NRSG 326 Review Questions

When planning care for a client with Hep a, the nurse should review labs for which value?

prothrombin time

1. Following the initiation of cancer cells in the body, cancer cells may enter a latent period lasting 1- 40 years. During this period promoting agents may include all of the following except: a. Dietary fat b. Alcohol consumption c. Physical and psychological stress d. Dairy and eggs

D. Dairy and eggs unhealthy lifestyles all promote Ca

A client with a bleeding ulcer is vomiting bright red blood. The nurse should assess the client for which indicator of early shock? a. HR above 100 bpm b. Dry flushed skin c. Anuria-urine output less than .3ml'kg d. Loss of consciousness

a. HR above 100bpm

A client presents with cirrhosis of the liver secondary to alcohol abuse. Which assessment findings would warrant immediate action by the nurse? a) Ascites and hematemesis b) Pulmonary edema c) Jugular vein distention d) Cramps and watery diarrhea

a. ascites and hematemesis

A nurse is caring for a client with multiple myeloma. Which laboratory value is the nurse most likely to see? a. Hypercalcemia b. Hyperkalemia c. Hypernatremia d. Hypermagnesemia

a. hypercalcemia

Two complications in chronic kidney disease are renal bone disease and malignant calcifications. These two complications are due to an imbalance of what two electrolytes? a. Hypocalcemia and hyperphosphatemia b. Hypercalcemia and hyperkalemia c. Hypokalemia and hyperphosphatemia d. Hypercalcemia and hyperkalemia

a. hypocalcemia and hyperphosphatemia

A patient has a lung biopsy back with the following TNM staging T4N4M1. a. Large tumour, extensive involvement of lymph nodes, moderate number of metastases b. 4 tumours, 4 lymph nodes, organ metastases c. Small tumour, 4 lymph nodes with mets d. Lung cancer, node involvement, mets to liver

a. large tumour, extensive involvement of lymph nodes, moderate number of metastases

The nurse is assessing a client who has begun external radiation therapy. What is anrusing observation that confirms the presence of early side effects of the radiation. a. Skin erythema followed by dry desquamation b. A gradual weight loss and GI disturbances c. Vertigo when sitting up quickly d. Excoriation and blisters on the affected skin

a. skin erythema followed by dry desquamation

The nurse is reviewing the cart of a client who recently had a cervical biopsy. the test results indicate TIS, N0, M0. How will the nurse interpret this information? a. The cancer is in situ which mean that it is localized and not invasive at this time b. The origin of the cancer is probably in the uterus and further testing will be necessary c. The lymph nodes are involved ...

a. the cancer is in situ which mean that it is localized and not invasive at this time

A client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note. (bilirubin in the urine is post-hepatic or intra-hepatic → then look at urobilinogen, urobilinogen is decreased in post-hepatic) a. Yellow sclera b. Light amber urine c. Circumoral pallor - around the mouth being pale d. Black, tarry stools

a. yellow sclera

A client has a massive bleeding from esophageal varices. In what order from first to last should the nurse and care team provide care for this client? All options must be used. A. maintain a patent airway. B. control hemorrhaging. C replace fluids. D. relieve the client's anxiety. (as soon as someone has a GI bleed, administer fluids before controlling hemorrhage. Hypotensive → open IV "999" on pump) a. 1a, 2b, 3d, 4c b. 1a, 2b, 3c, 4d c. 1a, 2c, 3b, 4d d. 1b, 2a, 3c, 4d e. 1a, 2d, 3b, 4c

b. 1a,2b,3c,4d

A surgical patient with chronic kidney disease, is now several days post operative and has not had a good bowel movement. The physician wants the patient to be given a laxative. The nurse sees that the physician has ordered magnesium citrate. The nurse decides to question the order because. a. This magnesium salt would be too strong for the pt b. Magnesium admin could worsen the patient's condition c. Magnesium citrate cannot be given orally d. Magnesium citrate can cause N&V

b. Magnesium admin could worsen the patient's condition

Which of the following is incorrect regarding cancer a. Cancer 5-year survival rate is improving amongst all types of cancer b. Since 1988 incidence of cancer has slowly increased among men c. Since 1988 incidence of cancer has slowly increased among women d. Almost half of all Canadians will develop cancer in their lifetime

b. Since 1988 incidence of cancer has slowly increased among men

Which treatment is most appropriate for the client with tumour lysis syndrome (concern in potassium, what was in the cells is not out of the cells → Hyperkalemia, acidosis, hyponatremia...? a. Give abx. b. Give IV hydration c. Give packed RBCs d. Give potassium chloride IV

b. give IV hydration

A nurse is caring for a client with hepatic encephalopathy and ascites. Which elements are important to include in this client's diet (select all that apply) a. High fat (moderate healthy fats are good) b. Low sodium c. High in vitamins d. Low carbohydrates (would want high carb base diet)

b. low sodium c. high in vitamins

A client with acute liver failure exhibits confusion, a declining level of consciousness, and slowed respirations. The nurse finds him very difficult to arouse. The diagnostic information which best explains the clients behaviour? a) Elevated liver enzymes and low serum protein level b) Subnormal serum glucose and elevated serum ammonia levels c) Subnormal clotting and platelet count d) Elevated BUN and Cr levels and hyperglycemia

b. subnormal serum glucose and elevated ammonia levels

The nurse is caring for a client scheduled to have a percutaneous liver biopsy. Which assessment finding warrant the postponement of the procedure? (select all that apply) a. Increased JVP (this is an expected finding as they are fluid overloaded) b. Marked ascites (pronounced ascites- need to do a paracentesis first so you don't accidently perforate the abdomen ) c. HGB of less than 9g/dL (90 mmol/L0 (risk of bleeding with a liver biopsy) d. Platelet count of 150000/mm3 (150x10 9/L)

b.Marked ascites (pronounced ascites- need to do a paracentesis first so you don't accidently perforate the abdomen ) c.HGB of less than 9g/dL (90 mmol/L0 (risk of bleeding with a liver biopsy)

The nurse is providing discharge instruction for a client with cirrhosis. Which statement best indicates that the client has understood the teaching? a) "I should eat a high-protein, high- carb diet to provide energy b) "It is safer for me to take acetaminophen for pain instead of aspirin" c) "I should avoid constipation to decrease chances of bleeding" d) "If i get enough rest and follow my diet, it is possible for my cirrhosis to be cured"

c. "I should avoid constipation to decrease chances of bleeding"

a client is receiving chemotherapy for metastatic colon cancer is admitted to the oncology unit due to several days of vomiting. Assessment findings include: irregular pulse, blood pressure of 88/43, respiratory rate of 14, serum potassium of 2.9 mmol/L (normal is 3.5-5.0 mmol/L) and arterial blood gases of: PH 7.46, PaCO 45, PaO2 95, HCO3 29 (22-26) → metabolic alkalosis a. Oxygen at 4L/min per nasal cannula b. Potassium 40 mEq PO now c. IV infusion of D5 ½ NS with 40 mEq KCL at 125 m:/hr d. IV infusion of NaHCO3 at 75 mL/h

c. c. IV infusion of D5 ½ NS with 40 mEq KCL at 125 m:/hr

Which diagnostic test is first used to evaluate a client with an upper GI? A) Endoscopy B) Upper GI series C) Hemoglobin levels and hematocrit D) arteriography

c. hemoglobin levels and hematocrit

A nurse is caring for a client in acute renal failure. The nurse should expect hypertonic glucose, insulin infusions, and sodium bicarbonate to be used to treat: a. Hypernatremia b. Hypokalemia c. Hyperkalemia d. Hypercalcemia

c. hyperkalemia

The nurse is caring for a client with cirrhosis. Which assessment findings indicate that the client has deficient vitamin K absorption caused by this hepatic disease? a. Dyspnea and fatigue b. Ascites and orthopnea c. Purpura and petechiae d. Gynecomastia and testicular atrophy

c. purpura and petechiae

A client is receiving chemotherapy with several antineoplastic agents. Which nursing observation is considered a common side effect of chemotherapy? a. Slow, slurred speech b. Increased leukocytes on complete blood count c. Stomatitis and oral ulcers (difficulty with eating, oral mucosa, inflammation in digestive track and in the mouth) d. Sinus dysrhythmias with bradycardia

c. stomatitis and oral ulcers

Which of the following is NOT CORRECT with respect to renal bone disease and malignant calcifications? a. The condition are due to the kidneys loss of ability to activate Vit D b. The conditions are due to the kidneys loss of ability to excrete certain electrolytes c. Secondary hyperparathyroidism results in excretion of parathyroid hormone even when not indicated d. The best way to correct this imbalance is with dialysis

d. The best way to correct this imbalance is with dialysis

A nurse is caring for a client with metastatic cancer. What manifestations should alert the nurse to the development of hypercalcemia (stones, bones, thrones, grones, psychiatric overtones)? a. Tinnitus and bradycardia b. Decreased level of consciousness and muscle weakness c. Agitation and tremors d. Diaphoresis and hyperreflexia

d. decreased level of consciousness and muscle weakness

The nurse is caring for a client with esophageal varices. The nurse should discuss which laboratory report finding with the health care provider (HCP)? a. Normal serum albumin b. Decreased ammonia c. Slightly decreased levels of calcium d. Elevated PT/INR

d. elevated PT/INR

The client's serum potassium level is elevated in acute renal failure, and the nurse administers sodium polystyrene sulfonate. The mechanism of action for this drug is to: a. Increase potassium excretion from the colon b. Release hydrogen ions for sodium ions c. Increase calcium absorption in the colon d. Exchange sodium for potassium ions in the colon

d. exchange sodium for potassium ions in the colon

The nurse teaches the client with chronic renal failure when to take aluminum hydroxide gel (phosphate binder). Which statement indicates that the client understands the teaching? a. I will take it Q4 hours around the clock' b. I will take it between meals and at bedtime c. I will take it when I have an upset stomach d. I will take it with meals and bedtime snacks

d. i will take it with meals and before bedtime snacks