Cellular Regulation
Oxytocin
a hormone released by the pituitary gland that causes increased contraction of the uterus during labor and stimulates the ejection of milk into the ducts of the breasts.
A client with an invasive carcinoma of the bladder is receiving radiation to the lower abdomen in an attempt to shrink the tumor before surgery. What should the nurse do, considering the side effects of radiation? Correct 1 Observe the feces for the presence of blood. 2 Monitor the blood pressure for hypertension. 3 Administer enemas to remove sloughing tissue. 4 Provide a high-bulk diet to prevent constipation.
Correct 1 Observe the feces for the presence of blood. Radiation may damage the bowel mucosa, causing bleeding. Blood pressure changes are not expected during radiation therapy. Enemas are contraindicated with lower abdominal radiation because of the damaged intestinal mucosa. Diarrhea, not constipation, occurs with radiation that influences the intestine.
Which drug taken by a pregnant woman shows a delayed teratogenic effect in the offspring, making the effect difficult to identify? 1 Aspirin 2 Heparin 3 Ethyl alcohol Correct 4 Diethylstilbestrol
Correct 4 Diethylstilbestrol Diethylstilbestrol may cause vaginal cancer in a female child 18 or more years after birth. Aspirin suppresses contractions during labor and may cause bleeding in the mother. Heparin does not cause fetal harm but may cause osteoporosis in the mother. Ethyl alcohol causes drug dependence or alcohol withdrawal syndrome in neonates.
A registered nurse is teaching the student nurse about drugs used to treat hyponatremia in hospitalized clients. Which statements made by the student nurse indicate a need for further teaching? Correct 1 "Tolvaptan is given intravenously." 2 "Tolvaptan used for more than 30 days causes liver failure." 3 "These drugs promote water retention with no sodium loss." 4 "Conivaptan use should be stopped when the serum sodium levels increase more than 12 mEq/L in 24 hours."
Correct 1 "Tolvaptan is given intravenously." Tolvaptan is a vasopressin antagonist which is given orally. When used at higher doses or for longer than 30 days, tolvaptan may cause liver failure and death. Tolvaptan and conivaptan are drugs that promote water excretion without causing sodium loss. Tolvaptan has a black box warning that rapid increases in serum sodium levels of greater than 12 mEq/L in 24 hours may be associated with central nervous system demyelination and can lead to serious complications and death.
Which oxytocic drug may help to control uterine bleeding post-delivery and promote milk ejection? Correct 1 Oxytocin 2 Mifepristone 3 Dinoprostone 4 Ergot alkaloids
Correct 1 Oxytocin Oxytocin is used to induce labor, control uterine bleeding after delivery, and promote milk ejection during lactation. Mifepristone is generally used to induce abortion. Dinoprostone induces labor but has no effect on milk ejection or uterine bleeding. Although ergot alkaloids control uterine bleeding after delivery, they do not cause milk ejection during lactation.
A client is admitted to the hospital for the implantation of radon seeds in the oral cavity. Which intervention is most important when the nurse is caring for this client after the procedure? 1 Providing a regular diet within two days Correct 2 Administering nursing care in a short period 3 Giving frequent mouth care at least four times daily 4 Having a member of the family stay with the client continually
Correct 2 Administering nursing care in a short period Nursing care should be organized and administered efficiently so that the nurse's exposure to radiation is kept to a minimum. A regular diet is contraindicated until the radon seeds are removed because chewing can dislodge the seeds. Frequent mouth care is contraindicated because it can dislodge the seeds; drying of the mucous membranes cannot be prevented. A family member should not be in attendance continually because this will expose the family member to excessive radiation.
A postmenopausal woman has been administered raloxifene for osteoporosis. Which parameter should be assessed to ensure the efficacy of the drug and thus its continuation of use? 1 Body weight Correct 2 Bone density 3 Calcium levels in urine 4 Esophageal functioning
Correct 2 Bone density An increase in bone density indicates a good therapeutic response to raloxifene. Thus this parameter should be assessed during therapy for osteoporosis. Body weight may or may not increase with bone weight, and this parameter should not be used to assess a positive response to the drug. Calcium levels in the blood indicate response to the therapy rather than calcium levels in urine. Esophageal dysfunction is a contraindication to bisphosphonate therapy
The nurse is providing postoperative care to a client with lung cancer who had a partial pneumonectomy. When inspecting the client's dressing, the nurse notes puffiness of the tissue around the surgical site. When the nurse palpates the site, the tissue feels spongy, and crackles can be felt. How does the nurse describe this assessment finding? 1 Stridor Correct 2 Crepitus 3 Pitting edema 4 Chest distention
Correct 2 Crepitus There is air in the tissues, and palpation results in a crackling sound referred to as crepitus. Stridor is a harsh, high-pitched sound usually produced on inspiration because of airway obstruction. Pitting edema is excessive accumulation of fluid in tissue spaces. The size of the chest is determined by the bony structure; a barrel chest with an increase in the anteroposterior (AP) diameter is associated with chronic obstructive pulmonary disease (COPD), not cancer of the lung.
The results of a biopsy indicate that a client has a malignant sarcoma of the liver, and chemotherapy via regional perfusion is the treatment of choice. What reason does the nurse provide to explain to the client why this method of drug administration probably was selected? 1 Drug therapy can be continued at home with little difficulty. Correct 2 Larger doses of drugs can be delivered to the actual site of the tumor. 3 Toxic effects of the chemotherapeutic drugs are confined to the area of the tumor. 4 Combinations of drugs are used to attack neoplastic cells at various stages of the cell cycle.
Correct 2 Larger doses of drugs can be delivered to the actual site of the tumor. Regional perfusion therapy permits relative isolation of the tumor area and saturation with the drug(s) selected. This method of drug administration requires medical and nursing supervision and cannot be continued at home. Although toxic effects are confined mainly to the treated area, some migration may still occur. Combinations of chemotherapeutic drugs are administered via intravenous or oral routes, not via regional perfusion.
A nurse is reviewing the health history and laboratory results of a school-aged child admitted to the pediatric unit with acute nonlymphoid leukemia (acute myeloid leukemia). What clinical findings does the nurse expect? Select all that apply. 1 Oliguria Correct 2 Listlessness 3 Few stem cells 4 Difficulty swallowing Correct 5 Bone marrow depression
Correct 2 Listlessness Correct 5 Bone marrow depression Listlessness in a child with leukemia is caused by anemia; anemia is expected in children with leukemia because of generalized bone marrow depression. Depressed bone marrow production of formed elements of blood is characteristic of nonlymphoid leukemia; it leads to neutropenia and increases susceptibility to infection. Urine output will be within expected limits; there is no kidney involvement at this stage of the disease. There are more, not fewer, stem cells in the peripheral blood and bone marrow; the production of mature blood cells is depressed. The swallowing reflex is not affected.
Which assessments should a nurse perform in a woman who is prescribed clomiphene? Select all that apply. 1 Allergies to ergot alkaloids Correct 2 Reproductive and uterine status Correct 3 Concomitant use of antidepressants Correct 4 Family stability and economic status 5 Maternal history for estimated gestation
Correct 2 Reproductive and uterine status Correct 3 Concomitant use of antidepressants Correct 4 Family stability and economic status The client's reproductive and uterine status should be assessed because clomiphene may result in multiple pregnancies. The concomitant use of antidepressants with clomiphene may cause fertility impairment. Assessing the client's family stability and economic status is essential because this can be a risk factor for multiple pregnancies. Clomiphene is not an ergot alkaloid; therefore, assessing for allergies to ergot alkaloids is not appropriate. Clomiphene is not administered during pregnancy; therefore, assessing the maternal history for estimated gestation of the client is irrelevant.
A nurse, assessing an 18-year-old client, palpates a heavy, hard mass on the lateral aspect of the testis. Which treatment is contraindicated for this condition? 1 Radiotherapy 2 Chemotherapy Correct 3 Testicular biopsy 4 Radical inguinal orchiectomy
Correct 3 Testicular biopsy Testicular biopsy is contraindicated in this client, who likely has testicular cancer, because it can cause the spread of malignant cells and worsen disease severity. Radical inguinal orchiectomy is the preferred treatment for testicular cancer. Radiotherapy and chemotherapy are prescribed after radical inguinal orchiectomy.
An ultrasound scan of a baby shows that the proximal tubule in the kidney is not well developed. Which drug treatment in the mother during her pregnancy might have caused this condition in the baby? 1 Antimicrobials 2 Sex hormones 3 Antiseizure drugs Correct 4 Angiotensin-converting enzyme inhibitors
Correct 4 Angiotensin-converting enzyme inhibitors Angiotensin-converting enzyme inhibitors may cause poor development or absence of the proximal tubule as a teratogenic effect. Antimicrobials may cause heart defects. Sex hormones may cause defects related to the reproductive system. Antiseizure drugs may cause neural tube defects.