Exam 3
a pt diagnosed with hypothyroidism has a problem with a. pituitary gland b. hypothalamus c. thyroid gland d. adrenal gland
A
A.M who is diagnosed with hypoparathyroidism was admitted tot he hospital because of seizure attacks and abdominal pain. what assessment response by the pt should the nurse be MOST concern about a. pt had a hand spasm when the nurse was taking blood pressure b. pt had no response when the nurse runs a finger over her facial nerve c. pt had a non-blanchable redness on right heel d. pt's toes curled in when an object is ran over the bottom of foot
A
the nurse teaches a postmenopausal patient with stage III breast cancer about the expected outcomes of cancer treatment. which patient statement indicates that the teaching has been effective? a. I will need to have follow-up examinations for many years after I have treatment before I can be considered cured b. the cancer will be cured if the entire tumor is surgically removed c. after cancer has not recurred for 5 years, it is considered cured d. cancer is never considered cured, but the tumor can be controlled with surgery, chemotherapy, and radiation
A
which assessment finding in a 36-year-old patient is most indicative of a need for further evaluation a. a breast nodule that is 1 cm in size, nontender, and fixed b. bilateral breast nodules that are tender with palpation c. a breast lump that increases in size before the menstrual period d. a breast lump that is small, mobile, with a rubbery consistency
A
which is a most common sign and symptoms of Addison's disease a. hyperpigmentation b. easy bruising c. increased body hair d. dehydration
A
which prescribed medication should the nurse administer first to a 60-year-old patient admitted to the emergency department in thyroid storm? a. propranolol (Inderal) b. iodine (lugol's solution) c. methimazole (Tapazole) d. propylthiouracil (PTU)
A
you are a new graduate working the AM shift on the floor and you just received report of the following patients. who would you want to see first a. a 2 day post op thyroidectomy pt who is feeling drowsy and weaker this morning with hypoactive bowel sounds b. a new admit from the ED who presented with s/s of hyperparathyroidism and is now scheduled for a parathyroidectomy c. a pt with hyperthyroidism is reported to be eaten high calorie dinner trays d. a pt who is on levothyroxine with a lab result of 3.6mlU/L TSH
A
the pt has a low-grade carcinoma on the left lateral aspect of the prostate gland and has been on active surveillance status for 5 years. six months ago his last prostate-specific antigen (PSA) level was 5 ng/mL . which manifestation now indicate that the prostate cancer may eb growing and he needs a change in his care (select all that apply) a. prostate gland becomes more nodular and harder b. presence of WBCs in urine c. onset of ED d. serum PSA level 10ng/mL now
A, D
42 year old female diagnosed with ovarian cancer will common have the following surgical intervention a. pelvic exenteration b. bilateral salpingo-oophorectomy c. vaginal hysterectomy d. subtotal hysterectomy
B
A patient who is scheduled for a right breast biopsy asks the nurse the difference between a benign tumor and a malignant tumor. which answer by the nurse is correct? a. benign tumors are likely to recur in the same location b. malignant tumors may spread to other tissues or organs c. malignant cells reproduce more rapidly than normal cells d. benign tumors do not cause damage to other tissues
B
a 22-year-old pt reports her concern about not having a menstrual period for the past 7 months. which statement by the pt indicates a possible related factor to the amenorrhea a. I drink at least 3 glasses of nonfat milk every day b. I run 7 to 8 miles every day to keep my weight down c. iam not sexually active but currently I have and IUD d. I was treated for a STI 2 years ago
B
a 31-year-old pt who'd been diagnosed with human papilloma virus (HPV) infection gives a health hx that includes smoking tobacco, taking oral contraceptives, and having been treated twice for vaginal candidiasis. which topic will the nurse include in pt teaching a. risk factors for cervical cancer b. use of water-soluble lubricants c. anti fungal cream administration d. possible difficulties with conception
B
which nursing action should be included in the plan of care for a patient returning to the surgical unit following a left radical mastectomy with dissection of axillary lymph nodes a. teach the patient to use the ordered patient-controlled analgesia (PCA) every 10 minutes b. post a sign at the bedside warning against venipuncture of blood pressures in the left arm c. obtain a permanent breast prosthesis before the patient is discharged from the hospital d. insist that the patient examine the surgical incision when the initial dressings are removed
B
which nursing assessment of a 69-year-old pt is most important to make during initiation of thyroid replacement with levothyroxine (Synthroid) a. orientation and alertness b. apical pulse rate c. fluid balance d. nutritional intake
B
the medications used for a medical adrenalectomy include the following a. levothyroxine b. mifepristone c. prednisone d. ketoconazole
B, C, D
a 30-year-old patient seen in the emergency department for severe headache and acute confusion is found to have a serum sodium level of 118 mEq/L (normal range 135-145 mEq/L). the nurse will anticipate the need for which diagnostic test a. growth hormone stimulation test b. antidiuretic hormone level c. adrenocorticotropic hormone level d. urinary 17-ketosteriods
C
a 62-year-old patient with hyperthyroidism is to be treated with radioactive iodine (RAI). the nurse instructs the patient a. about radioactive precautions to take with all body secretions b. that symptoms of hyperthyroidism should be relieved in about a week c. that symptoms of hypothyroidism may occur as the RAI therapy takes effect d. to discontinue the antithyroid medications taken before the radioactive therapy
C
a 63-year-old patient with primary hyperparathyroidism has a. serum phosphorus level of 1.7 mg/dl (normal range 2.5 to 4.5 mg/dl). and calcium of 14 mg/dl (normal range 8.5-10.2 mg/dl). which nursing action should be included in the plan of care a. restrict the patient to bed rest b. assess for positive chvostek's sign c. encourage 4000 ml of fluids daily d. institute routine seizure precautions
C
a pt had had elf-sided mastectomy and an axillary lymph node dissection. which nursing intervention is appropriate a. teaching the pt how to avoid injury to the left arm b. assessing the pt's range of motion for the left arm c. administering an analgesic 30 min before scheduled arm exercises d. evaluating the pt'd understanding of instruction about drain care
C
a pt who was admitted with myxedema coma and diagnosed with hypothyroidism is improving and expected to be discharged in 2 days. which teaching strategy will be best for the nurse to use? a. ensure privacy for teaching by asking visitors to leave b. offer multiple options for management of therapies c. provide written reminders of self-care info d. delay teaching until pt discharge date is confirmed
C
which nursing action should be included in the plan of care for a pt returning to the surgical unit following a left modified radical mastectomy with dissection of axillary lymph nodes a obtain a permanent breast prosthesis before the pt is discharged from the hospital b. insist that the pt examine the surgical incisions when the initial dressings are removed c. post a sign at the bedside warning against venipuncture of blood pressures int he left arm d. teach the pt to use the ordered pt-controlled analgesia (PCA) every 10 mins
C
an 82-year-old pt in a long-term care facility is newly diagnosed with hypothyroidism, the nurse needs to be aware that in elderly pts levothyroxine could cause the following: select all that apply a. visual changes b. hearing loss c. weight loss d. osteroporosis e. a-fib f. skin changes
C, D, E
a 70-year-old patient who has had a transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH) is being discharged from the hospital today. the nurse determines that additional instruction is needed when the patient says which of the following? a. I will avoid driving until I get approval from my doctor b. I should continue to schedule yearly appointments for prostate exams c. I will increase fiber and fluids in my diet to prevent constipation d. I should call the doctor if I have incontinence at home
D
which action should the nurse take when a 35-year-old pt hs a result of minor cellular changes on her Pap test a. teach the pt about colonoscopy b. administer the HPV vaccine c. teach the pt about punch biopsy d. schedule another Pap test in 6 months
D
a 37-year-old patient is being admitted with a diagnosis of Cushing syndrome. which findings will the nurse expect during the assessment? a. purplish streaks on the abdomen b. bronzed appearance of the skin c. chronically low blood pressure d. decreased axillary and pubic hair
A
a 48-year-old pt who is schedualed for a radical prostatectomy expressed his concern that he may not be able to maintain an erection during intercourse. what should the nurse tell him a. provide teaching about meds for ED b. offer reassurance that this the of surgery will not lead to ED c. suggest the practice of abstinence d. offer reassurance that ejaculation will not be affected
A
a 58 year old female patient diagnosed with ovarian cancer will be txt with ___ round of chemo a. 6 rounds b. 12 rounds c. 2 rounds d. 8 rounds
A
a patient who is diagnosed with cervical cancer that is classified as T1,N0,M0 asks the nurse what the letters and numbers mean. which response by the nurse is most appropriate? a. the cancer involves only the cervix b. it is difficult to determine the original site of the cervical cancer c. the cancer cells look almost like normal cells d. further testing is needed to determine the spread of the cancer
A
after a 48-year-old patient has had a modified radical mastectomy, the pathology report identifies the tumor as an estrogen-receptor positive adenocarcinoma. the nurse will plan to teach the patient about a. tamoxifen (Nolvadex) b. trastuzumab (Herceptin) c. raloxifine (Evista) d. estradiol (Estrace)
A
the nurse is teaching her pt with benign prostatic hyperplasia (BPH) about his medications. what should be included in his pt teaching regarding the use of alpha-adrenergic blockers a. monitor for changes in vision b. caution the pt to move slowly when getting up or changing positions c. take the education in the morning before meals d. avoid drinking grape fruit juice
B
the purpose of using androgen synthesis inhibitors and androgen receptor blockers in prostate cancer management is to: a. increase the production of luteinizing hormone b. reduce the effect of androgen on the growth of adenocarcinoma c. reduce the Gleason score d. increase the amount of circulating testosterone
B
what is the deadliest of all gynecologic cancer and the fifth leading cause of cancer deaths among American women a. vuvlar cancer b. ovarian cancer c. cervical cancer d. endometrial cancer
B
a 42 year old female pt presents to the ED with flank pain and along with the kidney calculi, the pt is diagnosed with hyperparathyroidism. the nurse expects to see the following a. hypercalemia and hyperphosphatemia b. hypercalcemia and hypophosphatemia c. hypocalcemia and hypophophatemia d. hyperkalemia and hypophophatemia
B
a 55-year old woman comes into your clinic and tells you that she is worried about developing ovarian cancer because she has a family hx of both breast and ovarian cancers. she asks you if there are any preventative measure she could take. which of the following statements would NOT be an appropriate response a. taking oral contraceptives for at least 5 years could significantly reduce your risk for ovarian cancer b. a diet high in fat can be adopted ovarian cancer from developing c. having multiple full-term pregnancies is associated with lower risks d. breastfeeding for longer periods has been shown to lower your risk of ovarian cancer
B
a 76-year-old pt who has been diagnosed with stage 2 prostate cancer chooses the option of active surveillance. the nurse will plan to a. provide the pt with info about cyrotherapy b. schedule the pt for annual prostate-specific antigen testing and digital rectal exam c. vaccinate the pt with sipuleucel-T (provenge) d. teach the pt about placement of intraurethral stens
B
a nurse is taking care of a patient diagnosed with Addison's disease. which of the following statements indicates that the patient needs further teaching a. I will notify my healthcare provider when I have a fever b. I will not have to adjust my mediations c. I will consume a diet high in salt and low in potassium d. I will increase my fluid intake
B
after obtaining the info shown in the accompanying figure regarding a pt with Addison's disease, which prescribed action will the nurse take first assessment: - complains of fatigue - bronze-colored skin -poor skin turgor vital signs: - BP 76/40 mmHg - Heart rate 126 beats/min - Respirations 24 breaths/min - oxygen saturations 94% laboratory data - sodium 123 mEq/L - potassium 5.1 mEq/L - glucose 62 mg/dl a. give 4 oz of fruit juice orally b. infuse 5% dextrose and 0.9% saline c. recheck the blood glucose level d. administer oxygen therapy as needed
B
the nurse is planing post care for a pt who is being admitted to the surgical unit form the recovery room after transsphenoidal resection of a pituitary tumor. which nursing action should be included a. monitor continuous pulse ox for 24 hours b. measure urine volume every hour c. palpate extremities for edema d. check hematocrit every 2 hours for 8 hours
B
the nurse is taking care of a breast cancer pt who is taking an estrogen receptor blocker.which of the following is a side effect of the medications that the nurse should teach the pt a. dry mouth b. hot flashes c. hair loss d. hirsutism
B
you are caring for a patient with uterine cancer who is being treated with intracavity radiation therapy. the nursing assistant reports that the patient insisted on ambulation the the bathroom and now "something feels like its coming out". what is the priority action? a. assess the nursing assistant knowledge; explain the rationale for strict bed rest b. assess for dislodgment; use forceps to retrieve and a lead container to store as needed c. notify the physician about the potential or confirmed dislodgment of the radiation implant d. assess the patient's knowledge of the treatment plan and her willingness to participate
B
what are the factors increase a woman's risk of ovarian cancer? pick all that apply a. breast feeding b. increased age c. obesity d. history of skin cancer e. BRCA-1 mutation
B, C, E,
A patient has just arrived on the unit after a thyroidectomy. which action should the nurse take first? a. check the blood pressure and pulse b. support the patient's head with pillows c. assess the patient's respiratory effort d. observe the dressing for bleeding
C
the nurse is assessing the sexual-reproductive health pattern of a 32-year-old woman. which questions is most useful in determining the pt's sexual orientation and risk factors a. what types of sexual activities of you prefer b. are you heterosexual, homosexual, or bisexual c. do you have sex with men, women, or both d. which gender do you prefer to have sex with
C
the nurse is caring for a 62-year-old man after a transurethral resection of the prostate (TURP). which instructions should the nurse include in the teaching plan a. prostate exams are not needed after surgery b. restrict fluids to prevent incontinence c. avoid stringing during defecation d. sexual functioning will not be affected
C
the nurse supervises the care of a patient with a temporary radioactive cervical implant. which action by unlicensed assistive personnel (UAP), if observed by the nurse, would require an intervention? a. the UAP flushes the toilet once after emptying the patient's bedpan b. the UAP gives the patient an alcohol-containing mouthwash to use for oral care c. the UAP stands by the patient's bed for 30 minutes talking with the patient d. the UAP places the patient's bedding in the laundry container in the hallway
C
what info about continuous bladder irrigation will the nurse teach to a pt who is being admitted for a transurethral resection of the prostate (TURP) a. hydration and urie output are maintained by bladder irrigation b. antibiotics are infused continuously through the bladder irrigation c. bladder irrigation prevents obstruction of the catheter after surgery d. bladder irrigation decreased the risk of post-op bleeding
C
when attempting to confirm the diagnosis of Cushing's syndromes common diagnostic test is a. 48-hour urine for free cortisol b. DHEA level c. low-dose dexamethasone suppression test d. comprehensive chemistry planel
C
when using the accompanying illustration to teach a patient about breast self-examination, the nurse will include the information that moat breast cancers are located in which part of the breast (aint nobody got time to post the illustration) 1 upper left quad 2 upper right quad 3 lower left quad 4 lower right quad 5 nipple a. 3 b. 2 c. 1 d. 4
C
which assessment finding for a 33-year-old female patient admitted with Graves' disease requires the most rapid intervention by the nurse a. bilateral exophthalmos b. blood pressure 166/100 mmHg c. temperature 103.8F (40.4 C) d. heart rate 136 beats/minute
C
a nursing diagnosis that is likely to be appropriate for a 67-year-old woman who has just ben diagnosed with stage III ovarian cancer is a. risk for infection related to impaired immune function b. situational low self-esteem related to guilt about delaying medical care c. sexual dysfunction related to loss of vaginal sensation d. anxiety related to cancer diagnosis and need for txt decisions
D
after transurethral resection of the prostate (TURP), a 64-year-old pt with continuous bladder irrigation complains of painful bladder spams. the nurse observes clots in the urine. which action should the nurse take first a. increase the flow rate of the bladder irrigation b. remove the 3-way catheter and insert a Coude catheter c. administer the prescribed IV morphine sulfate d. manually instill and then withdraw 50mL of saline into the catheter
D
the nurse explains to a 37-year-old pt being prepared for colonoscopy with a cervical biopsy that the procedure a. required that the pt have nothing to eat or drink for 6 hours before the procedure b. will take place in the same-day surgery center so that local anesthesia can be used c. is similar to a speculum examination of the cervix and should result in little discomfort d. involves dilation of the cervix and biopsy of the tissue lining the uterus
D
the nurse teaches a pt who is scheduled for a prostate needs biopsy about the procedure. which statement, if made by the pt, indicates that teaching was effective a. the biopsy will determine how much longer I have to live b. the biopsy will indicate whether the cancer has spread to other organs c. the biopsy will remove the cancer in my prostate gland d. the biopsy will help decided the txt for my enlarged prostate
D
which info will the nurse teach a 48-year-old pt who has been newly diagnosed with Graves' disease a. exercise is contraindicated to avoid increasing metabolic rate b. surgery will eventually be required to remove the thyroid gland c. restriction of iodine intake in needed to reduce thyroid activity d. antithyroid medications may take several months for full effect
D
which pt in the women's health cline will the nurse expect to teach about an endometrial biopsy a. the 35-year-old pt who has used oral contraceptives fro 15 years b. the 55-year-old pt who had 3 to 4 alcoholic drinks each day c. the 45-year-old pt who has had 6 full-term pregnancies and 2 spontaneous abortions d. the 25-year-old pt who has a family hx of hereditary nonpolyposis colorectal cancer
D