TEST 2
The nurse is teaching a community course about cancer prevention. Which contributing factors to malignancy will the nurse include in the teaching? Select all that apply. A. Oxidative stress B. Lifestyle factors C. Hormonal influences D. Acute inflammation E. Environmental variables
A. Oxidative stress B. Lifestyle factors C. Hormonal influences E. Environmental variables
A nurse is caring for a client with a 15% carboxyhemoglobin level. Which clinical manifestations will the nurse expect to find in the client? Select all that apply. A. Exertional dyspnea B. Headache C. Tachycardia D. Dizziness. E. Confusion
A. Exertional dyspnea B. Headache D. Dizziness
The nurse in preadmission testing is taking a health history from a patient who will be having an elective hysterectomy. Which vitamin deficiency should be addressed before surgery to ensure proper blood clotting during surgery? A. Vitamin K deficiency B. Vitamin A deficiency C. Vitamin E deficiency D. Vitamin C deficiency
A. Vitamin K deficiency
When assessing a patient with left-sided tension pneumothorax, the nurse would expect to auscultate: A. adventitious breath sounds over the left lung. B. lack of breath sounds over the right lung. C. wheezing on expiration. D. a sucking sound across both lung fields.
A. adventitious breath sounds over the left lung.
A nurse is educating a group of clients on the health risks of air pollution. Which client is at the greatest risk of exposure to air pollution? A. A client who regularly engages in outdoor activities. B. A client with a family history of asthma. C. A client who lives in a remote, rural community. D. A client who works as a bookkeeper in a busy office environment.
A. A client who regularly engages in outdoor activities.
When planning care for a patient with resorption atelectasis, the nurse should keep which of the following principles in mind? A. Excess mucous production is the most common cause of the associated obstruction. B. Fibrotic changes reduce lung expansion. C. Alveolar collapse occurs that is undetected by chest x-ray. D. An accumulation of excess air compresses lung tissue.
A. Excess mucous production is the most common cause of the associated obstruction.
When assessing a patient's skin, the nurse needs to keep in mind that: A. light-skinned and dark-skinned people have the same number of melanocytes. B. light-skinned people do not have melanocytes. C. dark-skinned people have more melanocytes than light-skinned people. D. melanocytes in light-skinned people do not produce melanin.
A. light-skinned and dark-skinned people have the same number of melanocytes.
A nurse educator is providing review of material to staff nurses regarding the process of inflammation. Which statement by the nurse indicates an understanding of the material? Select all that apply. A. "Inflammation requires the immune cells to talk to each other." B. "Inflammation regulates the behavior of cells." C. "Inflammation is a temporary cell-to-cell interaction." D. "Inflammation occurs between closely knit cell pathways." E. "Inflammation is critical for the development of the body."
A. "Inflammation requires the immune cells to talk to each other." C. "Inflammation is a temporary cell-to-cell interaction."
A nurse is performing follow up education for a client who recently underwent a punch biopsy procedure for suspected melanoma. Which statement by the client indicates appropriate understanding of melanin? A. "Melanin protects certain cells from UV light." B. "Melanin is composed of hemoglobin, a blood component." C. "Melanin an example of an external pigment." D. "Melanin is a yellow-brown pigment composed of fats."
A. "Melanin protects certain cells from UV light."
A community health nurse is teaching a class on the effects of heart injury. Which statement from class attendees indicates an appropriate understanding of the course material? A. "My heart cells may fully recover if blood supply returns within 15 minutes." B. "When my heart cells sustain an injury, they can no longer function normally." C. "Even if my heart cells die, the damage to my heart is still reversible." D. "When my heart cells are deprived of oxygen, irreversible damage occurs."
A. "My heart cells may fully recover if blood supply returns within 15 minutes."
A client with a burn injury asks, "Why does swelling happen after a burn?" What is the nurse's best initial response? A. "Swelling occurs in order to prepare the injured area for healing." B. "Swelling occurs because of the release of chemicals that impact the vessels.." C. "Swelling occurs because the vessels leak fluid into the surrounding tissue." D. "Swelling occurs because the vessels dilate, which slows the flow of blood."
A. "Swelling occurs in order to prepare the injured area for healing."
A nurse is providing dietary education for a client. Which statement by the client indicates an understanding of dietary antioxidants? A. "Vitamin E is one of the most important dietary lipid-soluble antioxidants." B. "Vitamin C is a dietary, fat-soluble antioxidant." C. "Dietary vitamins are an example of enzymatic antioxidants." D. "Antioxidants are only found in healthy, whole foods."
A. "Vitamin E is one of the most important dietary lipid-soluble antioxidants."
How many breaths per minute does a patient who breathes 250 mL/breath need to achieve a normal alveolar ventilation of 4.2 L/minute? A. 42 breaths per minute B. 16 breaths per minute C. 20 breaths per minute D. 12 breaths per minute
A. 42 breaths per minute
The nurse is caring for a client with systemic inflammatory response syndrome (SIRS). Which assessment finding would the nurse anticipate? Select all that apply. A. A heart rate of greater than 90 beats per minute B. A body temperature of less than 36°C or greater than 38°C C. A respiratory rate of greater than 16 respirations per minute D. A white blood cell (WBC) count less than 3,000 cells/mm3 or greater than 12,000 cells/mm3 E. The presence of greater than 20% immature neutrophils
A. A heart rate of greater than 90 beats per minute B. A body temperature of less than 36°C or greater than 38°C D. A white blood cell (WBC) count less than 3,000 cells/mm3 or greater than 12,000 cells/mm3
When changing the dressing on a wound healing by secondary intention, what finding would the nurse expect to observe? A. A large amount of exudate B. Minimal granulation tissue C. A clean incision D. An incision closed by sutures
A. A large amount of exudate
A nurse is caring for a client with non-small cell lung cancer (NSCLC) that has metastasized to the brain. What changes in the client's cells have occurred to allow metastasis? Select all that apply. A. Altered cytoskeletal control leads to the loss of internal and external cellular functions. B. Human leukocyte antigen (HLA) may be present, allowing malignant cells to escape detection by the immune system. C. Alterations in lectin binding allow cancer cells to avoid sticking to leukocytes and platelets. D. The cytoskeleton loses rigidity, making cells more amenable to proliferation. E. Further growth is inhibited at the primary site, encouraging cells to spread to other sites in the body.
A. Altered cytoskeletal control leads to the loss of internal and external cellular functions. D. The cytoskeleton loses rigidity, making cells more amenable to proliferation.
Which of the following individuals is at greatest risk for developing idiopathic pulmonary fibrosis (IPF)? A. A 65-year-old Caucasian man who currently smokes B. A 55-year-old African American nonsmoking man C. A 30-year-old Caucasian women who smoked briefly in her early 20s D. A 58-year-old Asian nonsmoking woman
A. A 65-year-old Caucasian man who currently smokes
When assessing a patient's skin, which of the following characteristics of skin should the nurse keep in mind? A. Blood vessels in the dermis nourish the epidermis. B. Lymphatic vessels drain the epidermis. C. Hair follicles originate in the dermis. D. The epidermis is highly vascular.
A. Blood vessels in the dermis nourish the epidermis.
Which clinical manifestation would the nurse expect when assessing an adult obese patient with bibasilar atelectasis? A. Diminished chest expansion B. Diminished breath sounds in all lung fields C. Barrel-shaped chest D. Intercostal retractions on inspiration
A. Diminished chest expansion
The nurse is conducting family planning with a healthy couple. The man's father had cystic fibrosis and his mother was healthy with no family history of the condition. The woman's family has no history of cystic fibrosis. Which is the most appropriate response for the nurse to make when asked about the risk of their child having cystic fibrosis? A. Each child has a 50% chance of being a carrier for cystic fibrosis. B. All children will have cystic fibrosis. C. All children will be carriers for cystic fibrosis. D. Each child has a 50% chance of cystic fibrosis.
A. Each child has a 50% chance of being a carrier for cystic fibrosis.
The nurse prepares to administer a glucocorticoid agent to a client with an inflammatory disorder. What is the nurse's understanding of the purpose of glucocorticoids in the hypothalamic-pituitary-adrenal (HPA) axis? A. Glucorticoids act with cytokines to decrease the inflammatory response. B. Glucocorticoids stimulate the pituitary, decreasing inflammation. C. Glucocorticoids cause the release of cytokines that downregulate the inflammatory response. D. Glucocorticoids increase the number of active immune cells in the body.
A. Glucorticoids act with cytokines to decrease the inflammatory response.
Which of the following is not an indication for administering 100% oxygen to a patient with a restrictive lung disorder? A. Hypoxemia caused by a venous-to-arterial shunt B. Hypoxemia caused by deep breathing C. Hypoxemia caused by hypoventilation D. Hypoxemia caused by a thickened alveolar-capillary membrane
A. Hypoxemia caused by a venous-to-arterial shunt
The nurse is reviewing a client's list of medications. Which medications does the nurse understand to be anti-inflammatory in action? Select all that apply. A. Ibuprofen B. Prednisone C. Aspirin D. Acetaminophen E. Celecoxib
A. Ibuprofen B. Prednisone C. Aspirin E. Celecoxib
A nurse is caring for an older adult client in a long-term care facility. What is the nurse's understanding of replicative senescence? A. It is the limitation of the number of times a cell can divide. B. It is the body's ability to repair cells damaged by reactive oxygen species (ROS). C. It refers to the brain's ability to recall memories. D. It is caused by decreased caloric intake.
A. It is the limitation of the number of times a cell can divide.
Which characteristics would the nurse expect in the stool of a child with cystic fibrosis? A. Large foul-smelling stools B. Thin pencil-like stools C. Black tarry stools D. Clay-colored stools
A. Large foul-smelling stools
The nurse is teaching pursed lip breathing to a patient with severe COPD. Which behavior indicates to the nurse that teaching has been effective? A. Lips are puckered on exhalation. B. Lips are puckered on inhalation. C. Lips are wide apart on inhalation. D. Lips are pursed on inhalation and exhalation. Question is complete.
A. Lips are puckered on exhalation.
When developing a nursing care plan for a child with cystic fibrosis, which problem should be addressed? A. Malabsorption of fat-soluble vitamins B. Malabsorption of water-soluble vitamins C. Malabsorption of proteins D. Malabsorption of carbohydrates
A. Malabsorption of fat-soluble vitamins
The nurse is preparing to administer a human papilloma virus (HPV) vaccine to a client. What does the nurse understand about infections and cancer incidence? A. Many of the leading cancers in the world are due to infections like HPV. B. The HPV vaccine is effective for preventing all types of HPV infections. C. Screening for cervical cancer is no longer necessary after receiving the HPV vaccine. D. HPV vaccination is effective for the treatment of cervical cancer.
A. Many of the leading cancers in the world are due to infections like HPV.
A nurse is performing an assessment on a client with acute ionizing radiation exposure. Which assessment findings does the nurse anticipate? Select all that apply. A. Nausea B. Constipation C. Fatigue D. Vomiting E. Hypercoagulability
A. Nausea C. Fatigue D. Vomiting
The nurse is reviewing the medication list of a patient with impaired wound healing. Which medication would be of concern to the nurse? A. Prednisone B. Vitamin C C. Cefazolin D. NPH insulin
A. Prednisone
The nurse is reviewing laboratory results for a patient who is BRCA1 and BRCA2 positive. The nurse understands that the client and the client's immediate family may be at increased risk for which malignancies? Select all that apply. A. Prostate B. Ovarian C. Multiple Myeloma D. Pancreatic E. Melanoma
A. Prostate B. Ovarian D. Pancreatic E. Melanoma
When conducting community assessments, the nurse knows that which population has the highest risk of asthma? A. Puerto Ricans B. African Americans C. Hispanics D. Asians
A. Puerto Ricans
Which laboratory finding would the nurse expect in a patient with empyema secondary to lung abscess? A. Purulent exudate with yellow-green pus B. Straw-colored clear pleural fluid C. Blood tinged pleural fluid D. Cloudy pleural fluid with frank pus
A. Purulent exudate with yellow-green pus
The nurse is assessing a client with local cellulitis due to an insect bite. Which symptoms will the nurse anticipate? A. Redness B. Swelling C. Pain D. Heat E. Chills
A. Redness B. Swelling C. Pain D. Heat
A nurse is caring for a premature newborn who has experienced oxidative stress when transitioning from fetal circulation to newborn circulation. Which conditions is the newborn at risk for developing? Select all that apply. A. Retinopathy of prematurity B. Intravascular hemorrhage C. Respiratory distress syndrome (RDS) D. Gestational diabetes mellitus E. Necrotizing enterocolitis
A. Retinopathy of prematurity B. Intravascular hemorrhage C. Respiratory distress syndrome (RDS) E. Necrotizing enterocolitis
What characteristics would the nurse expect to assess in a patient with a keloid scar? A. Scar extends beyond border of original injury. B. Scar develops within 1 month of injury. C. Scar is pruritic and edematous. D. Scar is within boundaries of original injury.
A. Scar extends beyond border of original injury.
Which instruction should be included in the teaching plan for a patient with a chronic wound? A. Stop smoking to improve wound healing. B. Limit fluids to prevent edema. C. Maintain bedrest to avoid wound disruption. D. Limit food intake to reduce obesity.
A. Stop smoking to improve wound healing.
A nurse is performing an assessment on a client, and notes findings consistent with hypoxemia. Which manifestation suggest this diagnosis? A. Tachypnea B. Hyperthermia C. Bradycardia D. Hemiparesis
A. Tachypnea
A nurse is caring for a client with gangrene present on the client's leg. What is the nurse's understanding of the client's condition? Select all that apply. A. There are two types of gangrene: wet and dry. B. Gangrene describes a mass of necrotic tissue. C. The client has an active infection. D.Gangrene is caused by cell injury culminating in apoptosis. E. The client has a form of coagulation necrosis.
A. There are two types of gangrene: wet and dry. B. Gangrene describes a mass of necrotic tissue. E. The client has a form of coagulation necrosis.
The nurse is assessing a client for signs and symptoms of cancer. Which assessment findings does the nurse understand may indicate the presence of cancer? Select all that apply. A. Thickening or a lump in any part of the body B. The recent development of a fever C. A change in bowel or bladder habits D. An obvious change in a mole E. Abdominal pain
A. Thickening or a lump in any part of the body C. A change in bowel or bladder habits D. An obvious change in a mole
A nurse is caring for a client with a retinoblastoma. What aspect of the cell cycle does the nurse understand to be the cause of this client's condition? A. This condition developed during the DNA synthesis phase of the cell cycle. B. This condition is a result of TP53 activation, which contributes to apoptosis. C. The presence of retinoblastoma protein is the cause of this condition. D. This condition occurs during cellular angiogenesis.
A. This condition developed during the DNA synthesis phase of the cell cycle.
The nurse is reviewing the pulmonary function test of a patient. Which result would the nurse expect to find in a patient with normal lung function? A. Tidal volume 500 mL B. Inspiratory capacity 2,000 mL C. Expiratory reserve volume 500 mL D. Inspiratory reserve volume 1,500 mL
A. Tidal volume 500 mL
A nurse is reviewing a client's pathology report which notes the presence of intracellular hyaline. What condition does the nurse identify as an example where intracellular hyaline may be present? A. Tumor B. Decreased vascularity C. Scar tissue D. Arteriosclerosis
A. Tumor
A patient in the emergency department reports tightness in his chest and shortness of breath after mowing his lawn several hours ago on a warm, humid day. On assessment, the patient has a heart rate of 110 beats/minute, respiratory rate of 32 breaths/minute, blood pressure of 130/80 mm Hg, and an oral temperature of 97.2 degrees F. Expiratory wheezing is heard on auscultation of his lungs. The nurse suspects that the patient is most likely experiencing asthma due to: A. allergens. B. air pollution. C. infection. D. exercise.
A. allergens
The school nurse notes a concave appearance to the anterior chest wall in a middle-school child. The nurse documents this finding as: A. pectus excavatum. B. pectus carinatum. C. kyphoscoliosis. D. lordosis.
A. pectus excavatum.
When assessing a patient with right-sided closed tension pneumothorax, the nurse would expect to find: A. the trachea displaced to the left. B. air exits the chest wall during exhalation. C. an open chest wound. D. the trachea displaced to the right.
A. the trachea displaced to the left.
The nurse preceptor on a cancer ward is educating a novice nurse about the theory of carcinogenesis. Which statements by the novice nurse requires additional follow up by the nurse preceptor? A. "During step 2, promotion, a cancer-causing agent damages DNA." B. "Step 3, progression, involves the accumulation of mutations in my body's cells." C. "Promoters are characterized by their ability to initiate carcinogenesis." D. "Vitamins may modify how carcinogens can affect my body's cells."
A. "During step 2, promotion, a cancer-causing agent damages DNA."
The nurse is preparing to administer prednisone to a client with an inflammatory condition. Which statement by the client requires further follow up by the nurse? A. "I will take the medication to treat the cause of my inflammation." B. "Applying ice to the affected area may not be helpful." C. "I can anticipate that my swelling will decrease." D. "I will elevate the affected area."
A. "I will take the medication to treat the cause of my inflammation."
The nurse is providing education to the parent of an infant about innate immunity. Which statement by the parent indicates an understanding of the material? A. "Innate immunity is the body's first line of defense." B. "Innate immunity is a delayed response of the immune system." C. "Innate immunity responds to a specific antigen to prevent illness." D. "Innate immunity is the basis for vaccinations."
A. "Innate immunity is the body's first line of defense."
The nurse is teaching a community health class about the epidemiology of cancer. Which statement should the nurse include in the teaching? A. "Racial disparities in cancer incidence are affected by healthcare accessibility." B. "Cancer is the leading cause of death in developing countries." C. "Because of intensive antismoking campaigns, lung cancer no longer has the highest death rate among cancers." D. "Brain tumors are the least commonly diagnosed malignancies in children."
A. "Racial disparities in cancer incidence are affected by healthcare accessibility."
The nurse is providing education for a client diagnosed with systemic lupus erythematosus (SLE). Which statement will the nurse include in the teaching material? A. "Your body is in a state of imbalance due to problems removing dead cells." B. "Excessive inflammation occurs when you have less white blood cells." C. "Removal of dead cells in your body causes an immune response." D. "Excessive inflammation occurs when you have abnormally-shaped cells."
A. "Your body is in a state of imbalance due to problems removing dead cells."
When assessing a healthy adult, the nurse would expect an inspiratory: expiratory (I:E) ratio of: A. 1:2 B. 1:4 C. 1:5 D. 1:3
A. 1:2
A nurse is educating a client who asks, "Why don't I get sick every time my body's cells are stressed?" How will the nurse respond? A. "To avoid injury, cells generally adapt to stressors by expending more resources." B. "Changes can occur in the body's cells that favor cellular survival." C. "The body's cells are not at risk for injury under stressors alone." D. "When cells are exposed to stressors, they focus exclusively on specialized functions."
B. "Changes can occur in the body's cells that favor cellular survival."
The nurse is providing education for a client diagnosed with HER2/neu positive breast cancer. What will the nurse include in the teaching about this condition? A. "You are at greater risk for developing Burkitt lymphoma." B. "HER2/neu positivity is a result of gene amplification in your condition." C. "Your condition is less likely to be poorly differentiated." D. "Your children may be at a higher risk for the development of cancer."
B. "HER2/neu positivity is a result of gene amplification in your condition."
A nurse is educating a client with cervical dysplasia diagnosed by Papanicolaou (Pap) smear. Which statement by the client requires further follow up by the nurse? A. "This condition may be reversible." B. "I have cervical cancer." C. "My cervical cells have grown in a deranged manner." D. "This is an abnormal condition."
B. "I have cervical cancer."
When assessing a surgical wound healing by tertiary intention, the nurse expects granulation tissue to begin to appear during which time period? A. Two weeks after surgery B. 3-5 days after surgery C. 1-3 days after surgery D. A week after surgery
B. 3-5 days after surgery
What type of wound would the nurse expect to find in a patient who has a wound healing by primary intention? A. A surgical wound with a large amount of exudate B. A surgical wound that is clean and well-approximated C. A large abraded area that is infected D. A pressure ulcer with pink granulation tissue in the wound bed
B. A surgical wound that is clean and well-approximated
Which of the following teaching points should the nurse include as part of a community program on aspiration in adults? A. The use of dentures reduces the risk of aspiration. B. Alcohol increases the risk of aspiration. C. The risk of aspiration increases in warm weather. D. A foreign body is more likely to obstruct both bronchi.
B. Alcohol increases the risk of aspiration.
Which principle should the emergency department nurse bear in mind when treating patients for foreign body obstruction of the airway? A. A school-age child is more likely to aspirate a small foreign body into the left mainstem bronchus. B. An adult is more likely to aspirate a small foreign body into the right mainstem bronchus. C. A school-age child is more likely to aspirate a small foreign body into the right mainstem bronchus. D. An adult is more likely to aspirate a small foreign body into the left mainstem bronchus.
B. An adult is more likely to aspirate a small foreign body into the right mainstem bronchus.
Which of the following healthy individuals is most at risk for aspiration? A. A 22-year-old B. A 3-year-old C. A 78-year-old D. A 55-year-old
B. A 3-year-old
The nurse is caring for four patients who have abdominal surgical wounds. Which patient in this surgical nurse's assignment does the nurse assess to be at greatest risk for wound dehiscence? A. A 60-year-old man on low-dose corticosteroids prior to surgery on postoperative day 1 B. A 68-year-old-man with diabetes on postoperative day 5 C. A 40-year-old obese woman on postoperative day 2 D. A 40-year-old woman with no past medical history on postoperative day 5
B. A 68-year-old-man with diabetes on postoperative day 5
A patient is having a test to measure airflow speed during maximal exhalation through the mouth. Which test does the nurse explain to the patient? A. Incentive spirometry B. Body plethysmography C. Spirometry D. Nitrogen washout
C. Spirometry
Which findings would the nurse expect to assess in a history from a patient with moderate (Gold 2) COPD? A. Not aware of respiratory symptoms, cough and sputum may be present B. Dyspnea on exertion, chronic cough, and sputum production C. Shortness of breath (SOB), reduced exercise capacity, fatigue, and exacerbations D. Chronic respiratory failure
B. Dyspnea on exertion, chronic cough, and sputum production
The nurse is caring for a client with acute inflammation. What possible outcomes of acute inflammation does the nurse anticipate while caring for the client? Select all that apply. A. Serous inflammation B. Fibrosis formation C. Chronic inflammation D. Resolution E. Abscess formation
B. Fibrosis formation C. Chronic inflammation D. Resolution E. Abscess formation
The nurse is caring for a group of clients with conditions involving inflammation. Which condition is most closely related to the concept of immunity? A. Colon cancer B. Hypersensitivity reaction C. Asthma D. Frostbite
B. Hypersensitivity reaction
Lab results for a client are consistent with inflammation. What is the nurse's understanding of inflammation? Select all that apply. A. It indicates the presence of an infection. B. It is a response to tissue injury. C. It involves the destruction of tissue. D.It begins the process of tissue repair. E. It is defined as a protective tissue response.
B. It is a response to tissue injury. C. It involves the destruction of tissue. D.It begins the process of tissue repair. E. It is defined as a protective tissue response.
In evaluating the effectiveness of negative pressure wound therapy in patients with high-risk surgical wounds, the nurse should expect: A. Healing by secondary intention B. Less wound dehiscence C. Greater risk of wound infection D. Stronger scar formation
B. Less wound dehiscence
A client's laboratory results are consistent with chronic inflammation. Which potential causes of chronic inflammation does the nurse suspect? Select all that apply. A. Poor blood supply B. Prolonged exposure to irritants C. Malnutrition D. Autoimmune diseases E. Unresolved or repeated acute infections
B. Prolonged exposure to irritants D. Autoimmune diseases E. Unresolved or repeated acute infections
Which finding would the nurse expect when assessing a patient with a hypertrophic scar following second degree burns? A. Painless scaring B. Scarring raised above the surface of surrounding skin C. Scarring that grows outside boundaries of original injury D. A scar that develops 2 to 3 months after injury
B. Scarring raised above the surface of surrounding skin
A nurse is performing an assessment on a client diagnosed with carbon monoxide (CO) poisoning. Which assessment findings would the nurse anticipate? Select all that apply. A. Bradycardia B. Syncope C. Headache D. Dyspnea E. Hypertension
B. Syncope C. Headache D. Dyspnea
The oncology nurse is preparing to administer pembrolizumab, a targeted cancer treatment, to a client with non-small cell lung cancer (NSCLC). What is the nurse's understanding of targeted cancer treatment? A. Targeted therapy is only available through clinical trials. B. Targeted therapy is known as personalized medicine. C. In targeted therapy, a normal gene is inserted to replace an abnormal gene. D. Targeted therapy has a higher degree of toxicity than standard chemotherapy.
B. Targeted therapy is known as personalized medicine.
A nurse is caring for a client with endometrial hyperplasia. What is the nurse's understanding of the condition of the client's endometrial cells? A. The cells have increased intracellular protein. B. The cells have increased in number. C. The cells have increased motility. D. The cells have increased in size.
B. The cells have increased in number.
The nurse is caring for a client with leukemia who is experiencing a blast crisis. What is the nurse's understanding of the client's condition? Select all that apply. A. The new cells resulting from the client's condition have distinct morphology and specialized functions. B. The cells resulting from a blast crisis are found in the bone marrow and/or blood. C. This condition occurs in early stage leukemias, such as chronic myelogenous leukemia. D. The most immature cells in the body are labeled as blast cells. E. A blast crisis is the rapid proliferation of immature cell.
B. The cells resulting from a blast crisis are found in the bone marrow and/or blood. D. The most immature cells in the body are labeled as blast cells. E. A blast crisis is the rapid proliferation of immature cell.
The nurse is caring for a client with T1N0MX cancer. What is the nurse's understanding of the client's cancer staging? Select all that apply. A. The client's primary tumor cannot be evaluated. B. The client has not been evaluated for distant metastases. C. The client has no regional lymph node spread. D. The client has carcinoma in situ. E. The client has innumerable distant metastases.
B. The client has not been evaluated for distant metastases. C. The client has no regional lymph node spread.
A nurse is caring for a client with lymphocytosis. Which possible causes of this finding does the nurse identify? Select all that apply. A. Inflammatory bowel disease B. Tuberculosis C. Myelogenous leukemia D. Parasitic infections E. Lymphoma
B. Tuberculosis E. Lymphoma
Which findings typically cause an individual with idiopathic pulmonary fibrosis (IPF) to first seek medical care? A. Peripheral edema and dyspnea on exertion B. Cyanosis and clubbing of fingernails C. Dyspnea on exertion and cough with minimal sputum production D. Shallow and fast respirations
C. Dyspnea on exertion and cough with minimal sputum production
The assessment of a patient with persistent moderate severity asthma will most likely reveal: A. normal activity is extremely limited. B. daily use of short-acting beta-2 agonist for symptom control. C. awakening from sleep no more that 3 to 4 times/month. D. normal FEV1 between exacerbations.
B. daily use of short-acting beta-2 agonist for symptom control.
When planning home care for a child with asthma, the nurse should tell the family to: A. remove items that commonly trigger attacks. B. remove items that seem to trigger an attack. C. remove all animals from the house. D. remove stuffed animals from the bed.
B. remove items that seem to trigger an attack
When assessing a wound in the remodeling phase of healing, the nurse would expect to find: A. acute inflammation. B. scar tissue formation. C. granulation tissue. D. a fibrin clot.
B. scar tissue formation.
The nurse is caring for a client recently discovered to have grade 2 colon cancer. Which statement by the client is consistent with the client's continuum of care? A. "I have just completed chemoradiation therapy." B. "I am still discussing my diagnosis with my providers." C. "I am due for a survivorship follow up visit." D. "I am in the middle of cancer treatment."
B. "I am still discussing my diagnosis with my providers."
Which patient statement indicates that the nurse's teaching about prevention of COPD has been effective? A. "Use of a water pipe does not lead to COPD." B. "Pipe smoking can cause COPD." C. "Only cigarette smoking can cause COPD." D. "Secondhand smoke does not lead to COPD."
B. "Pipe smoking can cause COPD."
Which finding is most likely when assessing the chest of a patient with emphysema? A. 1:2 anteroposterior (AP) diameter/transverse diameter B. 2:1 anteroposterior (AP) diameter/transverse diameter C. 1:4 anteroposterior (AP) diameter/transverse diameter D. 1:3 anteroposterior (AP) diameter/transverse diameter
B. 2:1 anteroposterior (AP) diameter/transverse diameter
A client is experiencing systemic effects from local inflammation. Which body response should the nurse explain that is occurring? A. Leukocytosis response B. Acute-phase response C. C-reactive protein response D. Fever response
B. Acute-phase response
The nurse is providing discharge instructions to a patient with multiple lacerations and puncture wounds following a motor vehicle accident. Which statement by the patient indicates an understanding of the instructions? A. "Scabs prevent the wound edges from coming together." B. "Scabs interfere with healing." C. "The scab helps with wound repair." D. "I should remove any scabs that form."
C. "The scab helps with wound repair."
The nurse is providing education for a client diagnosed with an adenoma. Which statement by the client requires further follow up by the nurse? A. "This is a well-differentiated neoplasm." B. "This means that the affected cells were encapsulated." C. "This is a malignancy of the mesenchymal tissue." D. "This is a slow-growing condition."
C. "This is a malignancy of the mesenchymal tissue."
A nurse is caring for a client with a diagnosis of nephrogenic diabetes insipidus. Which statement will the nurse include when teaching the client about the condition? A. "Your condition is the result of a defect in the chloride channel, resulting in increased sodium and water resorption." B. "You have an inflammatory condition affecting calcium transport in airway smooth muscle cells." C. "You have a condition resulting from renal channelopathy." D. "Your condition is the result of acquired channelopathy caused by the immune system."
C. "You have a condition resulting from renal channelopathy."
Calculate the alveolar ventilation of a patient in the postanesthesia care unit, following general anesthesia, if the patient inhales 400 mL of air in each breath 10 times per minute. A. 3.0 L/min B. 1.5 L/min C. 2.5 L/min D. 2.0 L/min
C. 2.5 L/min
A nurse is caring for a group of clients. Which clients have disorders associated with chronic inflammation? Select all that apply. A. A client with a knee replacement B. A client with bacterial meningitis C. A client with advanced Alzheimer disease (AD) D. A client with osteoporosis E. A client with major depression
C. A client with advanced Alzheimer disease (AD) E. A client with major depression
Which of the following would the nurse expect to assess in a child with bronchiectasis? A. A mild nonproductive cough B. A cough that produces clear frothy sputum C. A severe persistent cough with mucopurulent sputum D. An intermittent dry hacking cough
C. A severe persistent cough with mucopurulent sputum
The nurse is assessing a client diagnosed with an early stage malignancy. What does the nurse understand about the local effects of cancer? A. A new lump or tissue thickening will determine the extent of the cancer. B. Lymphadenopathy means the cancer is progressing. C. Assessment findings are likely to be linked to the tissue source of the tumor. D. A growing tumor is not likely to exert pressure on the surrounding tissue.
C. Assessment findings are likely to be linked to the tissue source of the tumor.
Which finding would the nurse expect in a patient with a large tension pneumothorax? A. Diaphragm is higher on the affected side. B. Diaphragm is lower on the ipsilateral side. C. Diaphragm is lower on the affected side. D. Diaphragm is higher on the ipsilateral side.
C. Diaphragm is lower on the affected side.
Which finding would the nurse expect when assessing a full thickness wound? A. Dermis remains intact. B. Epidermis remains intact. C. Epidermis and full thickness of dermis is destroyed. D. Only epidermis is destroyed.
C. Epidermis and full thickness of dermis is destroyed.
A patient with suspected asthma is scheduled for a challenge test. What result would confirm the diagnosis? A. Exhalation of high amounts of carbon dioxide B. Exhalation of low amounts of carbon dioxide C. Exhalation of high amounts of nitrogen oxide D. Exhalation of low amounts of nitrogen oxide
C. Exhalation of high amounts of nitrogen oxide
Which pulmonary function test result would the nurse expect to find in a patient with mild COPD? A. FEV1/FVC < 70%, 30% <FEV1 < 50% predicted B. FEV1/FVC < 70%, FEV1 < 30% predicted C. FEV1/FVC < 70%, FEV1 > 80% predicted D. FEV1/FVC < 70%, 50% <FEV1 < 80% predicted
C. FEV1/FVC < 70%, FEV1 > 80% predicted
Which nutritional deficiencies should the plan of care address to improve oxygen delivery and wound healing in the patient with a pressure ulcer? A. Magnesium deficiency B. Copper deficiency C. Iron deficiency D. Zinc deficiency
C. Iron deficiency
Which of the following descriptions of the course of idiopathic pulmonary fibrosis (IPF) would the nurse include in a teaching plan to a patient newly diagnosed with this disorder? A. It can be cured. B. It is an acute disorder. C. It is progressive and may be lethal. D. It can be successfully controlled with medication.
C. It is progressive and may be lethal.
The nurse is preparing to provide education to a client with a diagnosis of a malignant neoplasm. What is the nurse's understanding of the client's condition? A. This condition is life-threatening. B. In this condition, cells typically grow slowly. C. Malignant cells represent a range of ploidy statuses. D. Malignant cells have minimal nuclear variation in size and shape.
C. Malignant cells represent a range of ploidy statuses.
The nurse is caring for a client diagnosed with appendicitis. The nurse understands that this is an example of which type of inflammation? A. Serous inflammation B. Fibrinous inflammation C. Purulent inflammation D. Ulceration
C. Purulent inflammation
In formulating a plan of care for a patient with colon cancer who will be having a colon resection, which local factor should the nurse recognize as affecting wound healing? A. Poor nutrition B. Smoking C. Reduced blood flow and hypoxia D. Advanced age
C. Reduced blood flow and hypoxia
The nurse is caring for a client with a healing surgical incision. Which organs does the nurse understand are integral to regulating the client's inflammation? Select all that apply. A. Kidneys B. Skin C. Thymus D. Appendix E. Spleen
C. Thymus E. Spleen
The plan of care to reduce asthma risks in a patient with poorly controlled asthma would be to: A. preventing symptoms. B. being satisfied with care received. C. preventing emergency room visits. D. requiring a short-acting bronchodilator not more than twice a week.
C. preventing emergency room visits.
An assessment of a patient with restrictive lung disease will most likely reveal: A. deep, rapid breathing. B. deep, slow breathing. C. shallow, rapid breathing. D. shallow, slow breathing.
C. shallow, rapid breathing.
The nurse is providing education for a client with Crohn disease. Which statement will the nurse include when teaching the client about the disease? A. "Crohn disease is the result of an acute inflammatory response." B. "Crohn disease is a condition caused by the immune system targeting diseased tissue." C. "Crohn disease is a chronic inflammatory disorder." D. "Crohn disease is an active allergic response."
C. "Crohn disease is a chronic inflammatory disorder."
The nurse is educating a client who has breast cancer that has metastasized to the bone. Which statement by the client requires additional follow up by the nurse? A. "Like all cancer, mine is the result of damaged DNA or RNA." B. "My cancer has spread from its primary site." C. "I have two different types of cancer." D. "My cancer may have developed by nature, nurture, or a combination of the two."
C. "I have two different types of cancer."
A nurse is teaching a community health class about the causes of cancer. Which statement will the nurse include when teaching about the formation of cancer? A. "Tumors form when enzymes cause the uncontrolled destruction of cell components." B. "When cellular contents leak out through altered cell walls, cancer may occur." C. "When cells do not divide enough, a tumor may form.." D. "When cellular death is altered, cancer may occur."
D. "When cellular death is altered, cancer may occur."
Which statement made by a patient with suspected sarcoidosis requires more teaching by the nurse? A. "Corticosteroids can help reduce acute symptoms of sarcoidosis." B. "My red, watery eyes are most likely from my sarcoidosis." C. "As an African American women, I have a higher risk of dying from this disease than a Caucasian woman." D. "A blood test can diagnosis sarcoidosis."
D. "A blood test can diagnosis sarcoidosis."
Which response by a parent of a 24-week-old fetus undergoing intrauterine surgery indicates that the parent understands fetal wound healing? A. "Due to a weak inflammatory response, the wound will not heal as strongly as a wound in an adult." B. "Fetal wounds heal slower than adult wounds." C. "If we wait for 32 weeks' gestation, my baby will have little or no scarring." D. "My baby should have little or no scarring if we do the surgery now."
D. "My baby should have little or no scarring if we do the surgery now."
A nurse is assessing the medical history of a client presenting for an office visit. Which assessment finding is most likely to indicate a possible injury to endothelial cells? A. A tick removal procedure completed two weeks ago. B. A raised, blistering rash on the client's leg caused by poison ivy. C. A healing abrasion on the client's arm. D. A 20 pack-year history of smoking.
D. A 20 pack-year history of smoking.
A nurse is caring for a number of clients. Based on the site of injury, which client is at the most immediate risk for hypoxia-induced cell injury? A. A client admitted with a chest wall injury. B. A client admitted for a right femoral head fracture. C. A client admitted with an injury to the right great toe. D. A client admitted with a traumatic brain injury.
D. A client admitted with a traumatic brain injury.
Following change-of-shift report, the nurse on a surgical unit is reviewing the assignment. Which 70-year-old patient does the nurse assess as being at greatest risk for impeded wound healing? A. A man with hyperlipidemia B. A woman on antihypertensive medication C. A woman who quit smoking 10 years ago D. A man with diabetes mellitus
D. A man with diabetes mellitus
Which assessment findings would alert the nurse of an impending wound dehiscence on a patient with an abdominal incision on postoperative day 5? A. Incision edges are well-approximated. B. Incision has a healing ridge. C. Incision is pink with scant serous drainage. D. Abdominal dressing has purulent drainage.
D. Abdominal dressing has purulent drainage.
The hospital outreach nurse is teaching a community program about chronic obstructive pulmonary disease (COPD). Which concept should the nurse keep in mind while preparing for this program? A. Nonsmokers do not develop COPD. B. COPD is always caused by a genetic mutation. C. Smoking is associated with all cases of COPD. D. An interaction between genetic and inhaled irritants may cause COPD.
D. An interaction between genetic and inhaled irritants may cause COPD.
Which is the most appropriate medication for the nurse to administer when a patient with COPD experiences acute shortness of breath? A. Oral mucolytic agents B. Oral antibiotics C. Inhaled corticosteroids D. Inhaled fast-acting bronchodilator
D. Inhaled fast-acting bronchodilator
The nurse is caring for a client with a diagnosis of metastatic cancer with a pathogenic bone fracture. The nurse understands that this condition occurs by which mechanism? A. Increased osteoclast activating factors (OcAFs) result in increased pressure in the bone, resulting in pathogenic fracture. B. Increased osteoblastic growth factors (ObGFs) results in a fragile bony structure. C. Pathogenic fractures occur due to the breakdown of the bone network and loss of the bony matrix. D. Pathogenic fractures occur by either increased pressure in the bone, or breakdown of the bony matrix.
D. Pathogenic fractures occur by either increased pressure in the bone, or breakdown of the bony matrix.
A nurse cares for a client experiencing an acute-phase inflammatory response. Which clinical manifestation does the nurse expect upon physical assessment? A. Decreased erythrocytes B. Decreased serum proteins C. Leukopenia D. Pyrexia
D. Pyrexia
Which assessment is the nurse most likely to make in a patient with flail chest? A. The flail portion of the chest moves outward with inspiration. B. The flail portion of the chest does not move with respiration. C. The flail portion of the chest moves inward with expiration. D. The flail portion of the chest moves inward with inspiration.
D. The flail portion of the chest moves inward with inspiration.
The nurse is reviewing discharge instructions with a client whose colon cancer exhibits VEGF overexpression. Which statement regarding the client's condition is true? A. ATP production is inhibited by the presence of VEGF. B. Angiogenesis only occurs in VEGF overexpressing tumors. C. VEGF positive tumor cells do not require glycolysis to generate energy for growth. D. VEGF causes the growth of new vessels, forming a microcirculatory system.
D. VEGF causes the growth of new vessels, forming a microcirculatory system.
When preparing a nursing care plan for a patient with a restrictive lung disorder, the nurse should keep in mind that restrictive lung disorders: A. result in overinflated alveoli. B. increase elasticity of the lungs. C. do not affect lung perfusion. D. decrease the volume of airflow to the lungs.
D. decrease the volume of airflow to the lungs.
The nurse is providing education to a client about to undergo an allogeneic hematopoietic stem cell transplant (HSCT). What statement by the client indicates the need for additional follow up by the nurse? A. "I will receive multiple types of cancer treatment to promote a better outcome." B. "I will require radiation treatment to my brain, since most chemo doesn't cross the blood-brain barrier." C. "I have discussed all of my concerns related to fertility and sexuality." D. "I can expect a full recovery with a low risk for complications."
D. "I can expect a full recovery with a low risk for complications."
A nurse is providing education to a client with alopecia areata. Which statement by the client indicates an understanding of this condition? A. "My condition is due to my body perceiving my skin as foreign." B. "My condition is caused by initiating an inflammatory response to diseased tissue." C. "My condition is caused by anti-inflammatory cytokines." D. "My condition is a tissue-specific autoimmune disease."
D. "My condition is a tissue-specific autoimmune disease."
