Leonard study guide II

Which explanation will the nurse offer to a patient with glioblastoma and a T 1NXM 0 classification, when asked what the terminology means?

"The brain tumor measures about 1 to 2 cm and shows no regional lymph nodes and no distant metastasis."

Which response is best for a patient who is receiving chemotherapy for stomach cancer and tells the nurse he or she has a metallic taste in his or her mouth?

"Unfortunately, it is a side effect of the chemotherapy medications."

Which medication education does the nurse provide for a patient who takes combination tenofovir/emtricitabine for pre-exposure prophylaxis (PrEP) for human immune deficiency virus (HIV)?

"You will be protected only after 7 days of consistent dosing."

Which factor increases the risk for developing a multidrug-resistant organism (MDRO)? Select all that apply. One, some, or all responses may be correct.

-Antibiotics prescribed for conditions that did not need them -Higher doses of antibiotics prescribed than required -Formation of biofilm coating on medical devices

A patient asks if there are any drugs that help prevent the development of cancer. How will the nurse respond? Select all that apply. One, some, or all responses may be correct.

-Aspirin reduces the risk for colon cancer. -Lycopene reduces the risk for prostate cancer. -Tamoxifen reduces the risk for breast cancer.

Which information would the nurse include when conducting a community health education class on diet and cancer risk reduction? Select all that apply. One, some, or all responses may be correct.

-Avoid beef and processed meats. -Increase consumption of whole grains. -Eat "colorful fruits and vegetables," including greens.

Which hepatitis virus may cause liver cancer? Select all that apply. One, some, or all responses may be correct.

-B -C

Which nursing occurrence is a cause for postexposure prophylaxis (PEP) with combination antiretroviral therapy (cART)? Select all that apply. One, some, or all responses may be correct.

-Being stuck by a contaminated sharp needle -Being a victim of sexual assault

Which factor is indicative of altered GI function secondary to cancer? Select all that apply. One, some, or all responses may be correct.

-Bowel obstruction due to external compression -Decreased appetite resulting from taste changes -Imbalance between food intake and energy use

A patient's serum contains a highly elevated level of immunoglobulin E (IgE) antibodies (140 IU/mL). What could be the possible effects of this elevated IgE? Select all that apply.One, some, or all responses may be correct.

-Capillary leak -Pruritus and inflammation. -Excessive release of histamine

Which age-related change increases the risk for infection in older adults? Select all that apply. One, some, or all responses may be correct.

-Decreased cough reflex -Decreased antibody production -Slowed gastric motility

Which factor increases the risk for infection in older adults? Select all that apply. One, some, or all responses may be correct.

-Decreased subcutaneous tissue -Decreased antibody production -Decreased cough and gag reflexes -Decreased intestinal motility

Which sign or symptom is a central nervous system (CNS) indication of acquired immune deficiency syndrome (AIDS)? Select all that apply. One, some, or all responses may be correct.

-Dementia -Confusion

Which finding indicating dehydration would the nurse monitor in a patient with a fever? Select all that apply. One, some, or all responses may be correct.

-Dry mucous membranes -Confusion or disorientation -Decreased urine output

Which sign or symptom would the nurse teach a patient newly diagnosed with systemic lupus erythematosus (SLE) to report to the health care provider (HCP)? Select all that apply. One, some, or all responses may be correct.

-Edema -Weight gain -Decreased output

Which intervention would the nurse implement for a patient with a high fever? Select all that apply. One, some, or all responses may be correct.

-Encourage fluid intake. -Apply ice packs to the patient's body. .-Apply cool compresses to the skin and pulse points.

Which observation would the nurse expect to find when assessing a patient with cancer who has been diagnosed with thrombocytopenia? Select all that apply. One, some, or all responses may be correct.

-Fatigue -Bruising -Weakness -Bleeding

Which finding would the nurse expect upon assessment of a patient who is experiencing cachexia? Select all that apply. One, some, or all responses may be correct.

-Fatigue -Weakness -Muscle wasting -Severe weight loss

The nurse expects which symptom in an adult with an acute infection that has occurred within 4 weeks of first being infected with human immune deficiency virus (HIV)? Select all that apply. One, some, or all responses may be correct.

-Fever -Night sweats -Muscle aches

A patient presents to the emergency department with facial swelling, difficulty breathing, and difficulty speaking. Based on these findings and a diagnosis of an anaphylactic reaction, which action would the nurse initially perform? Select all that apply. One, some, or all responses may be correct. .

-Give epinephrine -Administer oxygen

A patient recently diagnosed with Clostridium difficile infection is admitted to the hospital. Which personal protective equipment (PPE) would the nurse wear when completing a physical assessment of the patient? Select all that apply. One, some, or all responses may be correct.

-Gown -Gloves -Shoe cover

Which body tissue cell has the capacity of dividing throughout one's life span? Select all that apply. One, some, or all responses may be correct.

-Hair -Uterus -Bone marrow -Stomach

Which criterion is a component of a diagnosis of acquired immune deficiency syndrome (AIDS)? Select all that apply.One, some, or all responses may be correct.

-Human immune deficiency virus (HIV) positive -CD4+ T-cell count percentage of less than 14% -An opportunistic infection -CD4+ T-cell count of less than 200 cells/mm 3 (0.2 × 10 9/L)

The nurse is performing a physical examination of a patient who has streptococcal pharyngitis infection. Which precaution would the nurse take? Select all that apply. One, some, or all responses may be correct.

-If possible, place the patient in a private room. -Perform handwashing before leaving the patient's room. -Place a surgical mask on the patient when the patient travels to the radiology department.

Which complication will likely cause thrombocytopenia in a patient with cancer? Select all that apply. One, some, or all responses may be correct.

-Impaired immune function -Impaired platelet production -Impaired bone marrow function -Impaired blood-producing function

Which complication likely caused a patient with cancer to have anemia? Select all that apply. One, some, or all responses may be correct.

-Impaired tissue oxygenation -Impaired blood producing function

Which information would the nurse include when teaching a patient newly diagnosed with systemic lupus erythematosus (SLE) about managing the disease and preventing setbacks? Select all that apply. One, some, or all responses may be correct.

-Include aerobic exercise. -Plan frequent rest periods. -Avoid crowded public areas. -Stay in shady areas outdoors. -Use mild, nonastringent soap.

For which population may pre-exposure prophylaxis (PrEP) for the human immune deficiency virus (HIV) be appropriate? Select all that apply. One, some, or all responses may be correct.

-Injection drug users -Men who have sex with me -Non monogamous heterosexually active men and women -Adults who are HIV negative and in a relationship with a partner who is HIV positive

Which feature can be found in a normal cell? Select all that apply. One, some, or all responses may be correct.

-Low mitotic index -Tight adherence -Euploidy

Which common cancer is related to tobacco use? Select all that apply. One, some, or all responses may be correct.

-Lung cancer -Cancer of the tongue -Cancer of the larynx

Which is a common mode of transmission for cancer metastasis? Select all that apply. One, some, or all responses may be correct.

-Lymphatic -Bloodborne -Extension into surrounding tissues

Which factor places patients at increased risk for infection? Select all that apply. One, some, or all responses may be correct.

-Malnutrition -Chemotherapy -Antibiotic therapy -Corticosteroid therapy

Which statement pertaining to cancer development is correct? Select all that apply. One, some, or all responses may be correct. .

-Mutated normal cells may become neoplastic cells. -Secondary prevention is screening for early detection. -Primary prevention is preventing exposure to causes of cancer

How is the TNM classification of T isN 0M x for a patient with lung cancer interpreted? Select all that apply. One, some, or all responses may be correct.

-No metastasis -Carcinoma in situ -Prescence of metastasis cannot be assessed

Which bacterial infection may occur as an opportunistic infection in patients with acquired immune deficiency syndrome (AIDS)? Select all that apply. One, some, or all responses may be correct.

-Nocardiosis -Tuberculosis

Which food item may cause anaphylaxis in some individuals? Select all that apply.One, some, or all responses may be correct.

-Nuts -Eggs -Peanuts -Shellfish

A patient sitting in the waiting area has a wound that is draining profusely. Which action would the nurse take? Select all that apply. One, some, or all responses may be correct.

-Place the patient in an examination room. -Perform hand hygiene before putting on gloves. -Apply gloves and wear a gown before touching the patient.

A higher incidence of which condition occurs among pregnant women with the human immune deficiency virus (HIV)? Select all that apply. One, some, or all responses may be correct.

-Premature delivery -Transmission of the disease to the infant -Low-birth-weight infants

Which symptom is associated with an anaphylactic reaction? Select all that apply.One, some, or all responses may be correct.

-Red blotches -Itching and urticaria -Erythema and angioedema

Which factor is required for the transmission of infection? Select all that apply. One, some, or all responses may be correct.

-Reservoir of infectious agents -Susceptible host with a portal of entry -Mode of transmission

Which component is a requirement of Standard Precautions? Select all that apply. One, some, or all responses may be correct.

-Respiratory hygiene/cough etiquette -Safe injection practices

Which preventive intervention would the nurse suggest to a patient who is at risk for developing colon cancer? Select all that apply. One, some, or all responses may be correct.

-Schedule an annual fecal occult blood test. -Refer for a polypectomy if the patient has associated polyps.

Which is a common means of human immune deficiency virus (HIV) transmission? Select all that apply. One, some, or all responses may be correct.

-Sexual -Perinatal -Parenteral

Which cause would the nurse suspect for a patient with cancer who has a white blood cell (WBC) count of 1200/mm 3? Select all that apply. One, some, or all responses may be correct.

-The patient may have leukemia. -Cancers cells have invaded the bone marrow.

Which feature does a benign tumor cell have? Select all that apply. One, some, or all responses may be correct.

-They have orderly growth patterns. -They grow by hyperplastic expansion. -They are encapsulated by fibrous connective tissue.

Which sign/symptom will the nurse include when teaching a patient about cancer warning signs? Select all that apply. One, some, or all responses may be correct.

-Unusual bleeding and discharge -Change in bowel or bladder habits -Nagging cough or a hoarse voice

Which information regarding the Occupational Safety and Health Administration (OSHA) is accurate? Select all that apply. One, some, or all responses may be correct.

-Violating OSHA regulations can result in fines or disciplinary action. -OSHA regulations protect staff members in the health care workplace. -OSHA mandates that sharp objects and needles be handled with care.

Which information would be included when teaching a group of scouts about ticks and Lyme disease prevention when hiking and camping? Select all that apply. One, some, or all responses may be correct.

-Wear closed toe shoes -Use insect repellent with DEET

In which situation would the nurse prioritize handwashing instead of using an alcohol-based hand rub (ABHR)? Select all that apply. One, some, or all responses may be correct.

-With visibly soiled hands -When an infection is caused by spore-forming organisms -Before the administration of eyedrops

A patient with a vancomycin-resistant enterococcus (VRE) infection is placed on Contact Precautions. Which intervention would the nurse include in the plan of care? Select all that apply. One, some, or all responses may be correct.

-pply gloves before entering the room. -Assign the patient to a private room. -Use of gown to prevent contact with body fluids. -Use Transmission-Based Precautions during transport outside of the room.

Which patient condition or disorder is an example of a type IV hypersensitivity reaction? Select all that apply. One, some, or all responses may be correct.

-sarcoidosis -poison ivy skin rashes

Which time frame is the window of opportunity to begin postexposure prophylaxis (PEP) with combination antiretroviral therapy (cART) for a nurse who has been exposed to the blood of a patient who is human immune deficiency virus (HIV) positive?

36 hours

Which patient is at high risk for developing an infection?

65-year-old woman who had coronary bypass surgery 4 days ago

The nurse compares the number of CD4+ T-cells in human immune deficiency virus (HIV) infection and healthy adults and identifies that how many of the cells are present in a cubic millimeter (mm 3) of the healthy adult's blood?

800 to 1000 CD4+ T-cells/mm 3.

Which type of hypersensitivity occurs when a patient receives the wrong blood type during a transfusion, leading to a hemolytic transfusion reaction?

Cytotoxic reactions

Which finding is common with infectious disease?

Fever

Which instruction would the nurse give to a patient who has had an allergic reaction to environmental airborne allergens?

Thoroughly clean cloth drapes, carpeting, and upholstered furniture.

Which statement indicates inadequate understanding about precautionary measures to take while treating a patient with a history of allergic reaction during an emergency situation?

IV fluid administration is avoided in the patient.

Which information will the nurse teach a patient about the care and use of the "bee sting kit" device?

Obtain a replacement device if the drug is discolored.

When administering an antibiotic IV for the first time, which action is first before checking the five rights?

Review the clinical records and ask the patient about any known allergies.

A patient presents to the clinic after removing several ticks 10 days ago and asks the nurse about vector-borne diseases such as Lyme disease. After completing the health history, the nurse would assess for which symptom first?

Round, raised bulls-eye rash

Which assessment finding will the nurse anticipate for a patient with allergic rhinitis?

Runny nose with itchy, watery eyes

Which immune cell or component is involved in a type IV hypersensitivity reaction?

T-cells

Which disorder is indicated in a patient with cancer with a platelet level of 35,000/μL?

Thrombocytopenia

A patient with an infected wound is being discharged from the hospital to his or her home and will require long-term antibiotic therapy. Which information would the nurse teach the patient and the caregiver?

Wash hands thoroughly and often with soap and water.

A patient has developed a methicillin-resistant infection in the foot after undergoing surgical débridement for gangrene. Which action would the nurse take?

Wear a gown and gloves to prevent contact with the patient or contaminated items.

When must the nurse decontaminate the hands using soap and water instead of alcohol-based hand rub?

When hands are visibly soiled with blood

When a patient's first positive human immune deficiency virus (HIV) test result takes place within 6 months after a negative HIV test result, the nurse recognizes that the patient's laboratory classification, according to the Centers for Disease Control and Prevention (CDC), will change from Class 0 to Class 1 if which event occurs?

When the CD4+ T-cell count is greater than 500 cells/mm 3 (0.5 × 10 9/L) or a percentage of 29% or greater.

Which screening guideline is recommended for the early detection of cancer?

Yearly fecal occult blood test for adults of all ages

Which type of laboratory test measures a patient's response to the virus in patients with human immune deficiency virus (HIV)?

antibody testing

Which cancer may the patient with familial polyposis be at risk for developing in the future?

colorectal cancer

Which role will decongestants play in the treatment of a type I hypersensitivity?

reduce edema

Which action would the nurse perform between changing the wound dressing of a patient and administering medication?

Remove gloves and perform hand hygiene before administering the medication.

A 52-year-old patient relates to the nurse that she has never had a mammogram because she is terrified that she will have cancer. Which response by the nurse is therapeutic?

"Finding a cancer in the early stages increases the chance for cure."

Which response is best when a patient with painful terminal liver cancer is concerned with becoming addicted to the pain medications?

"I understand your concern. Addiction will not occur because your pain is real. It is important that we keep your pain under control."

How would the nurse best respond to a young patient with breast cancer who tells the nurse during chemotherapy that she feels as if she is not thinking clearly?

"It is not uncommon for patients to feel this way. It can be caused by chemotherapy."

Which response by the nurse is most accurate when a patient with terminal cancer asks about the potential for chronic pain?

"Pain can be a major problem for those with terminal cancer."

A patient diagnosed with leukemia has developed an infection. Which response would nurse give the patient about the reason for the infection? Select all that apply. One, some, or all responses may be correct.

-"Impaired immune function occurs most often in patients with leukemia." -"Impaired blood-producing functions occur most often in patients with leukemia."

The nurse recommends which method of sexual contact to reduce the risk for human immune deficiency virus (HIV) transmission? Select all that apply. One, some, or all responses may be correct.

-Abstinence -Monogamy -Condom use

Which hypersensitivity reaction is characterized by the antigen-antibody complex formation that gives rise to an inflammatory response? Select all that apply.One, some, or all responses may be correct.

-Anaphylaxis -Serum sickness -Rheumatoid arthritis -Immune hemolytic anemia

The nurse is caring for a patient with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection. Which prescribed drug would the nurse expect to administer to treat the infection?

Minocycline

Based on laboratory reports, the nurse concludes that a patient's immunity is compromised and provides which instruction to the patient? Select all that apply. One, some, or all responses may be correct.

-"Avoid digging in the garden." -"Wash your genitals twice a day with antimicrobial soap if total bathing is not possible."

Which question will the nurse ask during an assessment of a patient who is suffering from type I hypersensitivity? Select all that apply.One, some, or all responses may be correct.

-"Do you have any food or drug allergies?" -"Do you have any family members with a type I allergy?" -"When did this problem begin and how long does each episode last?"

In which order would the nurse perform effective hand hygiene?

1.Wet the hands with clean water. 2.Lather the hands with soap. 3.Apply friction with hands for 15 seconds. 4.Rinse hands under running water.

Which medication would the nurse expect to administer to a patient with a history of asthma that develops shortness of breath and stridor and becomes hypotensive during allergy skin testing?

Epinephrine

Which cancer-related disorder would cause a patient to experience restlessness, anxiety, wheezing, and blood-tinged frothy sputum?

Pulmonary edema

How often should the patient taking tenofovir/emtricitabine for pre-exposure prophylaxis (PrEP) for human immune deficiency virus (HIV) be tested for HIV?

Every 3 months

Which action would the nurse take immediately when caring for a patient experiencing an anaphylactic reaction to an IV infusion? .

Apply oxygen using a high-flow nonrebreather mask

What nursing intervention is the immediate priority when caring for a patient with the following symptoms: wheezing, difficulty breathing, angioedema, blood pressure (BP) of 70/52 mm Hg, and apical pulse of 122 beats/min that is irregular?

Apply oxygen using a high-flow nonrebreather mask at 90% to 100%.

Which nursing action is first when caring for a patient that is experiencing reduced chest movement and impaired airflow, hypotension, and a rapid, weak, irregular pulse?

Assessing gas exchange

When repositioning a patient with metastatic cancer, which precaution would the nurse keep in mind?

Extra care must be taken to avoid fractures.

Which nursing action is a priority for a patient having an allergic reaction to penicillin, who has symptoms of swollen lips and tongue, soft palate, and widespread hives with pruritus?

Administering IV epinephrine

Which factor in the development of infection is specific to the host?

Advanced age

Which nursing action would be most appropriate for a patient with cancer who is experiencing anorexia?

Advise a diet high in protein and carbohydrates.

By which mode is the Mycobacterium tuberculosis infection transmitted?

Airborne

Why does anal intercourse have the highest risk for human immune deficiency virus (HIV) transmission?

Anal intercourse allows seminal fluid to make contact with rectal mucous membranes and also tears the mucous membranes, making infection more likely.

Which sexual act carries the highest risk for the transmission of human immune deficiency virus (HIV)?

Anal sex

A patient with cancer is experiencing fatigue and weakness. Which disorder could these symptoms be related to?

Anemia

Which statement is accurate regarding the increasing incidence of multidrug-resistant organisms?

Antibiotics often have been given to patients for conditions that do not require antibiotics.

Which condition is associated with a type II hypersensitivity reaction?

Autoimmune hemolytic anemia

A patient with a type I allergy is treated with antihistamines and corticosteroids. Which other measure can help the patient to prevent future recurrence of allergies?

Avoidance therapy

The nurse suspects metastasis from left breast cancer to the thoracic spine when the patient has which symptom?

Back pain

To prevent possible human immune deficiency virus (HIV) transmission, which is the nurse's priority action after getting stuck by a hollow-bore needle through a latex glove?

Bleed the wound and wash it for at least 1 full minute.

Which laboratory changes are most likely in a patient whose immune system is being overwhelmed by the human immune deficiency virus (HIV)?

CD4+ T-cell counts fall, viral numbers rise

According to the Centers for Disease Control and Prevention (CDC) laboratory classifications for human immune deficiency virus (HIV), which class has defining features which include a CD4+ T-cell count of less than 200 cells/mm 3 (0.2 × 10 9/L) or a percentage of less than 14%?

Class 3

Which strategy is recommended for preventing infection transmission by health care workers?

Combination of hand hygiene and use of gloves

Which preventive nursing intervention is best in planning care for a patient admitted to the hospital who has a contact type I hypersensitivity to latex?

Communicate the need for avoidance therapy to the health care team.

A patient who is on mechanical ventilation has developed methicillin-resistant Staphylococcus aureus (MRSA) infection. Which type of precautions would the nurse implement?

Contact Precautions

The nurse is caring for a patient diagnosed with vancomycin-resistant enterococcus (VRE) infection. Which type of precautions would the nurse use when providing patient care?

Contact Precautions

What method is considered the best way to identify a microorganism causing infection?

Cultivate the pathogen in tissue cultures.

For which disorder is the patient with cancer receiving chemotherapy at risk?

Decreased platelets

A patient who is receiving an IV antibiotic begins to cough and states, "My throat feels like it is swelling." Which action will the nurse take next?

Discontinue infusing the antibiotic.

A patient with a history of cellulitis has developed septicemia. Which additional complication is likely to occur?

Disseminated intravascular coagulation (DIC)

Which instruction will have the greatest effect in cancer prevention for teenagers?

Do not smoke cigarettes.

Which symptom will the nurse anticipate finding in a patient with lung cancer?

Dyspnea

The nurse educates a patient who is immunocompromised about preventing infection and identifies that which occurrence warrants immediate notification of the health care provider (HCP)?

Foul-smelling or cloudy urine

Which class of drugs for human immune deficiency virus (HIV) infection prevents viral binding?

Fusion inhibitors

A pathology report of a patient with prostate cancer who underwent prostate surgery shows moderately differentiated cancer cells, indicating that some cells have retained some of the characteristics of normal cells, and many others have more malignant characteristics. Based on this finding, the nurse expects documentation of which malignancy grade?

G2

Which factor is the most important for preventing the transmission of infection from a patient to others?

Hand hygiene and gloves

Which statement about hand hygiene is aligned with recommendations by the Centers for Disease Control and Prevention (CDC)?

Hand hygiene must be done after contact with a patient's intact skin, such as when taking a pulse.

Which event occurs in a type II hypersensitivity reaction? Immunoglobulin G (IgG) antibody reacts with host cell membrane.

Immunoglobulin G (IgG) antibody reacts with host cell membrane.

A patient who is receiving antipyretic therapy has a blood pressure of 80/50 mm Hg and is diaphoretic, with a recurring fever. Which action would the nurse take?

Increase the patient's fluid intake.

Which condition may develop due to the effect of leukemia on white blood cells (WBCs)?

Increased risk for infection

Which statement about the process of malignant transformation is correct?

Insulin and estrogen enhance the division of an initiated cell during the promotion phase.

Which purpose is served by the U.S. Occupational Safety and Health Administration (OSHA)?

It protects health care workers from injury or illness at their places of employment.

The nurse is preparing to administer a newly prescribed antimicrobial agent to a patient. Which action would be the nurse's priority?

Making sure that the patient is not allergic to the agent

Droplet Precautions have been put into place for a patient with an active infection. Which condition would the nurse suspect the patient to have?

Meningitis

Which factor is the distinction between human immune deficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS)?

Number of CD4+ T-cells

Patients with low CD4+ T-cell counts are at risk for which condition that is caused by organisms that are present as part of the body's microbiome and usually kept in check by normal immunity?

Opportunistic infections

The home health nurse is caring for a patient who has a history of a kidney transplant and takes cyclosporine and prednisone to prevent rejection. Which assessment datum is most important to communicate to the transplant team?

Palpable lump in the patient's axilla

Which sign or symptom will the nurse ask the patient about when assessing for bladder cancer?

Presence of blood in the urine

Which type of hypersensitivity is anaphylaxis?

Rapid hypersensitivity

The nurse manager for a long-term care facility is in charge of implementing a plan to decrease the spread of infection within the facility. Which part of the plan would the nurse delegate to nursing assistants at the facility?

Reinforcing the need for handwashing after caring for patients

Which is the mechanism of action of epinephrine?

Stimulates the alpha- and beta-adrenergic receptors

Which hypersensitivity reaction symptom requires the most immediate action by the nurse?

Stridor

Which activity performed by the community health nurse best reflects primary prevention of cancer?

Teaching a class on cancer prevention

After teaching a patient with systemic lupus erythematosus (SLE) ways to manage disease-related pain by decreasing inflammation, which action made by the patient indicates a need for further instruction?

Uses acetaminophen for pain

Which action by a patient with thrombocytopenia would require the nurse to intervene?

The patient blows his or her nose forcefully.

How are malignant tumor cells that are graded G 1 characterized?

They closely resemble the cells from which they were produced.