Gently move the ankle through the range of motion. b. Apply a heating pad to reduce muscle spasms. c. Use pillows to elevate the ankle above the heart. d. Keep the ankle loosely wrapped with gauze.

Use pillows to elevate the ankle above the heart.

Which finding for a patient who is taking hydroxychloroquine (Plaquenil) to treat rheumatoid arthritis is likely to be an adverse effect of the medication? Select one: a. Abdominal cramping b. Blurred vision c. Elevated Blood Pressure d. Joint tenderness

Blurred vision

The nurse explaining esomeprazole (Nexium) to a patient with recurring heartburn describes that the medication Select one: a. reduces gastroesophageal reflux by increasing the rate of gastric emptying. b. neutralizes stomach acid and provides relief of symptoms in a few minutes. c. treats gastroesophageal reflux disease by decreasing stomach acid production. d. coats and protects the lining of the stomach and esophagus from gastric acid.

treats gastroesophageal reflux disease by decreasing stomach acid production.

The nurse is caring for a patient diagnosed with stage I colon cancer. When assessing the need for psychologic support, which question by the nurse will provide the most information? Select one: a. "Can you tell me what has been helpful to you in the past when coping with stressful events?" b. "How long ago were you diagnosed with this cancer?" c. "Are you familiar with the stages of emotional adjustment to a diagnosis like cancer of the colon?" d. "Do you have any concerns about body image changes?"

"Can you tell me what has been helpful to you in the past when coping with stressful events?"

A patient complains of shoulder pain when the nurse moves the patient's arm behind the back. Which question should the nurse ask? Select one: a. "Are you able to sleep through the night without waking? b. "Do you have difficulty when you are putting on a shirt?" c. "Are you able to feed yourself without difficulty?" d. "Do you ever have trouble lowering yourself to the toilet?"

"Do you have difficulty when you are putting on a shirt?"

When the nurse brings medications to a patient with rheumatoid arthritis, the patient refuses the prescribed methotrexate. The patient tells the nurse, "My arthritis isn't that bad yet. The side effects of methotrexate are worse than the arthritis." The most appropriate response by the nurse is Select one: a. "It is important to start methotrexate early to decrease the extent of joint damage." b. "Methotrexate is less expensive than some of the newer drugs." c. "Methotrexate is effective and has fewer side effects than some of the other drugs." d. "You have the right to refuse to take the methotrexate."

"It is important to start methotrexate early to decrease the extent of joint damage."

A patient who is diagnosed with cervical cancer classified as Tis, N0, M0 asks the nurse what the letters and numbers mean. Which response by the nurse is accurate? Select one: a. "The cancer cells look like normal cells." b. "Further testing is needed to determine the spread of the cancer." c. "It is difficult to determine the original site of the cervical cancer." d. "The cancer involves only the cervix."

"The cancer involves only the cervix."

The nurse finds that a patient can flex the arms when no resistance is applied but is unable to flex when the nurse applies light resistance. The nurse should document the patient's muscle strength as level Select one: a. 3 b. 0 c. 1 d. 2

3

A patient with metastatic cancer of the colon experiences severe vomiting after each administration of chemotherapy. Which action, if taken by the nurse, is appropriate? Select one: a. Administer prescribed antiemetics 1 hour before the treatments. b. Have the patient eat large meals when nausea is not present. c. Offer dry crackers and carbonated fluids during chemotherapy. d. Give the patient a glass of a citrus fruit beverage during treatments.

Administer prescribed antiemetics 1 hour before the treatments.

While the nurse is obtaining the health history of a 75-year-old female patient, which of the following has the greatest implication for the development of cancer? Select one: a. Advancing age b. Being a woman c. Cigarette smoking as a teenager d. Family history of hypertension

Advancing age

The nurse assesses a patient who is receiving interleukin-2. Which finding should the nurse report immediately to the health care provider? Select one: a. Generalized muscle aches b. Crackles heard at the lung bases c. Oral temperature of 100.6° F (38.1° C) d. Complaints of nausea and anorexia

Crackles heard at the lung bases

After administering a dose of promethazine to a patient with nausea and vomiting, what medication side effect does the nurse explain is common and expected? Select one: a. Tinnitus b. Sensation of falling c. Drowsiness d. Reduced hearing

Drowsiness

A cancer patient's susceptibility to the syndrome of inappropriate antidiuretic hormone (SIADH) can be suspected with which of the following laboratory results? Select one: a. Serum potassium of 5.2 mmol/L b. Serum sodium of 120 mmol/L c. Blood urea nitrogen (BUN) of 10 mg/dL d. Hematocrit of 40%

Serum sodium of 120 mmol/L

The nurse determines that teaching regarding cobalamin injections has been effective when the patient with chronic atrophic gastritis states Select one: a. "These injections will increase the hydrochloric acid in my stomach." b. "The cobalamin injections will prevent gastric inflammation." c. "The cobalamin injections will prevent me from becoming anemic." d. "These injections will decrease my risk for developing stomach cancer."

The cobalamin injections will prevent me from becoming anemic."

A patient with left knee pain is diagnosed with bursitis. The nurse will explain that bursitis is an inflammation of Select one: a. the connective tissue joining bones within a joint. b. a synovial membrane that lines the joint. c. a fluid-filled sac found at some joints. d. the fibrocartilage that acts as a shock absorber in the knee.

a fluid-filled sac found at some joints.

A 38-year old woman receiving chemotherapy for breast cancer develops a Candida albicans oral infection. The nurse will anticipate the need for Select one: a. referral to a dentist for professional tooth cleaning. b. administration of nystatin tablets. c. the use of antiviral agents. d. hydrogen peroxide rinses.

administration of nystatin tablets.

The nurse instructs a client with chronic kidney disease who is receiving hemodialysis about dietary modifications. The nurse determines that the client understands these dietary modifications if the client selects which items from the dietary menu Select one: a. cured pork, grits, strawberries, orange juice b. sausage and eggs, banana, orange juice c. bacon, cantaloupe melon, tomato juice d. cream of wheat, blueberries, coffee

cream of wheat, blueberries, coffee

A client who is recovering from surgery has been advanced from a clear liquid to a full liquid diet. The client is looking forward to the diet change since he is "bored" with the clear liquid diet. The nurse should offer which full liquid item to the client? Select one: a. Tea b. Gelatin c. Popsicle d. Custard

custard

The nurse is caring for a patient treated with IV fluid therapy for severe vomiting. As the patient recovers and begins to tolerate oral intake, which food choice would be most appropriate? Select one: a. Dry toast b. Plain yogurt c. Iced tea d. Hot coffee

dry toast

The nurse is preparing to hang the first bag of parenteral nutrition solution via the central line of an assigned client. The nurse should obtain which most essential piece of equipment before hanging the solution? Select one: a. Urine test strips b. noninvasive blood pressure monitor c. electronic infusion pump d. blood glucose meter

electronic infusion pump

The nurse will anticipate preparing an older patient who is vomiting "coffee-ground" emesis for Select one: a. gastric analysis. b. endoscopy. c. barium studies. d. angiography.

endoscopy.

A young adult patient is hospitalized with massive abdominal trauma from a motor vehicle crash. The patient asks the nurse about the purpose of receiving famotidine (Pepcid). The nurse will explain that the medication will Select one: a. prevent aspiration of gastric contents. b. inhibit development of stress ulcers. c. lower the risk for H. pylori infection. d. decrease nausea and vomiting.

inhibit development of stress ulcers.

An appropriate nursing intervention for a patient who has acute low back pain and muscle spasms is to teach the patient to Select one: a. keep the head elevated slightly and flex the knees when resting in bed. b. avoid the use of cold packs because they will exacerbate the muscle spasms. c. twist gently from side to side to maintain range of motion in the spine. d. keep both feet flat on the floor when prolonged standing is required.

keep the head elevated slightly and flex the knees when resting in bed.

The nurse is caring for a client with cirrhosis of the liver. To minimize the effects of the disorder, the nurse teaches the client about foods that are high in thiamine. The nurse determines that the client has the best understanding of the dietary measures to follow if the client states an intention to increase the intake of which food? Select one: a. Milk b. Legumes c. Broccoli d. Chicken

legumes

A factory line worker has repetitive strain syndrome in the left elbow. The nurse will plan to teach the patient about Select one: a. elbow injections. b. modifying arm movements. c. wearing a left wrist splint d. surgical options.

modifying arm movements.

The nurse will anticipate teaching a patient experiencing frequent heartburn about Select one: a. proton pump inhibitors. b. endoscopy procedures. c. a barium swallow. d. radionuclide tests.

proton pump inhibitors.

Which nursing action can the registered nurse (RN) delegate to unlicensed assistive personnel (UAP) who are assisting with the care of a patient with scleroderma? Select one: a. Monitor for difficulty in breathing. b. Check finger strength and movement. c. Apply capsaicin (Zostrix) cream to hands. d. Document the patient's oral intake.

Document the patient's oral intake.

A patient who had a gastroduodenostomy (Billroth I operation) for stomach cancer reports generalized weakness, sweating, palpitations, and dizziness 15 to 30 minutes after eating. What long-term complication does the nurse suspect is occurring? Select one: a. Malnutrition b. Dumping syndrome c. Bile reflux gastritis d. Postprandial hypoglycemia

Dumping syndrome

The nurse, caring for a group of clients on an acute care medical-surgical nursing unit, determines that which clients would be the least likely candidate for parenteral nutrition? Select one: a. A client with extensive burns b. A client who has had an open cholecystectomy c. A client with cancer who is septic d. A client with persistent nausea and vomiting from chemotherapy e. A client with severe exacerbation of Crohn's disease

A client who has had an open cholecystectomy

A patient with muscular dystrophy is hospitalized with pneumonia. Which nursing action will be included in the plan of care? Select one: a. Discuss the need for genetic testing with the patient. b. Teach the patient about the muscle biopsy procedure. c. Logroll the patient every 2 hours. d. Assist the patient with ambulation.

Assist the patient with ambulation.

A patient has peptic ulcer disease that has been associated with Helicobacter pylori. About which medications will the nurse plan to teach the patient? Select one: a. Amoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec) b. Sucralfate (Carafate), nystatin, and bismuth (Pepto-Bismol) c. Metoclopramide (Reglan), bethanechol (Urecholine), and promethazine d. Famotidine (Pepcid), magnesium hydroxide (Mylanta), and pantoprazole (Protonix)

Amoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec)

The nurse teaches a patient with cancer of the liver about high-protein, high-calorie diet choices. Which snack choice by the patient indicates that the teaching has been effective? Select one: a. Lime sherbert b. Cream cheese bagel c. Fresh strawberries d. Blueberry yogurt

Blueberry yogurt

A client is being weaned from parenteral nutrition and is expected to take solid food today. The ongoing solution rate is 100ml/hour. The nurse anticipates that which prescription regarding the PN solution will accompany the diet prescription? Select one: a. Decrease the parenteral nutrition rate to 50ml/hour b. start 0.9% normal saline at 25 ml/hr c. Discontinue the Parenteral nutrition d. continue current infusion at 100ml/hr

Decrease the parenteral nutrition rate to 50ml/hour

A patient has a sliding hiatal hernia. What nursing intervention will reduce the symptoms of heartburn and dyspepsia? Select one: a. Keeping the patient NPO b. Putting the bed in the Trendelenburg position c. Giving various antacids to determine which one works for the patient d. Having the patient eat 4 to 6 smaller meals each day

Having the patient eat 4 to 6 smaller meals each day

The nurse is teaching a client who has iron deficiency anemia about foods she should include in the diet. The nurse determines that the client understands the dietary modifications if which items are selected from the menu? Select one: a. Cooked rolled oats and fish b. Nuts and milk c. Oranges and dark green leafy vegetables d. Coffee and tea

Oranges and dark green leafy vegetables

Which information obtained during the nurse's assessment of a patient's nutritional-metabolic pattern may indicates increased risk for musculoskeletal problems? Select one: a. The patient is 5 ft, 2 in tall and weighs 180 lb. b. The patient takes a multivitamin daily. c. The patient is 5 ft, 2 in tall and weighs 180 lb. d. The patient dislikes fruits and vegetables

The patient is 5 ft, 2 in tall and weighs 180 lb.

A patient returned from a laparoscopic Nissen fundoplication for hiatal hernia 4 hours ago. Which assessment finding is most important for the nurse to address immediately? Select one: a. The patient complains of 7/10 (0 to 10 scale) abdominal pain. b. The patient is experiencing intermittent waves of nausea. c. The patient has hypoactive bowel sounds in all four quadrants. d. The patient has no breath sounds in the left anterior chest

The patient has no breath sounds in the left anterior chest

A 58-yr-old patient has just been admitted to the emergency department with nausea and vomiting. Which information requires the most rapid intervention by the nurse? Select one: a. The patient is lethargic and difficult to arouse. b. The patient has had a small intestinal resection. c. The patient has been vomiting for 4 days. d. The patient takes antacids 8 to 10 times a day.

The patient is lethargic and difficult to arouse.

The nurse would incorporate which of the following into the plan of care as a primary prevention strategy for reduction of the risk for cancer? Select one: a. Using skin protection during sun exposure while at the beach b. Colonoscopy at age 50 and every 10 years as follow-up c. Yearly mammography for women aged 40 years and older d. Yearly prostate specific antigen (PSA) and digital rectal exam for men aged 50 and over

Using skin protection during sun exposure while at the beach

The nurse monitors the client receiving parenteral nutrition for complications of the therapy and should assess the client for which manifestations of hyperglycemia? Select one: a. nausea, vomiting, and oliguria b. fever, weak pulse, and thirst c. sweating, chills, and abdominal pain d. weakness, thirst, and increased urine output

weakness, thirst, and increased urine output