E #6

The nurse is interviewing a client and assessing risk for abuse and violence. Which of the following clients has the highest risk? 38 yo F, in a same-sex relationship 20 yo F, that is pregnant with an alcoholic boyfriend 5 yo M, that recently had a sibling born 69 yo M, living in an assisted living center

20 yo F, that is pregnant with an alcoholic boyfriend

Which hormone(s) is (are) believed to have a role in the development of prostate cancer? Prolactin Endorphins Androgens Estrogens

Androgens Androgens are hormones synthesized in the testes and adrenal cortex in males that promote expression of male sex characteristics. They are believed to have a role in the development of prostate cancer. Estrogens, endorphins, and prolactin have not been linked to the development of prostate cancer.

The nurse is reviewing data collected during a health history and physical assessment and determines that a client is at risk for developing breast cancer. Which data supports this client's risk for developing breast cancer? (Select all that apply.) Menopause at age 55 Age 60 Breastfed four children Body mass index 22 Sister had breast cancer

Age 60 Sister had breast cancer

What approach is appropriate for interpreting the prostate-specific antigen (PSA) level as a diagnostic factor for prostate cancer? A fluctuating PSA level indicates prostate cancer. An abnormal PSA level alone is not enough to diagnose prostate cancer. A PSA level lower than 4.0 ng/mL indicates prostate cancer. A PSA level higher than 4.0 ng/mL indicates prostate cancer.

An abnormal PSA level alone is not enough to diagnose prostate cancer. The National Cancer Institute used to consider a PSA level of 4.0 ng/mL or lower to be normal, but men with normal PSA levels may still have prostate cancer. PSA levels above 4.0 ng/mL or PSA levels that fluctuate could be an indication of prostate cancer, but it could also indicate prostatitis or urinary tract infection. Therefore, PSA levels must be interpreted in conjunction with the patient's health history and other diagnostic tests to confirm a diagnosis of prostate cancer.

The nurse is caring for a 78-year-old woman who was recently diagnosed with breast cancer. What consideration may the nurse need to make for this woman that she may not need to make for younger women with breast cancer? Ensuring the woman has adequate emotional support Providing teaching related to breast-conservation treatments Discussing the woman's life expectancy Arranging transportation to appointments

Arranging transportation to appointments Older women may not have access to transportation if they or their partner do not drive. The nurse may need to help arrange transportation to appointments for these women. Older women are less likely to show emotional distress compared to younger women, and all clients with breast cancer should receive information related to life expectancy and breast-conservation techniques.

A client is returning to the oncology clinic after a skin biopsy on an arm lesion revealed malignant melanoma. Which additional diagnostic testing should the nurse expect to be ordered to evaluate this client for​ metastasis? (Select all that​ apply.) Radiation therapy Chest​ x-ray Bone scan Liver function tests CT scan of the liver

Chest​ x-ray Bone scan Liver function tests CT scan of the live

The nurse must report abuse to certain populations. Choose the groups that are in this mandatory reporting populations. (select all) Children Elderly Women Homeless Incarcerated

Children Elderly

Which complaint by the client should the nurse report to the physician as the most suspicious indication of colorectal cancer? Abdominal pain Constipation Rectal bleeding Diarrhea

Rectal bleeding Although all of these clinical manifestations can be related to colorectal cancer, abdominal pain, constipation, and diarrhea can have many etiologies unrelated to colorectal cancer. Rectal bleeding has fewer etiologies and should be assessed further for the potential cause.

What does current evidence suggest concerning digital rectal exam (DRE) for the prostate in the primary care setting for prostate CA screening? DRE is the gold standard for prostate cancer diagnosis. The evidence about DRE are inconclusive. Prostate cancer must have a DRE as part of the screening process. DRE is not a conclusive diagnostic exam.

DRE is not a conclusive diagnostic exam.

A nurse develops contact dermatitis from the use of latex gloves from frequent use over the years. This is an example of type ___ or delayed hypersensitivity. II I IV III

IV

The nurse is providing care to a client who was recently diagnosed with stage three breast cancer. The nurse is providing education regarding the possible treatment options for recovery and remission. Which possible options will the nurse include in the teaching session? (Select all that apply.) Lumpectomy Hormone therapy Mastectomy Radiation Palliative care

Lumpectomy Hormone therapy Mastectomy Radiation

For clients with cancer, what should the nurse regularly monitor to assess for cachexia? Weight Complete Blood Count Core Temperature Urinalysis

Weight

A potential long term side effect of chemotherapy is hearing loss nausea and vomiting sores on mucus membranes alopecia

hearing loss

Following a woman's first mammogram, she is told she has a stage I carcinoma. Based on this information the nurse understands that there is no treatment and prognosis is poor if treated the recovery and remission rate is high the client waited too long for her first mammogram prognosis cannot be determined at this time

if treated the recovery and remission rate is high

Primary cancer prevention includes: (select all that apply) not smoking eating a well balanced diet high in fiber take part in cancer screening early in life excercise regularly and maintain a healthy weight avoiding prolong sun exposure and using sunscreen

not smoking eating a well balanced diet high in fiber excercise regularly and maintain a healthy weight avoiding prolong sun exposure and using sunscreen

Which form of breast cancer is the most malignant form? Inflammatory carcinoma of the breast Carcinoma of the mammary ducts Paget disease Infiltrating ductal carcinoma

Infiltrating ductal carcinoma

Which individuals are more likely to develop lung cancer without a history of smoking? An athlete over age 50 An individual over age 50 An accountant with a genetic abnormality on chromosome 6 A steel worker with a genetic abnormality on chromosome 8

An accountant with a genetic abnormality on chromosome 6

A child with a severe allergy is at risk for an anaphylactic reaction to nuts. What would be the treatment of choice following and exposure at school? Intubation by trained personnel EpiPen auto injector Oral diphenhydramine 25mg Inhaled epineperine 1mg/2ml

EpiPen auto injector

A nursing instructor is teaching a group of student nurses about the risk factors for prostate cancer. Which statement will the nursing instructor include? "A diet low in dairy increases a man's risk for developing prostate cancer." "African American men are at lowest risk for prostate cancer." "Asian American and Native American men have the highest risk for developing prostate cancer." "Approximately one in eight men ages 70 and older will be diagnosed with prostate cancer."

"Approximately one in eight men ages 70 and older will be diagnosed with prostate cancer." African Americans are at a particularly high risk for developing prostate cancer. Approximately one in eight men ages 70 and older will be diagnosed with prostate cancer. A diet high in dairy increases a man's risk for developing prostate cancer.

A dark-skinned client tells the nurse of plans to bask in the sun on an upcoming vacation. The nurse questions the client about sunscreen use. Which response indicates the client needs further education? "The melanocytes in my skin provide me with increased protection from the sun." "I can still experience sun damage despite my dark skin tones." "I will avoid the sun between the peak hours of 10 a.m. and 4 p.m." "I don't need sunscreen because I am dark-skinned already."

"I don't need sunscreen because I am dark-skinned already." While the melanocytes in darker skin offer increased protection, the risk for skin cancer remains and sunscreen should be worn. The other client responses are correct.

The nurse is caring for a client who is undergoing diagnostic tests to rule out lung cancer. The client asks the nurse why a computed tomography (CT) scan was ordered. What is the best response by the nurse? "It is more specific in diagnosing your condition." "The doctor prefers this test." "To rule out the possibility that your problems are caused by pneumonia." "Why are you concerned about this test?"

"It is more specific in diagnosing your condition." Computed tomography (CT) is used to evaluate and localize tumors, particularly tumors in the lung parenchyma and pleura. It also is done before needle biopsy to localize the tumor. In addition, CT scanning can detect distant tumor metastasis and evaluate tumor response to treatment. A chest x-ray can be used to diagnose pneumonia. The client's question is valid and should not be minimized by asking why the client is having concerns about the test.

A 73-year-old man was just diagnosed with stage II prostate cancer. The client's wife hears the word "cancer" and immediately begins crying. She says, "How long does he have to live?" Which response by the nurse is appropriate? "If we treat the cancer aggressively with surgery and radiation, he should live several more years." "Prostate cancer is usually aggressive in older men, so he may only have a short time to live." "Don't worry about how long he will live. Just live every day to the fullest and enjoy the time you have left together." "Older men who are diagnosed with prostate cancer usually die from causes other than the cancer."

"Older men who are diagnosed with prostate cancer usually die from causes other than the cancer." In an older man with a lower stage of cancer at diagnosis, the cancer is likely slow-growing, and he is more likely to die from other preexisting comorbidities than from the cancer itself. Therefore, the nurse cannot predict how long the client may live after diagnosis. Prostate cancer is usually aggressive in younger men, not older men. Early-stage prostate cancer in older men may not be treated aggressively. Instead, the healthcare team may take a more conservative "watchful waiting" approach, depending on other health conditions. It is not within the nurse's scope of practice to suggest aggressive treatment strategies. The nurse should not dismiss the client's or client's family's concerns by telling them to not worry.

A client recovering from surgery to place a permanent colostomy as treatment for colon cancer is concerned that her spouse will no longer find her sexually attractive. Which response by the nurse is the most appropriate? "I will refer you to a counselor to talk about your concerns." "Tell me more about the concerns you are having." "Would you like me to speak with your husband for you?" "Do not worry about sex right now. It is more important to focus on recovery."

"Tell me more about the concerns you are having." Since the client has expressed concern to the nurse regarding sexual functioning, the nurse should ask the client to expand upon why there are concerns. Although a referral may be needed for the client at some point, this is not the most appropriate response by the nurse. Telling the client not to worry about the concern and offering to speak to her spouse are not the most appropriate responses at this time.

The nurse is caring for a client in a community clinic who wishes to quit smoking. The client asks the nurse, "If I quit smoking, will my risk of lung cancer be the same as a nonsmoker?" "Your risk of lung cancer will decline if you quit, but it will remain higher than a nonsmoker's." "No one knows for sure what the risk is for someone who quits smoking." "Your risk of lung cancer will be equal to that of a nonsmoker." "Your risk of lung cancer will never drop because the damage has already been done."

"Your risk of lung cancer will decline if you quit, but it will remain higher than a nonsmoker's." While the client's risk for lung cancer will diminish sharply upon quitting smoking, it will not drop to the level of someone who never smoked. The risk for someone who quits is known to be dramatically less than for someone who continues to smoke. Another factor when calculating risk is the client's exposure to secondhand smoke, which also increases risk

Which is true of abuse regardless of the specific type? (select all) it's often associated with substance abuseabuse is limited to actual and visible injury the abused person will seek help when they are injured it's about power and control the perpetrators are always male

it's often associated with substance abuse it's about power and control

The nurse is teaching a group of community members about preventing skin cancer. Which participant would be at the greatest risk for skin cancer? A teenager who wears a ski outfit when skiing A 60-year-old farmer who wears a baseball cap when working A baby underneath a large beach umbrella A 20-year-old lifeguard at the community pool who wears sunscreen

A 60-year-old farmer who wears a baseball cap when working Rationale: The older adult client has had more years of living to increase the risk of skin cancer from exposure to the sun. In addition, the farmer wears a cap that leave ears exposed, and there's no mention is made of protectant sunscreens or long-sleeved shirts and pants. The lifeguard, baby, and teenager have lesser risk because there are physical barriers to the sun identified in each option: sunscreen, umbrella, and ski outfit.

The nurse is reviewing the medical records for several clients who will be seen in the clinic today. According to the ABCD rule, which client may require removal of the skin lesion? A client with a lesion that is symmetrical with an irregular border, a single color, and diameter change from 4 mm to 5 mm A client with a lesion that is symmetrical, with a smooth border, a single color, and diameter that has stayed the same A client with a lesion that is asymmetrical with an irregular border, two colors, and diameter change from 5 mm to 7 mm A client with a lesion that is asymmetrical with a regular border, two colors, and diameter change from 4 mm to 3 mm

A client with a lesion that is asymmetrical with an irregular border, two colors, and diameter change from 5 mm to 7 mm To meet all four criteria for removal of a lesion, the lesion will be asymmetrical, have irregular borders, show color change or more than one color, and have a diameter greater than 6 mm.

During a routine physical examination of a client's lungs, the nurse notes a pink papule that is flat and erythematous with surface crusting on the client's skin of the upper chest. The nurse should notify the physician of this finding because the nurse suspects the papule might indicate Basal cell carcinoma Malignant melanoma Actinic keratosis Squamous cell carcinoma

Basal cell carcinoma Rationale: Superficial basal cell carcinoma is often found on the trunk, and it manifests as a papule or plaque that is flat, pink, erythematous, and crusting. Squamous cell carcinoma is most often found on parts that are exposed to the sun, such as the face and hands. It usually appears as a small, firm, red nodule that may bleed as it grows. Malignant melanoma manifests as black, brown, or multicolored nodules or plaques. Actinic keratosis is a precancerous condition. The lesion appears as a shiny, rough macule.

The nurse is evaluating care provided to a client recovering from surgery for colorectal cancer. Which outcomes indicate that care has been successful? (Select all that apply.) Client reports pain level as an 8 on a rating scale of 0 to 10. Client tolerates full liquid diet and is requesting solid food. Client states family members will care for the ostomy at home. Client performs morning ADL's with assistance. Client has an hourly urine output of 50 mL.

Client tolerates full liquid diet and is requesting solid food. Client has an hourly urine output of 50 mL.

The nurse is speaking with a client who wants information regarding colorectal cancer. Which statement indicates the client understood the information presented by the nurse? Colorectal cancer occurs more frequently in clients who have a history of inflammatory bowel disease. The risk of colorectal cancer decreases with age. Colorectal cancer can be detected in early stages by measuring the level of the carcinogenic embryonic antigen (CEA). Colorectal cancer has no symptoms in the early stage and there are no definitive diagnostic tests.

Colorectal cancer occurs more frequently in clients who have a history of inflammatory bowel disease. Colorectal cancer is asymptomatic in the early stages. Screening tools such as annual fecal occult blood testing and colonoscopy performed every 10 years can detect the cancer when it is still in the curable stage. Being over age 50 is a risk factor for colorectal cancer. Carcinogenic embryonic antigen (CEA) is not considered a diagnostic test but is used as a tumor marker to follow and manage the disease in clients diagnosed with the disease. The incidence of colorectal cancer is increased in clients with a history of inflammatory bowel disease.

A teen aged female presents to the Emergency Department in the early morning hours with a friend. The patient is lethargic, febrile, and tachycardic. The friend states that she thinks her friend was sexually assaulted at a party that night. What are the highest priority interventions for the nurse to perform? Apply painful stimulation to assess LOC and administer IV fluids Gather more information about the assault from the client and notify police ECG, IV, and regulate body temperature Give antipyretic medication and prepare for a sexual assault examination

ECG, IV, and regulate body temperature

A client is admitted with injuries sustained from a domestic dispute. When planning care, the nurse will include which short-term interventions? Select all that apply. Explore options for help. Improve quality of life by increasing self-esteem. Explore options for self-development. Determine immediacy of danger. Convey safety.

Explore options for help. Determine immediacy of danger. Convey safety.

A nurse is screening a client for prostate cancer. Which assessment findings would cause the nurse to suspect that the client has prostate cancer? (Select all that apply.) Scrotal edema Fatigue Back pain Frequent skin infections Hematuria

Fatigue Back pain Hematuria

The nurse is instructing a group of women between the ages of 40 and 50 about early detection of breast cancer. What should the nurse include in this teaching? Perform the genetic testing to assess risk. See a healthcare provider if there is a strong family history of breast cancer. Have a yearly mammogram. Have a clinical breast exam performed by a healthcare provider every 5 years.

Have a yearly mammogram.

The nurse is assessing a client for symptoms of prostate cancer. Which symptoms would indicate the client is experiencing an enlarged prostate? Select all that apply. Bone pain Fatigue Hematuria Weight loss Dysuria

Hematuria Dysuria

The nurse is caring for a client who is experiencing anaphylactic shock following the administration of a medication. Based on this data, which position is the most appropriate for the nurse to place the client? High-Fowler position Flat, with legs slightly elevated Trendelenburg position Supine position

High-Fowler position

While receiving discharge teaching, an adult client recovering from a prostatectomy is distressed to learn that episodes of incontinence may occur. Which should the nurse teach the client to help minimize incontinence? Kegel exercises Fluid restriction Steps to change the Foley catheter bag every day Proper administration of incontinence medication

Kegel exercises Urinary incontinence after surgery is not unexpected. Teaching the client Kegel exercises is the best way to help him eliminate or reduce occasions of stress incontinence. Restricting fluids may cause further urinary problems and is not advised. Medication and Foley catheters are not appropriate long-term treatments for this complication.

A nurse is caring for a client recovering from a wedge resection of the left lung for a tumor. What would be appropriate goals for the nursing diagnosis of ineffective airway clearance? (Select all that apply). Maintain a patent airway. Participation in daily cares by the client Express feelings and concerns. Maintain current weight. Minimize accumulation of fluid.

Maintain a patent airway. Minimize accumulation of fluid. Rationale: All of the outcomes for this client are viable, but appropriate outcomes for the diagnosis of ineffective airway clearance are maintaining a patent airway and minimizing the accumulation of fluid. The others address different diagnoses.

A young woman contacts the primary care clinic with concerns about a small lump she discovered on her breast. What advice should be given to this client? Advise that due to age there is no risk for cancer Make an appoint for the PCP to examine the lump Recommend the client mention this during the next annual exam Schedule a mammogram

Make an appoint for the PCP to examine the lump

A pediatric nurse is caring for an 8-month-old client. While making rounds, the nurse enters the room and finds the infant's father violently shaking the infant. The father attempts to make it appear as though the infant was choking. Upon further assessment, the nurse notes bruised areas on the infant's arms and legs. What is a priority action for the nurse to take? Discuss what the nurse witnessed with the other nurses. Discuss what the nurse witnessed with the infant's mother. Report what the nurse witnessed and assessed to the authorities. Call security to remove the father from the room.

Report what the nurse witnessed and assessed to the authorities.

An elderly bald man comes to the out patient clinic concerned about some skin lesions on his head and neck. He describes these as bumps that have multiplied and gotten larger over the past month. Upon examination the small lesions have a wart-like appearance, some are reddened, and they have a flaky scale texture. These lesions are likely Squamous cell carcinoma Melanoma Keratosis Basal cell carcinoma

Squamous cell carcinoma

A woman has a family history of breast cancer, and genetic testing has revealed a mutation in BRCA2. If this woman develops breast cancer, what is the most likely mechanism for why the cancer developed? The cells were stimulated to undergo rapid cell division. The cells underwent mitosis rather than meiosis. The cells' ability to suppress tumor growth was impaired. The cells' ability to accurately translate the RNA was impaired.

The cells' ability to suppress tumor growth was impaired

A patient involved in a high speed MVC presents via ambulance to the ED. Paramedics describe the crash as a roll-over wherein the driver (this patient) was ejected from the vehicle. The patient was ambulatory on scene. Based on the mechanism of injury, the nurse should suspect drug use and sensory impairment. minor injuries possible but nothing life threatening. life threatening injuries including spine fractures and internal organ trauma. no injuries since the patient could ambulate and is alert and oriented.

life threatening injuries including spine fractures and internal organ trauma.

A client with colorectal cancer has no metastasis in regional lymph nodes. What can the nurse conclude from this about metastasis of this cancer? The distal lymph nodes and other major organs will also not have metastasis. The tumor has instead metastasized through the circulatory system to other major organs. The nurse should not conclude anything about metastasis to other areas of the body. The tumor has instead metastasized to distal lymph nodes.

The nurse should not conclude anything about metastasis to other areas of the body. In some types of cancer, the regional lymph nodes are a good marker for metastasis. However, metastasis from colorectal cancer is not always an orderly process, and the absence or presence of metastasis in regional lymph nodes has no bearing on metastasis to distal lymph nodes or other major organs.

A client is in the hospital for chemotherapy treatments. They are place on neutropenic precautions. What is the rationale for this? This is reverse isolation to protect the client from infection while they are immunocompromised This helps reduce the GI side effects of the chemotherapy This isolation protects the care providers while the client receives the chemotherapy This isolation protects the other clients from infection while they are immunocompromised

This is reverse isolation to protect the client from infection while they are immunocompromised

A patient seeks care following a sexual assault. The medical facility notifies the rape team including a sexual assault nurse examiner (SANE) to conduct an assessment. What are the reasons for having a special team to conduct this examination and treatment? (select all that apply) This process properly collects evidence and preserves the chain of evidence This team focuses on this patient and allows the other health care team members to care for all other patients during the exam. Criminal laws require this team to gather evidence and information from the patient. This team will determine if a crime was committed and notify law enforcement. These specialists have specific training on how to manage the care of the patient and evidence.

This process properly collects evidence and preserves the chain of evidence This team focuses on this patient and allows the other health care team members to care for all other patients during the exam These specialists have specific training on how to manage the care of the patient and evidence.

What is the most common cause of skin cancer? Exposure to melanin Inflammation from psoriasis UV radiation from sunlight Damage from chemicals

UV radiation from sunlight Exposure to UV radiation from sunlight is a major cause of skin cancer. Tanning beds are another dangerous form of UV exposure. Melanin is a naturally-occurring skin pigment. Exposure to melanin itself does not cause skin cancer. Although damage from chemicals may lead to skin cancer, it is not a common case of skin cancer. Inflammation from psoriasis is not directly linked to skin cancer.

The nurse is providing discharge teaching to an older adult client with lung cancer. What changes in activities of daily living can the nurse suggest to help the older adult maintain independence? Wear shirts with buttons Use a shower chair Wear shoes with laces Use a self-leveling spoon

Use a shower chair Lung cancer reduces the amount of functional lung tissue, leading to activity intolerance when oxygen supply is insufficient. The nurse should teach the client ways to conserve energy, such as sitting on a shower chair while showering. Wearing slip-on shoes and shirts, not shoes with laces or shirts with buttons, can help conserve energy. Self-leveling spoons are important for individuals who have hand tremors; they do not help conserve energy when feeding.

The results of a​ client's biopsy indicates neoplasm. The nurse understands that which characteristic indicates that the neoplasm is​ benign? Invades surrounding tissues Noncohesive Rapid growth Well-defined borders

Well-defined borders ​Rationale: A benign neoplasm has​ well-defined borders, slow​ growth, is​ cohesive, and pushes other tissues out of the way. A malignant neoplasm invades surrounding​ tissues, is​ noncohesive, does not stop at tissue​ borders, and grows rapidly.

An adult client with a BMI of 39 who smokes 1 pack of cigarettes per day is admitted to the hospital with chest pressure and persistent cough. What additional information is needed to calculate pack years? number of years smoking a pack a day number of years smoking 1 pack a day, and number of years smoking more if any number of years not smoking number of years smoking number of packs smoked in the last year

number of years smoking 1 pack a day, and number of years smoking more if any

Why would radiation therapy precede surgery to remove a malignant tumor? locate the tumor's boarders prevent tumor lysis syndrome reduce the risk for infection reduce the tumor size

reduce the tumor size

Which is the best description of the abuse cycle? honeymoon phase- violent episode- resolution tensions build- violent episode- honeymoon phase tensions build- violent episode- silent phase- open window aggressive behavior- violent episode- honeymoon phase- relapse

tensions build- violent episode- honeymoon phase

Which description best defines how the the TNM Staging system classifies tumors? the system considers the tumor surface characteristics, the underlying tissue involvement, and metastasis the system considers the tumor location, the underlying tissue involvement, and level of metastasis the system considers the tumor size, the underlying tissue involvement, and metastasis. the system considers the age of the tumor, the underlying tissue involvement, and metastasis

the system considers the tumor size, the underlying tissue involvement, and metastasis.

The nurse is caring for a client who has presented with a new, suspicious of cancer, lesion on the right foot. Which question should the nurse ask during the client​ interview? (Select all that​ apply.) "Have you noticed any changes in the​ lesion?" ​"Do you wear running shoes?" ​"How many hours a day are you on your​ feet?" ​"Have you ever been badly​ sunburned?" "Have you been exposed to any chemicals in your​ job?"

​"Have you noticed any changes in the​ lesion?" ​"Have you ever been badly​ sunburned?" "Have you been exposed to any chemicals in your​ job?"