Med-Surg 3 Exam 1 Study Set

How the tumor tends to grow and the cell type

A client diagnosed with cancer has the tumor staged and graded based on what? How the tumor tends to grow and the cell type How the tumor spreads and tends to grow How the tumor spreads and differentiates How the tumor differentiates the cell type

Crohn's disease

A client presents with an infection in the area between the internal and external sphincters. In which chronic disease is this condition commonly seen? ulcerative colitis Crohn's disease irritable bowel syndrome diverticulosis

tumors have their own growth of blood vessels

Angiogenesis

Tobacco Asbestos

Chemical Agents that can cause cancer

o Determine presence, extent of tumor o Identify possible spread (metastasis) of disease or invasion of other body tissues o Evaluate function of involved, uninvolved body systems/organs o Obtain tissue, cell for analysis, including evaluation of tumor stage, grade

Diagnosis of Cancer

- High alcohol intake - High fat intake - Lots of nitrates

Diet factors that can cause cancer

Low residue

Diet modifications for patient diagnosed with chronic inflammatory bowel disease include which of the following? Iron restriction Low residue Low protein Calorie restriction

D. Following proper hand-washing techniques

During a health education session, a participant has asked about the hepatitis E virus. What prevention measure should the nurse recommend for preventing infection with this virus? A. Wearing a condom during sexual contact B. Avoiding chemicals that are toxic to the liver C. Limiting alcohol intake D. Following proper hand-washing techniques

Usually over weeks, delivered daily, calculated dose

EBRT (External Beam Radiation Therapy)

- N/V - Anorexia - Stomatitis - Mucositis

Gastrointestinal Effects from Chemotherapy

Classification of tumor cells How much does that tissue look like what it's supposed to. 1-4 system · 1 - well differentiated, resembles that of normal tissue · 4 - doesn't resemble that original tissue at all, poorly differentiated

Grading of cancer

Through the blood

Hematogenous spread

c. Anorexia and constipation e. Shortened QT interval f. Lack of muscle coordination a. Muscle weakness

Hypercalcemia is a dangerous complication of bone cancer. Therefore, nursing assessment includes evaluation of symptoms that require immediate treatment. Which of the following are signs/symptoms that are indictors of an elevated serum calcium? Select all that apply. c. Anorexia and constipation d. Prolonged ST segment e. Shortened QT interval b. Tachycardia f. Lack of muscle coordination a. Muscle weakness

- Dermatitis - Dry mouth - Wet desquamation (red and oozing skin) - Stomatitis - Xerostomia - Mucositis - *all depends of location of radiation*

Radiation Reactions

involves detection, screening to achieve early diagnosis, intervention

Secondary prevention

determines size of tumor, existence of metastasis TNM · T: extent of primary tumor · N: lymph node involvement · M: extent of metastasis

Staging of cancer

preventing reoccurrence, reducing development of secondary cancers

Tertiary prevention

Jaundice Ascites Clubbing of the fingers

The nurse assesses a patient who is diagnosed with decompensated cirrhosis. Which of the following are clinical indicators consistent with that diagnosis? Select all that apply. Jaundice Splenomegaly Ascites A firm, enlarged liver Vascular spiders Clubbing of the fingers

Severe mid-abdominal to upper abdominal pain radiating to both sides and to the back

The nurse is asking the client with acute pancreatitis to describe the pain. What pain symptoms does the client describe related to acute pancreatitis? Sharp, stabbing pain in the left lower quadrant of the abdomen Severe abdominal pain that radiates to the right shoulder Severe mid-abdominal to upper abdominal pain radiating to both sides and to the back Dull pain, points to epigastric area

A chest x-ray

The nurse is caring for a client diagnosed with ductal carcinoma and lymph node involvement. Which diagnostic test, ordered by the physician, does the nurse identify as assessing possible metastasis? A multiple gated acquisition (MUGA) scan A complete blood count A bone density test A chest x-ray

Use dental floss every 24 hours. Rinse the mouth with normal saline. Use a lip lubricant.

The nurse is caring for an adult client who has developed a mild oral yeast infection following chemotherapy. What actions should the nurse encourage the client to perform? Select all that apply. Use dental floss every 24 hours. Scrub the tongue with a firm-bristled toothbrush. Rinse the mouth with normal saline. Use a lip lubricant. Eat spicy food to aid in eradicating the yeast

Allogenic · Donor has given their stem cells Autologous · Patient gives their own stem cells Syngeneic · Only applicable if the patient has an identical twin

Types of HSCT

HEP B HPV Mono

Viruses and Bacteria that causes cancer

Hyperkalemia Hyperphosphatemia Hyperuricemia

When malignant cells are killed (tumor lysis syndrome), intracellular contents are released into the bloodstream. This leads to which of the following? Select all that apply. Hyperkalemia Hyperphosphatemia Hypercalcemia Hyperuricemia

Removal of the tumor

Which of the following is the most successful treatment for gastric cancer? Removal of the tumor Radiation Palliation Chemotherapy

Pain Continuous aching in the back

Which of the following the are early manifestations of liver cancer? Select all that apply. Vomiting Fever Pain Jaundice Increased appetite Continuous aching in the back

Used for hematological cancers that effect marrow or solid tumors treated with chemotherapy dosage that ablates bone marrow

· Hematopoietic Stem Cell Transplantation (HSCT)

o Assessing fluid and electrolyte status o Assessing cognitive status o Modifying risks for infection and bleeding o Administering chemotherapy o Protecting caregivers

·Nursing Management in Chemotherapy

Hemorrhoids Enlarged liver size Ascites

A client is given a diagnosis of hepatic cirrhosis. The client asks the nurse what findings led to this determination. Which of the following clinical manifestations would the nurse correctly identify? Select all that apply. Hemorrhoids Accelerated behaviors and mental processes Excess storage of vitamin C Enlarged liver size Ascites

D. Measure the patient's abdominal girth daily Due to the risk of ascites, the nurse should monitor the patient's abdominal girth. There is no specific need to avoid the use of opioids or to monitor for dysphagia, and activity is usually limited.

An adult patient has been admitted to the medical unit for the treatment of acute pancreatitis. What nursing action should be included in this patient's plan of care? A. Encourage activity as tolerated. B. Monitor the patient for signs of dysphagia. C. Limit the use of opioid analgesics. D. Measure the patient's abdominal girth daily

- Presence of tumor-specific antigens, altered shape, structure, metabolism

Cell Characteristics

Lymphatic system

Lymphatic Spread

- If patient is on low dose radiation (ldr) - more restrictions and precautions - If patient is on high dose radiation (hdr) - less restrictions and precautions

Restrictions/Precautions when someone is on radiation therapy

Ineffective breathing pattern

The assessment of a client admitted with increased ascites related to cirrhosis reveals the following: pulse 86 beats per minute and weak, respirations 28 breaths per minute, blood pressure 130/88 mm Hg, and pulse oximetry 90%. Which nursing diagnosis should receive top priority? Excess fluid volume Imbalanced nutrition: less than body requirements Fatigue Ineffective breathing pattern

Tumors that are well oxygenated are more sensitive to radiation. Slower-growing tissues at rest (muscle) are more radioresistant. Tumors that are small in size and dividing rapidly are more sensitive.

Which of the following are true statements about effective radiation therapy? Select all that apply. Cells are least vulnerable during DNA synthesis. Tumors that are well oxygenated are more sensitive to radiation. Slower-growing tissues at rest (muscle) are more radioresistant. Tumors that are small in size and dividing rapidly are more sensitive.

Radical prostatectomy

Which of the following is considered first-line treatment for prostate cancer?

C. Palpate the area for a breast mass It would be most important for the nurse to palpate the breast to determine the presence of a mass and to refer the client to her primary provider. Edema and pitting of the skin may result from a neoplasm blocking lymphatic drainage, giving the skin an orange-peel appearance (peau d'orange), a classic sign of advanced breast cancer. The client's knowledge of breast cancer is relevant, but is not a time-dependent priority. This finding is not an age-related change. Assessment for signs of malignancy is a priority over infection, which is unlikely to cause these changes.

A 45-year-old woman comes into the health clinic for her annual checkup. She mentions to the nurse that she has noticed dimpling of the right breast that has occurred over a few months. What assessment would be most appropriate for the nurse to make? A. Assess the client's knowledge of breast cancer B. Palpate the client's breasts for tenderness and assess for infection C. Palpate the area for a breast mass D. Assure the client that this is likely an age-related change

B. "The enzymes that your pancreas produces have damaged the pancreas itself." Although the mechanisms causing pancreatitis are unknown, pancreatitis is commonly described as the autodigestion of the pancreas. Less commonly, toxic substances and microorganisms are implicated as the cause of pancreatitis.

A 55-year-old man has been newly diagnosed with acute pancreatitis and admitted to the acute medical unit. How should the nurse most likely explain the pathophysiology of this patient's health problem? A. "A virus that was likely already present in your body has begun to attack your pancreatic cells." B. "The enzymes that your pancreas produces have damaged the pancreas itself." C. "Bacteria likely migrated from your intestines and became lodged in your pancreas." D. "Toxins have accumulated and inflamed your pancreas."

Administer plasma Assist the client to a semi-Fowler position Administer pain-relieving medication Administer electrolytes

A client admitted with severe epigastric abdominal pain radiating to the back is vomiting and reports difficulty breathing. Upon assessment, the nurse determines that the client is experiencing tachycardia and hypotension. Which actions are priority interventions for this client? Select all that apply. Administer a low-fat diet Administer plasma Assist the client to a semi-Fowler position Administer pain-relieving medication Administer electrolytes

Apply pressure to the bleeding sites. Assess level of consciousness. Check intake and output records.

A client has been receiving chemotherapy. Upon assessing the client during morning rounds, the nurse notes the client is now bleeding from intravenous and venipuncture sites. Stool is positive for occult blood. The client is requesting to sit in a chair for a meal. The nurse implements the following interventions: (Select all that apply.) Apply pressure to the bleeding sites. Assess level of consciousness. Check intake and output records. Assist the client to a chair. Monitor vital signs once a shift.

B. avoids shaving the irradiated skin D. assesses the client for any sun exposure

A client has cancer of the neck and is receiving external beam radiation therapy to the site. The client is experiencing trauma to the irradiated skin. The nurse does all of the following. (Select all that apply.) A. uses cool water to wash the neck area B. avoids shaving the irradiated skin C. inspects for skin damage of the chest area D. assesses the client for any sun exposure E. applies an over-the-counter ointment to the skin

D. Continuous inflow and outflow of irrigation solution For continuous bladder irrigation, a triple-lumen indwelling urinary catheter is inserted. The three lumens provide for balloon inflation and continuous inflow and outflow of irrigation solution. PreviousNext

A client has just returned to the floor following a transurethral resection of the prostate. A triple-lumen indwelling urinary catheter has been inserted for continuous bladder irrigation. What, in addition to balloon inflation, are the functions of the three lumens? A. Continuous inflow and intermittent outflow of irrigation solution B. Intermittent inflow and continuous outflow of irrigation solution C. Intermittent inflow of irrigation solution and prevention of hemorrhage D. Continuous inflow and outflow of irrigation solution

Hypocalcemia

A client has returned to the floor after having a thyroidectomy for thyroid cancer. What laboratory finding may be an early indication of parathyroid gland injury or removal? Hyponatremia Hypokalemia Hypophosphatemia Hypocalcemia

Undiagnosed chronic pancreatitis

A client is admitted to the ICU with acute pancreatitis. The client's family asks what causes acute pancreatitis. The critical care nurse knows that a majority of clients with acute pancreatitis have what? Undiagnosed chronic pancreatitis Type 1 diabetes An impaired immune system An amylase deficiency

Vasopressin

A client is admitted to the hospital with acute hemorrhage from esophageal varices. What medication should the nurse anticipate administering that will reduce pressure in the portal venous system and control esophageal bleeding? Octreotide Vitamin K Epinephrine Vasopressin

Crohn's disease

A client is having a diagnostic workup for reports of frequent diarrhea, right lower abdominal pain, and weight loss. The nurse is reviewing the results of the barium study and notes the presence of "string sign." What does the nurse understand that this is significant of? Crohn's disease Irritable bowel syndrome Diverticulitis Ulcerative colitis

Sulfasalazine

A client is recently diagnosed with Crohn's disease and is beginning treatment. What first-line treatment does the nurse expect that the client will be placed on to decrease the inflammatory response? Azathioprine Sulfasalazine Ciprofloxacin Methotrexate

C. Increasing fluid intake to prevent dehydration

A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, what would the nurse stress the importance of? A. Taking only enteric-coated medications B. Wearing an appliance pouch only at bedtime C. Increasing fluid intake to prevent dehydration D. Consuming a low-protein, high-fiber diet

B. Ulcerative colitis

A client presents to the emergency department with complaints of acute GI distress, bloody diarrhea, weight loss, and fever. Which condition in the family history is most pertinent to the client's current health problem? A. Gastroesophageal reflux disease B. Ulcerative colitis C. Appendicitis D. Hypertension

albumin diuretics

A client with acute pancreatitis has jaundice with diminished bowel sounds and a tender distended abdomen. Additionally, lab results indicate hypovolemia. What will the physician order to treat the large amount of protein-rich fluid that has been released into the client's tissues and peritoneal cavity? Select all that apply. sodium dextrose solution albumin diuretics

D. cryoprecipitate and fresh frozen plasma.

A client with hepatitis C develops liver failure and GI hemorrhage. The blood products that most likely bring about hemostasis in the client are: A. platelets and packed red blood cells. B. whole blood and albumin. C. fresh frozen plasma and whole blood. D. cryoprecipitate and fresh frozen plasma.

Tacrolimus

A client with hepatitis who has not responded to medical treatment is scheduled for a liver transplant. Which of the following most likely would be ordered? Chenodiol Ursodiol Tacrolimus Interferon alfa-2b, recombinant

Part of the stomach Duodenum Gallbladder Part of the common bile duct

A client with pancreatic cancer has been scheduled for a pancreaticoduodenectomy (Whipple procedure). During health education, the client should be informed that this procedure will involve the removal of which of the following? Select all that apply. Part of the rectum Part of the stomach Duodenum Gallbladder Part of the common bile duct

"Do you feel any muscle twitches or spasms?"

A client with thyroid cancer has undergone surgery and a significant amount of parathyroid tissue has been removed. The nurse caring for the client should prioritize what question when addressing potential complications? "Are you experiencing any dizziness or lightheadedness?" "Do you feel flushed or sweaty?" "Are you having any pain that seems to be radiating from your bones?" "Do you feel any muscle twitches or spasms?"

Sexual activity Suboptimal sanitary habits Infection at school Consumption of sewage-contaminated water or shellfish

A mother brings her teenage son to the clinic, where tests show that he has hepatitis A virus (HAV). They ask the nurse how this could have happened. Which of the following explanations would the nurse correctly identify as possible causes? Select all that apply. Sexual activity Suboptimal sanitary habits Infection at school Consumption of sewage-contaminated water or shellfish Ingestion of undercooked beef

D. Gently washing the area surrounding the stoma using a facecloth and mild soap

A nurse is applying an ostomy appliance to the ileostomy of a client with ulcerative colitis. Which action is appropriate? A. Cutting the faceplate opening no more than 2 inches larger than the stoma B. Maintaining wrinkles in the faceplate so it doesn't irritate the skin C. Scrubbing fecal material from the skin surrounding the stoma D. Gently washing the area surrounding the stoma using a facecloth and mild soap

Inflammatory bowel disease

A nurse is assessing a client and obtains the following findings: abdominal discomfort, mild diarrhea, blood pressure of 100/80 mm Hg, pulse rate of 88 beats/minute, respiratory rate of 20 breaths/minute, temperature 100° F (37.8° C). What diagnosis will the nurse suspect for this client? liver failure diverticulitis inflammatory bowel disease (IBD) colorectal cancer

B. The client exhibits signs of adequate GI perfusion.

A nurse is caring for a client who has experienced an acute exacerbation of Crohn's disease. Which statement best indicates that the disease process is under control? A. The client expresses positive feelings about himself. B. The client exhibits signs of adequate GI perfusion. C. The client maintains skin integrity. D. The client verbalizes a manageable level of discomfort.

Hypercalcemia

A nurse is caring for a client with bone metastasis from a primary breast cancer. The client reports muscle weakness and nausea and is voiding large amounts frequently. The telemetry monitor is observed showing premature ventricular contractions. What should the nurse suspect based on the clinical manifestations? Hypercalcemia Hyperkalemia Hypocalcemia Hypokalemia

A. Inability of the liver to use vitamin K Decreased production of several clotting factors may be partially due to deficient absorption of vitamin K from the GI tract. This probably is caused by the inability of liver cells to use vitamin K to make prothrombin. This bleeding risk is unrelated to the roles of glucose, bile salts, or albumin.

A nurse is caring for a client with liver failure and is performing an assessment in the knowledge of the client's increased risk of bleeding. The nurse recognizes that this risk is related to the client's inability to synthesize prothrombin in the liver. What factor most likely contributes to this loss of function? A.Inability of the liver to use vitamin K B. Retention of bile salts C. Alterations in glucose metabolism D. Inadequate production of albumin by hepatocytes

A. "I'll only need chemotherapy treatment before receiving my bone marrow transplant."

A nurse is caring for a recently married, 29-year-old female client, who was diagnosed with acute lymphocytic leukemia. The client is preparing for an allogeneic bone marrow transplant. Which statement by the client demonstrates she understands the informed consent she gave about the diagnosis and treatment? A. "I'll only need chemotherapy treatment before receiving my bone marrow transplant." B. "I'll have to remain in the hospital for about 3 months after my transplant." C. "I always had a good appetite. Even with chemo I shouldn't have to make any changes to my diet." D. "I should be able to finally start a family after I'm finished with the chemo."

D. Bed rest lowers the metabolic rate and reduces enzyme production. The acutely ill patient is maintained on bed rest to decrease the metabolic rate and reduce the secretion of pancreatic and gastric enzymes. Staying in bed does not release energy from the body to fight the disease.

A nurse is creating a care plan for a patient with acute pancreatitis. The care plan includes reduced activity. What rationale for this intervention should be cited in the care plan? A. Inactivity reduces caloric need and gastrointestinal motility. B. Bed rest reduces the patient's metabolism and reduces the risk of metabolic acidosis. C. Reduced activity protects the physical integrity of pancreatic cells. D. Bed rest lowers the metabolic rate and reduces enzyme production.

A. Watery with blood and mucus The predominant symptoms of ulcerative colitis are diarrhea and abdominal pain. Stools may be bloody and contain mucus. Stools are not hard, dry, tarry, black or fatty in patients who have ulcerative colitis.

A nurse is preparing to provide care for a patient whose exacerbation of ulcerative colitis has required hospital admission. During an exacerbation of this health problem, the nurse would anticipate that the patient's stools will have what characteristics? A. Watery with blood and mucus B. Dry and streaked with blood C. Loose with visible fatty streaks D. Hard and black or tarry

"These therapies destroy the ability of your body to produce blood cells inside your bone marrow."

A nurse is providing teaching to a client who will undergo chemotherapy and radiation prior to hematopoietic stem cell transplantation (HSCT) for acute myeloid leukemia (AML). What statement will the nurse use to describe the purpose of the chemotherapy and radiation? "These therapies shrink your tumor to ensure the stem cell transplant is more effective." "These therapies destroy the ability of your body to produce blood cells inside your bone marrow." "These therapies destroy the bone marrow in an effort to shrink it and decrease your pain." "These therapies decrease your immune system to decrease the risk of allergic reaction."

Self-digestion of the pancreas by its own proteolytic enzymes

A nurse is teaching a client about the cause of acute pancreatitis. The nurse evaluates the teaching as effective when the client correctly identifies which condition as a cause of acute pancreatitis? Calcification of the pancreatic duct, leading to its blockage Use of loop diuretics to increase the incidence of pancreatitis Self-digestion of the pancreas by its own proteolytic enzymes Fibrosis and atrophy of the pancreatic gland

C. "Do not visit if you've had a recent infection." Before HSCT, clients are at a high risk for infection, sepsis, and bleeding. Visitors should not visit if they have had a recent illness or vaccination. Gowns should indeed be worn, but this is secondary in importance to avoiding the client's contact with ill visitors. Prolonged fasting is unnecessary. Negative outcomes are possible, but the procedure would not normally be so risky as to require the family to gather at the bedside.

A nurse provides care on a bone marrow transplant unit and is preparing a female client for hematopoietic stem cell transplantation (HSCT) the following day. What information should the nurse emphasize to the client's family and friends? A. "Make sure she doesn't eat any food in the 24 hours before the procedure." B. "Your family should likely gather at the bedside in case there's a negative outcome." C. "Do not visit if you've had a recent infection." D. "Wear a hospital gown when you go into the client's room."

B. Liver function tests (LFTs) Yellow skin is a sign of jaundice and the liver is a common organ affected by metastatic disease. An LFT should be done to determine if the liver is functioning. A CBC, platelet count and tests of renal function would not directly assess for liver disease.

A nurse who works in an oncology clinic is assessing a client who has arrived for a 2-month follow-up appointment following chemotherapy. The nurse notes that the client's skin appears yellow. Which blood tests should be done to further explore this clinical sign? A. Blood urea nitrogen and creatinine B. Liver function tests (LFTs) C. Complete blood count (CBC) D. Platelet count

Tofu Nutritional management of inflammatory bowel disease requires ingestion of a diet that is bland, low-residue, high-protein, and high-vitamin. Tofu meets each of the criteria. Spinach, multigrain bagels, and blueberries are not low-residue.

A patient admitted with inflammatory bowel disease asks the nurse for help with menu selections. What menu selection is most likely the best choice for this patient? Tofu Blueberries Multigrain bagel Spinach

B. IV hydromorphone (Dilaudid) The pain of acute pancreatitis is often very severe and pain relief may require parenteral opioids such as morphine, fentanyl (Sublimaze), or hydromorphone (Dilaudid). There is no clinical evidence to support the use of meperidine for pain relief in pancreatitis. Opioids are preferred over NSAIDs. PreviousNext

A patient has been diagnosed with acute pancreatitis. The nurse is addressing the diagnosis of Acute Pain Related to Pancreatitis. What pharmacologic intervention is most likely to be ordered for this patient? A. IM meperidine (Demerol) B. IV hydromorphone (Dilaudid) C. Oral oxycodone D. Oral naproxen (Aleve)

B. Encourage the patient to connect with a community-based support group. After the acute attack has subsided, some patients may be inclined to return to their previous drinking habits. The nurse provides specific information about resources and support groups that may be of assistance in avoiding alcohol in the future. Referral to Alcoholics Anonymous as appropriate or other support groups is essential. The patient already has an understanding of the effects of alcohol, and follow-up appointments will not necessarily result in lifestyle changes. Social work and spiritual care may or may not be beneficial.

A patient has been treated in the hospital for an episode of acute pancreatitis. The patient has acknowledged the role that his alcohol use played in the development of his health problem, but has not expressed specific plans for lifestyle changes after discharge. What is the nurse's most appropriate response? A. Educate the patient about the link between alcohol use and pancreatitis. B. Encourage the patient to connect with a community-based support group. C. Refer the patient to social work or spiritual care. D. Ensure that the patient knows the importance of attending follow-up appointments.

B. Maintain the patient in a semi-Fowler's position whenever possible. The nurse maintains the patient in a semi-Fowler's position to decrease pressure on the diaphragm by a distended abdomen and to increase respiratory expansion. A supine position will result in increased pressure on the diaphragm and potentially decreased respiratory expansion. Steroids and oral suctioning are not indicated.

A patient is being treated on the acute medical unit for acute pancreatitis. The nurse has identified a diagnosis of Ineffective Breathing Pattern Related to Pain. What intervention should the nurse perform in order to best address this diagnosis? A. Position the patient supine to facilitate diaphragm movement. B. Maintain the patient in a semi-Fowler's position whenever possible. C. Perform oral suctioning as needed to remove secretions. D. Administer corticosteroids by nebulizer as ordered.

D. An absence of blood in stool Bloody stool is far more common in cases of UC than in Crohn's. Rectal involvement is nearly 100% in cases of UC (versus 20% in Crohn's) and patients with UC typically experience severe diarrhea. UC is also characterized by a pattern of remissions and exacerbations, while Crohn's often has a more prolonged and variable course.

A patient's health history is suggestive of inflammatory bowel disease. Which of the following would suggest Crohn's disease, rather that ulcerative colitis, as the cause of the patient's signs and symptoms? A. Involvement of the rectal mucosa B. A pattern of distinct exacerbations and remissions C. Severe diarrhea D. An absence of blood in stool

B. Blood glucose levels In addition to administering enteral or parenteral nutrition, the nurse monitors serum glucose levels every 4 to 6 hours. Output should be monitored but in most cases it is not more important than serum glucose levels. A patient on parenteral nutrition would have no oral intake to monitor. Blood sugar levels are more likely to be unstable than indicators of renal function.

A student nurse is caring for a patient who has a diagnosis of acute pancreatitis and who is receiving parenteral nutrition. The student should prioritize which of the following assessments? A. Fluid output B. Blood glucose levels C. BUN and creatinine levels D. Oral intake

D. Promptly refer the client for medical assessment. Hodgkin lymphoma usually begins as an enlargement of one or more lymph nodes on one side of the neck. The individual nodes are painless and firm but not hard. Prompt medical assessment is necessary if a client has this presentation. However, there is no acute need to call 911. Delaying care for 1 week could have serious consequences and x-rays are not among the common diagnostic tests.

An adult client has presented to the health clinic reporting a firm, painless cervical lymph node. The client denies any recent infectious diseases. What is the nurse's most appropriate response to the client's complaint? A. Call 911. B. Facilitate a radiograph of the client's neck and have the results forwarded to the client's primary provider. C. Encourage the client to track the size of the lymph node and seek care in 1 week. D. Promptly refer the client for medical assessment.

A. Bilateral mastectomy bilateral mastectomy would be considered a prophylactic measure to reduce the risk of cancer in the client's unaffected breast. None of the other listed interventions would be categorized as being prophylactic rather than curative.

An adult woman's mother died of left breast cancer. If the client and her physician opt for prophylactic treatment, the nurse should prepare the woman for what intervention? A. Bilateral mastectomy B. More aggressive chemotherapy C. Radiation therapy D. Left mastectomy

The different leukemias all involve unregulated proliferation of white blood cells

An oncology nurse is providing health education for a client who has recently been diagnosed with leukemia. What should the nurse explain about commonalities between all of the different subtypes of leukemia?

B. The different leukemias all involve unregulated proliferation of white blood cells. Leukemia commonly involves unregulated proliferation of white blood cells. Decreased production of red blood cells is associated with anemias. Decreased production of white blood cells is associated with leukopenia. The leukemias are not characterized by their involvement with the lymphatic system.

An oncology nurse is providing health education for a client who has recently been diagnosed with leukemia. What should the nurse explain about commonalities between all of the different subtypes of leukemia? A. The different leukemias all involve the development of cancer in the lymphatic system. B. The different leukemias all involve unregulated proliferation of white blood cells. C. The different leukemias all result in a decrease in the production of white blood cells. D. The different leukemias all have unregulated proliferation of red blood cells and decreased bone marrow function.

Healthy cells exposed to carcinogens and then they start to become malignant cells Three-Step Process · Initiation - exposed to carcinogen · Promotion - repeated exposure · Progression

Carcinogenesis

- Uncontrolled growth with ability to metastasize and destroy tissue and cause death

Cell Proliferation

- Anemia - Leukopenia - Thrombocytopenia - at risk for bleeding

Hematopoietic effects from chemotherapy

- Prolonged estrogen therapy

Hormones that can cause cancer

Cell Proliferation - Uncontrolled growth with ability to metastasize and destroy tissue and cause death Cell Characteristics - Presence of tumor-specific antigens, altered shape, structure, metabolism

Malignant Process

Sunlight radiation chronic irritation (GERD)

Physical factors that can cause cancer

concerned with reducing cancer risk in healthy people

Primary prevention

Clay-colored stools Jaundice Dark urine

Sixty to eighty percent of pancreatic tumors occur in the head of the pancreas. Tumors in this region obstruct the common bile duct. Which of the following clinical manifestations would indicate a common bile duct obstruction associated with a tumor in the head of the pancreas? Select all that apply. Pruritus Clay-colored stools Weight gain Jaundice Dark urine

Age <30 or 50> Family hx Chronic ultra-violent light/sun exposure Having large number of moles Hx of indoor tanning Hx of sunburns Immunosuppression People who have light skin, blonde or red hair, or have blue or green eyes.

Skin Cancer Risk Factors

Flush the toilet several times after every use.

The nurse is caring for a thyroid cancer client following oral radioactive iodine treatment. Which teaching point is most important? Shield your throat area when near others. Flush the toilet several times after every use. Prepare food separately from family members. Use disposable utensils for the next month.

Soft, subcutaneous nodules along the tendons

The nurse is conducting a musculoskeletal assessment on a client documented to have rheumatoid arthritis. Which would the nurse anticipate finding when inspecting the client's fingers? Soft, subcutaneous nodules along the tendons Soft nodules along the palmar surface Hard nodules adjacent to the joints Hard nodules of bony overgrowth

Activity intolerance related to fatigue, general debility, muscle wasting, and discomfort Disturbed body image related to changes in appearance, sexual dysfunction, and role function Risk for injury related to altered clotting mechanisms

The nurse is preparing a care plan for a client with hepatic cirrhosis. Which nursing diagnoses are appropriate? Select all that apply. Altered nutrition, more than body requirements, related to decreased activity and bed rest Urinary incontinence related to general debility and muscle wasting Activity intolerance related to fatigue, general debility, muscle wasting, and discomfort Disturbed body image related to changes in appearance, sexual dysfunction, and role function Risk for injury related to altered clotting mechanisms

Pancakes with butter and honey, and orange juice

The nurse is teaching a client who was admitted to the hospital with acute hepatic encephalopathy and ascites about an appropriate diet. The nurse determines that the teaching has been effective when the client chooses which food choice from the menu? Omelet with green peppers, onions, mushrooms, and cheese with milk Baked chicken with sweet potato french fries, cornbread, and tea Pancakes with butter and honey, and orange juice Ham and cheese sandwich, baked beans, potatoes, and coffee

inflammation autoantibodies immune complexes susceptibility abnormal innate and adaptive immune responses damage

The nurse is working with a client with systemic lupus erythematosus (SLE). What are the immune abnormalities characterized by SLE? Select all that apply. inflammation autoantibodies immune complexes susceptibility abnormal innate and adaptive immune responses damage

Shorten the period of neutropenia

The nurse knows that interferon agents are used in association with chemotherapy to produce which effects in the client? Decrease the need for additional adjuvant therapies Shorten the period of neutropenia Suppression of the bone marrow Enhance action of the chemotherapy

Promote pain relief and quality of life

The nurse recognizes that goal of treatment for metastatic bone cancer is to: Cure the diseased bone and cartilage Diagnose the extent of bone damage Reconstruct the bone with a prosthesis Promote pain relief and quality of life

Serum lipase

The nurse should assess for an important early indicator of acute pancreatitis. What prolonged and elevated level would the nurse determine is an early indicator? Serum lipase Serum amylase Serum calcium Serum bilirubin

Albumin infusion

What intervention does the nurse anticipate providing for the patient with ascites that will help correct the decrease in effective arterial blood volume that leads to sodium retention? Platelet infusions Diuretic therapy Therapeutic paracentesis Albumin infusion

B. Teaching clients to wear sunscreen Primary prevention is concerned with reducing the risks of cancer in healthy people through practices such as use of sunscreen. Secondary prevention involves detection and screening to achieve early diagnosis, as demonstrated by Pap tests, mammograms, and testicular exams.

What nursing action best demonstrates primary cancer prevention? A. Encouraging yearly Pap tests B. Teaching clients to wear sunscreen C. Teaching testicular self-examination D. Facilitating screening mammograms

Irritability and drowsiness

When caring for a client with hepatitis B, the nurse should monitor closely for the development of which finding associated with a decrease in hepatic function? Irritability and drowsiness Fatigue during ambulation Pruritus of the arms and legs Jaundice

A 35-year-old female with Crohn's disease

Which client would be at greatest risk for the development of an anorectal fistula? A 50-year-old male with diverticulosis A 60-year-old male with polyps of the colon A 42-year-old female with irritable bowel syndrome A 35-year-old female with Crohn's disease

Provide diversional activities. Provide opportunities for the client to verbalize feelings. Support joints with splints and pillows.

Which intervention should the nurse implement to manage pain for the client with rheumatoid arthritis? Select all that apply. Support joints with splints and pillows. Assist the client to develop a sleep routine. Provide diversional activities. Provide opportunities for the client to verbalize feelings. Provide assistive devices for self-feeding.

D. Intermittent pain and diarrhea

Which is the most prominent sign of inflammatory bowel disease? A. Increased peristalsis and diarrhea B. Abdominal distention and constipation C. Hyperactive bowel sounds and constipation D. Intermittent pain and diarrhea