Final MS: Infection, Pain & Cancer

A client with appendicitis has an appendectomy. After surgery, what type of pain does the nurse anticipate the client will have?

Acute pain.

How should the administration of analgesics be scheduled to provide a uniform level of pain relief to a client?

Administering the analgesics on a regular basis, as per physician's order.

The nurse is caring for a client with breast cancer who has been receiving chemotherapy. The client was admitted with an infected lesion on her left leg. The physician has ordered Neupogen. What will Neupogen do for this client? Select all that apply.

Boost the immune system. Increase white blood cell production.

A client comes to the outpatient clinic to receive cortisone injections in the neck for pain that has been occurring consistently for 8 months. What type of pain is the client experiencing?

Chronic pain.

A client is hospitalized for an infected decubitus ulcer of the sacral area. The physician is planning to remove the dead and damaged tissue. What type of procedure will the nurse prepare the client for?

Debridement.

The nurse is caring for a client with kidney stones who is complaining of severe pain. What type of pain does the nurse understand the client is experiencing?

Visceral pain

A client is admitted to an acute care facility with a diagnosis of appendicitis. Which laboratory results demonstrate the client's leukocytosis?

White blood cell (WBC) count of 22,000 cells/mm3

A client with advanced cancer makes the following comment to the nurse, "Why are you bathing me? I am going to die no matter what." What is the most appropriate response of the nurse?

Would you like to talk about what you are feeling.

The nurse is caring for a client with an abscess on his back. The nurse observes purulent drainage coming from the abscess. What type os specimen does the nurse anticipate the physician will order to determine the type of bacteria present in the exudate?

A culture.

The client is scheduled for a breast lump excision and sentinel node biopsy. What should the nurse know in planning care for the client with a negative biopsy report?

A wide excision of lump will be performed.

The nurse is obtaining data regarding the medication that the client is taking on a regular basis. The client states he is taking duloxetine (Cymbalta), an antidepressant for the treatment of neuropathic pain. What type of therapy does the nurse understand the client is receiving?

Adjuvant drug therapy.

Following surgery for adenocarcinoma, the client learns the tumor stage is T3, N1, and M0. What treatment mode will the nurse anticipate?

Adjuvant therapy is likely.

A client is receiving morphine sulfate intravenously (IV) every 4 hours as needed for the relief of pain related to a surgical procedure the client had 3 days previously. The physician is discontinuing the IV and will be starting the client on oral pain medication. What would provide the client with optimal pain relief when discontinuing the IV dose?

Administer an equianalgesic dose.

A client is prescribed pain medications. Which of the following interventions will enable the client to consume an adequate meal during treatment?

Administer the medication 30 to 45 minutes before meals.

A client sustained second- and third-degree burns to the chest and neck 4 days ago and is now refusing analgesics stating, "I don't want to become addicted to pain medication." What is the best response by the nurse?

Although misusing the medication may cause addiction, there is little evidence that those who require narcotics for legitimate pain become addicted.

A client comes to the clinic and informs the nurse that he has a "painful area under his armpit". The nurse observes a 2-cm raised area that is erythemic and has a white substance inside it. What does the nurse suspect the client may be experiencing?

An abscess.

The nurse is caring for an older adult client who develops a fever, rash over the truck, and back and complains of feeling achy and very tired. What does the nurse suspect is occurring with the client?

An autoimmune response.

A nurse is having a yearly employee tuberculin skin test. Which skin test results would indicate a positive result?

An induration of 12 mm.

Which of the following advice does the nurse offer clients who are undergoing unsealed radiation therapy to reduce exposure?

Avoid kissing and sexual contact.

The nurse is providing client teaching for a client undergoing chemotherapy. What dietary modifications should the nurse advise?

Avoid spicy and fatty foods.

The nurse is working on a gerontology unit. A family member calls and tells the nurse they want to bring the family in to see one of the clients on the unit. The family member is concerned because several of the family members have colds. What instructions should the nurse provide to someone with a respiratory infection?

Avoid visiting older adults.

Which of the following nursing intervention contributes to achieving a client's pain relief?

Collaborate with the client about his or her gaol for a level of pain relief.

A client comes to the clinic with complaints of fever, chills, and coughing and is found to be positive for influenza. The nurse is aware that the flu is transmitted from one infected person to another. What type of infection is this considered?

Community-acquired.

The nurse is caring for a client in the hospital who has been taking an analgesic for pain related to a chronic illness and has developed a tolerance to the medication. What is the most appropriate action by the nurse?

Consult with the physician regarding the need for an increased dose of the drug and not to reduce its dosage of frequency of administration.

Which of the following would be considered a mechanical defense mechanism?

Coughing.

The nurse has admitted a new client to the unit. This client has an open draining sore on his leg. What diagnostic test would the nurse anticipate being ordered?

Culture and sensitivity.

A male client has been in pain for 12 hours related to the presence of kidney stones and states, "I can't take this pain any longer. It is getting worse by the minute." What does the nurse understand about the client's ability to tolerate pain?

Fatigue diminishes the ability to cope with pain and heightens the perception of pain.

The nurse is caring for a thyroid cancer client following oral radioactive iodine treatment. Which teaching point is most important?

Flush the toilet twice after every use.

An older adult is being treated with opioids for pain relief. Which of the following should the nurse strongly recommend to this client?

Follow a bowel regimen.

A client visits the clinics with the complaint of a circular rash on the upper right arm. The rash is diagnosed as tine corporis. What type of infection does the nurse anticipate the client will be treated for?

Fungus.

A client has been using NSAIDs daily over an extended period. Which of the following effects should the nurse carefully monitor for in this client?

Gastrointestinal bleeding.

The infection control nurse collects data that indicates an increase in the number of clients in the hospital with multidrug- resistant infections. What priority education should health care providers receive?

Hand hygiene

The nurse understands that the client should be vaccinated with human papilloma virus (HPV) vaccine per the health care provider's orders. What is this vaccine for?

Help prevent cervical cancer.

A client diagnosed with cancer has his tumor staged and graded based on what factors?

How they tend to grow and the cell type.

A client is recovering from a craniotomy with tumor debulking. Which comment by the client indicates to the nurse a correct understanding of what the surgery entailed?

I guess the doctor could not remove the entire tumor.

A client arrives in the orthopedic clinic with complaints of twisting the right ankle while playing softball. The nurse collects data including complaints of pain and swelling in the right ankle. What nursing intervention will the nurse provide that will increase vasodilation and reduce localized swelling?

Ice bag.

An elderly client has been diagnosed with metastatic cancer and has a poor prognosis of survival. The family asks the nurse for advice on whether to tell the client of the diagnosis or to keep it quiet. Which is the best response from the nurse?

In my experience, clients who know are more likely to be involved with their plan of care.

When providing are for a client with stage IV cancer, the nurse knows to include which intervention in the plan of care?

Incorporating touching and listening.

Which of the following laboratory findings, would be identified by the nurse as the greatest risk for a cancer client scheduled for implantable port?

Platelet count 98,000/mm

A client is diagnosed with a viral illness and requests an antibiotic to "cure" his illness. When the request is refused by the physician, the client states to the nurse, "I will never get better." What is the best response by the nurse?

Prescribing antibiotics for a viral infection may result in drug-resistant bacteria.

The intensive care unit nurse is caring for a client with a transmissible spongiform encephalopathy. The nurse knows that this type of encephalopathy is caused by what type infectious agent?

Prion.

A client informs the nurse that he "thinks he is getting sick" . Chief complaint of the client is low-grade fever, headache, and "has no energy". What stage of the infection does the nurse recognize the client is experiencing?

Prodromal stage.

A client is being taught to self-administer a narcotic analgesic by means of an intravenous pump system. Which of the following functions is designed to help prevent the client from unintentionally overdosing?

Programing the dosage and time interval into the device.

A client sustained severe burns over both lower extremities 1 week ago. The client informs the nurse that he had to wait for 30 minutes last night to receive pain medication, which caused the pain not to be relieved after administration. What suggestions could the nurse make to the physician to provide adequate relief of pain?

Provide the client with a patient controlled analgesia (PCA) pump.

A client is in the acute care facility for the administration of intravenous (IV) antibiotics to treat bacterial pneumonia. The client begins to have severe diarrhea 3 days after the IV antibiotics with abdominal cramping and pain. What does the nurse suspect the client has developed due to antibiotic use?

Pseudomembranous colitis.

When the client complains of increased fatigue following radiotherapy, the nurse knows this is most likely to be related to which factor?

Radiation can result in myelosuppression.

A client arrived in the emergency department with complaints of nausea and pain in the left shoulder and arm. The physician determines that the client is having a myocardial infraction (heart attack). What type of pain does the nurse understand the client is experiencing since the location of the pain is not the chest?

Referred pain.

The nurse is providing a gentle message on a painful area of a client's hip. What is the goal of the nurse in providing this intervention?

Release of endorphins and enkephalins.

The nurse gave a client an injection and, when attempting to recap the needle sustained a needle-stick injury to the finger. What is the priority action by the nurse?

Report the injury or exposure to the supervisor.

The nurse is monitoring a client who is in the hospital and has a fentanyl (Duragesic) path in place for the control of breakthrough pain for breast cancer. What would be a concern for the nurse when she obtains vitals signs for the client?

Respiratory rate of 10 breaths/minute

Which of the following is the most important potential nursing diagnosis for the client receiving opiate therapy?

Risk for Impaired Gas Exchange.

A severely cognitively impaired adult has had a surgical procedure, and the nurse is having a difficult time assessing the level of pain the client is having postoperatively. What method can the nurse use to obtain data about the client's pain?

Use behavioral comparison of the client's current and previous behavior patterns.

The nurse is caring for a group of five clients at the hospital. In order to control infections when caring for a group of clients, what intervention can the nurse perform?

Use standard precautions with all clients.

A client arrives at the emergency department complaining of severe diarrhea and vomiting that began after ingesting a hot dog at the ballpark 6 hours ago. How does the nurse understand that the contaminated food was transmitted to the client?

Vehicle.

While obtaining a health history, a client tells the nurse that her mother, grandmother, and sister died of cancer. The client wants to know what she can do to keep from getting cancer. What would be the nurse's best response?

You can't prevent cancer, but you can have your blood analyzed for tumor markers to see what your risk level is.

While completing an admission assessment, the client reports a family history of ovarian cancer among a maternal grandmother, aunt, and sister. The nurse knows that these cancers are most likely associated with what etiology?

Inherited gene mutation.

When caring for an older client who is receiving external beam radiation, which is the key point for the nurse to incorporate into the plan of care?

Inspect the skin frequently.

The nurse is administering a narcotic analgesic for the control of a newly postoperative client's pain. What medication will the nurse administer to the client?

Fentanyl (Duragesic)

The nurse has been assigned to obtain vital signs on several clients. While obtaining vital signs such as temperature, blood pressure, heart rate, and respiratory rate, what other vital sign should the nurse be sure to include in her documentation?

Pain.

Which phase of pain transmission occurs when the one is made aware of pain?

Perception.

The nurse is teaching a health class in the local public health center. What instructions should the nurse provide as the single important measure to prevent the spread of infection?

Thorough hand-washing.

Which nursing interventions are most important when implementing care for a client receiving temporary internal sealed radiation therapy? Select all that apply.

Time, distance, and shielding. Count wires, threads, or needles every shift. Avoid standing in direct path of implants.

A client is experiencing intractable pain related to terminal pancreatic cancer. What does the nurse understand about the goal of palliative sedation for the client?

To administer sedative medication at the minimum dosage necessary to decrease consciousness and relieve pain.

A client comes to the clinic and informs the nurse that he needs more analgesics for chronic pain. The client states that the medication is not as strong and that he requires more than the prescribed dose. What does the nurse suspect is occurring with the client?

Tolerance.

A nurse on the unit sustains a needle-stick injury while caring for a client whose infection status is unknown. What would be the best course of action for the nurse to follow?

Be tested for disease antibodies at appropriate intervals.

The client will be using transcutaneous electrical nerve stimulation (TENS) for the treatment of lower back pain. What does the nurse explain to the client that this will do for his back pain?

Deliver a burst of electricity to the skin and underlying nerves, decreasing pain.

Which of the following can be considered carcinogens?

Dietary substances.

A client arrives at the clinic with the complaint that she is having a vaginal discharge after having sexual intercourse with her boyfriend 1 week ago. The client is diagnosed with gonorrhea and given a prescription for treatment. What type of infection transmission does the nurse understand occurred?

Direct contact.

The nurse is aware that when corticosteroids are administered, it is important that which of the following occurs?

Doses are tapered when discontinuing.

Based on the understanding of the effects of chemotherapy, the nurse would anticipate which of the following clinical findings in a client 2 weeks post-therapy?

Ease of bruising.

The nurse is providing an educational presentation on dietary recommendations for reducing the risk of cancer. Which of the following food selections would demonstrate a good understanding of the information provided in the presentation? Select all that apply.

Egg white omelet with spinach and mushrooms. Steamed broccoli and carrots. Turkey breast on whole wheat bread.

The client is diagnosed with a benign brain tumor. Which of the following features of a benign tumor is of most concern to the nurse?

Tumor pressure against normal tissues.

A bowel resection is scheduled for a client with the diagnosis of colon cancer with metastasis to the liver and bone. Which statement by the nurse best explains the purpose of the surgery?

Tumor removal will promote comfort.

A client informs the nurse that she has been using a douche to cleanse the vagina on a daily basis and is now experiencing itching and burning in the vaginal area. What should the nurse explain to the client that occurs when the vagina pH is changed?

It causes destruction of the normal flora of the vagina and allows the development of vaginal infections.

A client informs the nurse that he has been taking ibuprofen every 6 hours for 3 weeks to help alleviate the pain of arthritis. The client has a history of a gastric ulcer and is taking a proton pump inhibitor for the treatment of this disorder. What should the nurse instruct the client about the use of the ibuprofen?

It would be best to contact the physician prior to take any over the counter medications.

The nurse is caring for a client with chronic back pain. What characteristics of chronic pain is the nurse aware of? Select all that apply.

Lasts greater than 6 months. Persists beyond healing stage.

The nurse is giving an educational talk to a local parent-teacher association. A parent asks how he can help his family avoid community-acquired infections. What would be the nurse's best response to help prevent and control community-acquired infections?

Make sure your family has all their childhood immunizations.

The nurse performs a breast examination on a client and finds a firm, non moveable lump in the upper outer quadrant of the right breast that the client reports was not there 3 weeks ago. What does this finding suggest?

Malignant tumor.

Cancer has many characteristics. What is one of the most discouraging characteristic of cancer?

Metastasis.

The nurse is working on a bone marrow unit knows that it is a priority to monitor which of the following in a client who has just undergone a stem cell transplant?

Monitor the client closely to prevent infection.

The nurse is caring for a client with the diagnosis of colon cancer with metastasis to the liver. Which statement made by the client indicates an understanding of the diagnosis?

My cancer has now spread to my liver.

A client, who had an above the knee amputation of the left leg related to peripheral vascular disease from uncontrolled diabetes, complains of pain in the left lower extremity. What type of pain is the client experiencing?

Neuropathic pain.

The nurse is caring for a client who has acquired immunodeficiency disease (AIDS) and has developed oral thrush. What type of infection is the nurse aware that has developed because of the immunocompromised state of the client?

Opportunistic.

The public health nurse is giving a talk on warning signals of cancer to a local community group. Which of the following are the warning signals of cancer? Select all that apply.

Sores that don't heal. Unusual bleeding or discharge. Persistent indigestion.

The nurse is invited to present a teaching program to parents of school-aged children. Which topic would be of greatest value for decreasing cancer risk?

Sun safety and use of sunscreen.

The nurse asks the client about a reddened area on the left arm. The client states that he was bitten by an insect, and it burned briefly. What type of pain does the nurse document this as?

Superficial somatic pain.

The nursing instructor is teaching beginning nursing students about infection. Towards the end of class, the instructor gives the students a scenario of a client with an infection who has developed fever and diarrhea. What should the student nurse instruct the client to avoid?

Tea and coffee.

A client is suspected of sepsis from a post surgical incision infection. What characteristic of sepsis would the nurse recognize? Select all that apply.

Temperature of 102 F. Heart rate of 120 beats/minute. Respiratory rate of 24 breaths/minute.

A preschool-aged child is admitted for complaints of abdominal pain and vomiting. What is the best method for the nurse to collect data about the pain level of the child?

The Wong-Baker FACES scale.

Chemotherapy has been used for the past 3 months to treat a client with pancreatic cancer. The CA 19-9 levels are rising. Which explanation would the nurse attribute as the most likely cause?

The cancer is growing despite the chemotherapy treatment.

A newly diagnosed cancer client is crying and states the following to the nurse, "I promised God that I will be a better person if I can just get better. "What is the appropriate assessment of this comment by the nurse?

The cancer is viewed as a punishment from past actions.

A client with a Staphylococcus aureus infection present in a sacral pressure ulcer has received treatment with three courses of antibiotics without eliminating the infection. What does the nurse understand has occurred with the client?

The client has a multidrug-resistant strain of bacteria.

A client is admitted to the acute care facility for vomiting and diarrhea. An intravenous (IV) catheter is inserted for the delivery of IV fluids. A family member is with the client and observes the nurse enter the room and begin touching the IV site without washing her hands or wearing gloves. Why should the client and family member be concerned with the nurse's actions?

The client will develop a health care-associated infection.

The nurse is caring for a client with a stage IV leg ulcer. The nurse is closely monitoring the client for sepsis. What would indicate that sepsis has occurred and that the nurse should notify the physician of immediately?

The client's heart rate is greater than 100 beats/minute.

Which of the following is the only reliable source for quantifying pain?

The client.

A client has received a diagnosis of Lyme disease. What does the nurse understand about the transmission of infection resulting in the disease?

The disease is spread by arthropods.

A family member wants to donate blood for a client who needs a blood transfusion. What information from the family member would make them ineligible for donation?

The family member was serving in the military in England in 1993 for 2 years.

A client with a 4-cm breast mass is scheduled for biopsy with frozen section followed by lumpectomy and possible mastectomy. The client asks the nurse, "What can't the doctor tell me specifically whether I will need to have my entire breast removed?" Which is the best response form the nurse?

The frozen section will determine presence of cancer and type of surgery required.

The nurse is caring for a client who is scheduled for chemotherapy. Which is the best statement the nurse can make about the client experiencing chemotherapy-induced alopecia?

The hair loss is usually temporary.

A family member of a client in a long-term care facility asks the nurse why he cannot insert a catheter so the client will not develop skin breakdown from being wet. What should the explanation include when the nurse responds to the family member?

The invasive nature of the catheter provides a portal for infection.