Exam 3 EAQ
Which leukocyte is responsible for the allergic response? -Basophils -Monocytes -Eosinophils -Macrophages
Basophils
Which integumentary manifestation can be noticed in a client with CD4+ count of 180/mm 3 (180/uL)? -Bruises -Cyanosis -Flushed and dry skin -Delayed wound healing
Delayed wound healing
Which diagnostic test confirms Hodgkin disease? -Bone scan -Lymph node biopsy -Computed tomography (CT) scan -Radioactive iodine (I-131) uptake study
Lymph node biopsy
A client is admitted to the hospital with jaundice. After numerous diagnostic tests, the health care provider diagnoses the client with cancer of the pancreas. Which is the most likely cause of the client's jaundice? -Necrosis of the pancreatic parenchyma caused by the neoplasm -Excessive serum bilirubin caused by red blood cell destruction -Obstruction of the common bile duct by the pancreatic neoplasm -Impaired liver function resulting in incomplete bilirubin metabolism
Obstruction of the common bile duct by the pancreatic neoplasm
Which intervention by the nurse would be beneficial to a client with human immunodeficiency virus (HIV) infection who is experiencing fatigue? -Recommending high-fiber foods -Scheduling ample periods of rest -Recommending dry and salty foods -Encouraging fluid intake of more than 2500 mL per day
Scheduling ample periods of rest
Which sign is common for early laryngeal cancer? -Aphasia -Dyspnea -Dysphagia -Hoarseness
Hoarseness
Which laboratory value is most important for the nurse to monitor in a client with acquired immunodeficiency syndrome (AIDS) that is receiving zidovudine? -Cardiac enzymes -Serum electrolytes -Complete blood counts (CBCs) -Human immunodeficiency virus (HIV) antibody levels
Complete blood counts (CBCs)
Which response would be given by a nurse caring for a client who is receiving radiation for cancer and states, "My family and friends say that I will get a radiation burn"? -"It will be no worse than a sunburn." -"A localized skin reaction usually occurs." -"Daily application of an emollient will prevent the burn." -"They may be misinformed."
"A localized skin reaction usually occurs."
Which reason for elevating the head when providing postoperative care for a client with esophageal cancer would a nurse explain to the nurse assistant? -Decreases the risks of nausea and vomiting -Facilitates coughing, deep-breathing, and turning -Decreases pain and pressure on the operative site -Reduces the risk for reflux of gastric materials into the esophagus
Reduces the risk for reflux of gastric materials into the esophagus
A 66-year-old woman who has a history of a 30-lb weight loss in 3 months with periods of constipation and diarrhea is diagnosed with cancer of the colon. Which information would the nurse incorporate into the client's teaching plan about malignant tumors of the colon and rectum? -They are easily detected. -They are usually localized. -They are found more frequently in women than in men. -They are the third most common cause of cancer in women.
They are the third most common cause of cancer in women.
Which hypersensitivity reaction would the nurse suspect in a client who underwent a tuberculin test 2 days ago who reports itching? -Type I hypersensitivity -Type II hypersensitivity -Type III hypersensitivity -Type IV hypersensitivity
Type IV hypersensitivity
Which test is beneficial in identifying prostate cancer in men? -Mammography -Ultrasonography -Endometrial biopsy -Radiographic examination
Ultrasonography
Which question would the nurse ask a client diagnosed with an oral cancerous lesion when assessing the client's need for related health education? -"Are you having difficulty sleeping?" -"Do feel like your gums are inflamed?" -"How frequently are you seeing the dentist?" -"Have you noticed any change in your appetite?"
"Have you noticed any change in your appetite?"
Which teaching related to bone marrow suppression related to cancer treatment should the nurse include in the client's teaching? -"Be prepared to experience alopecia." -"Increase fluids to at least 3 L per day." -"Monitor your intake and output of fluids." -"Use a soft toothbrush for oral hygiene."
"Use a soft toothbrush for oral hygiene."
A client with the diagnosis of breast cancer is scheduled to receive radiation therapy to the affected area. The nurse teaches the client about how to care for the area that will be irradiated. Which action, stated by the client, to avoid skin irritation and breakdown would require further teaching by the nurse? -"Leave the skin markings intact." -"Protect the skin from sources of heat." -"Wear soft clothing over the upper body." -"Use an oatmeal-based lotion after each treatment."
"Use an oatmeal-based lotion after each treatment."
Which information about activity would the nurse include in the teaching for a client who had a recent colostomy for colorectal cancer? -"With guidance, a near-normal lifestyle, including complete sexual function, is possible." -"Activities of daily living would be resumed as quickly as possible so you avoid being depressed." -"Most sports activities, except for swimming, can be resumed based on your overall physical condition." -"After surgery, changes in activities must be made to accommodate for the physiologic changes caused by the operation."
"With guidance, a near-normal lifestyle, including complete sexual function, is possible."
The nursing staff has a team conference on acquired immunodeficiency syndrome (AIDS) and discusses the routes of transmission of the human immunodeficiency virus (HIV). Which activity is associated with no risk of exposure to HIV? -Intercourse with just the spouse -Donation of a pint of whole blood -Use of a condom each time there is sexual intercourse -Limiting sexual contact to those without HIV antibodies
Donation of a pint of whole blood
Which nursing action would be included in the plan of care for a client who is diagnosed with cancer of the pancreas and is apprehensive and restless? -Encouraging expression of concerns -Administering antibiotics as prescribed -Teaching the importance of getting rest -Explaining that everything will be all right
Encouraging expression of concerns
Which test would the nurse explain will be used for the initial screening for AIDS? -CD4 T-cell count -Western blot test -Polymerase chain reaction test -Enzyme-linked immunosorbent assay (ELISA)
Enzyme-linked immunosorbent assay (ELISA)
Which information recommended by the American Cancer Society (ACS) would the nurse include when planning a community health program about screening for cancer? -Mammography should be performed yearly after 35 years of age for women. -Fecal occult blood testing should be performed yearly beginning at 50 years of age. -Breast self-examination should be performed monthly beginning at 30 years of age. -Digital rectal examinations and prostate-specific antigen (PSA) testing should be done yearly after 40 years of age for men.
Fecal occult blood testing should be performed yearly beginning at 50 years of age.
Which type of transfusion reaction would the nurse conclude a client probably is experiencing after developing flank pain, chills, fever, and hematuria after a transfusion? -Allergic -Pyrogenic -Hemolytic -Anaphylactic
Hemolytic
Why is it important to explain the nutritional aspects of palliative care to the family of a client with advanced bone cancer? -It enhances the client's quality of life. -It reduces the likelihood of a respiratory infection. -It prevents malabsorption syndrome from occurring. -It decreases the consequences of impaired glucose metabolism.
It enhances the client's quality of life.
Which statement is true about acquired immunity? -It is the body's second line of defense. -It results from the production of interferons. -It includes intact skin and mucous membranes. -It provides nonspecific immunity to the individual.
It is the body's second line of defense.
A client is scheduled for a colon resection after being diagnosed with a large cancerous tumor in the sigmoid colon. Which clinical finding would the nurse expect when completing the client's admission history and physical examination? -Diarrhea -Dehydration -Rectal bleeding -Clay-colored stool
Rectal bleeding
Which postsurgical outcome would the nurse anticipate for a client having palliative surgery for esophageal cancer? -Improved peristalsis and gastric emptying -Dilation of a narrowed area of the esophagus -Relief from dysphagia and restoration of continuity of the alimentary tract -Improved lower esophageal sphincter function and increased esophageal clearance
Relief from dysphagia and restoration of continuity of the alimentary tract
Which outcome indicates to the nurse caring for a client with invasive cancer of the bladder that radiation therapy has been successful? -Decrease in urine output -Increase in physical strength -Shrinkage of the tumor on scanning -Increase in the quantity of white blood cells (WBCs)
Shrinkage of the tumor on scanning
A client with cancer of the thyroid is scheduled for a thyroidectomy. Which information would the nurse teach the client? -The dietary intake of carbohydrates must be restricted. -Chemotherapy may be used in conjunction with the surgery. -Thyroxine replacement therapy will be required indefinitely. -A tracheostomy requires an alternative means of communication.
Thyroxine replacement therapy will be required indefinitely.
Which common physiologic response do all clients with cancer experience that accounts for weight loss? -Depression precipitates anorexia. -Tumor necrosis factor (TNF) affects the satiety center. -Decreased saliva impedes chewing and swallowing. -Nutrients are not absorbed through the gastrointestinal mucosa.
Tumor necrosis factor (TNF) affects the satiety center.
Which factor is associated with an increased risk of developing testicular cancer? -Epididymitis -Seminal vesiculitis -Undescended testis -Intercourse at an early age
Undescended testis
Which response would a nurse give to a client who reports being afraid of a diagnosis of cancer while awaiting the biopsy report before removal of a tumor? -"Worrying is not going to help the situation." -"Let's wait until we hear what the biopsy report says." -"It is very upsetting to have to wait for a biopsy report." -"Operations are not performed unless there are no other options."
"It is very upsetting to have to wait for a biopsy report."
Which response will the nurse give when a client in the clinic is offered the influenza vaccine and states, "I had the vaccination already last year, so I won't need it now"? -"The flu vaccine is recommended for everyone." -"You only need one flu shot in your lifetime to achieve immunity." -"As long as you are younger than 50 years old, you will not really need vaccination." -"The immunization changes, so you need to get the vaccine annually to stay protected."
"The immunization changes, so you need to get the vaccine annually to stay protected."
Which type of food would the nurse instruct the client with early-stage cancer of the esophagus treated with laser therapy to select when oral intake is permitted? -Cold -Liquid -Low in protein -Low in calories
Liquid
Which assessment finding would the nurse expect to find in a client with a history of cancer of the liver and jaundice? -Pruritus -Diarrhea -Blurred vision -Bleeding gums
Pruritus
During the immune response, which factor leads to chronic inflammation and damage to the host tissue? -Regulation of action -Remembering the invader -Responding to nonself invaders Recognition of the self from nonself
Recognition of the self from nonself
Which intervention would a nurse provide for a client with cancer of the stomach who expresses a lack of interest in food and who eats only small amounts? -Nourishment between meals -Small portions more frequently -Supplementary vitamins to stimulate the client's appetite -Only foods the client likes in small portions at mealtimes
Small portions more frequently
Which alternative therapy that may be beneficial can the nurse discuss with a client who has terminal bone cancer? -Biofeedback -Radiotherapy -Bariatric therapy -Radioactive implants
Biofeedback
Which common clinical manifestation would the nurse include in a teaching program about the signs and symptoms of colorectal cancer for a group of adults? -Rectal bleeding -Abdominal pain -Change in bowel habits -Alteration in caliber of stools
Change in bowel habits
Which color of stool would a nurse expect in a client with cancer of the head of the pancreas who has been admitted with weight loss, severe epigastric pain, and jaundice? -Green -Brown -Red-tinged -Clay-colored
Clay colored
A farmer seeks medical care for a large crusty patch of skin on the cheek. The client states that even after using different remedies it still bleeds easily and has not gotten better. Which risk factor in the client's history causes the nurse to suspect skin cancer? -Exposure to radiation -Location of the lesion -Self-treatment of lesions -Contact with soil contaminants
Exposure to radiation
Which diagnostic criterion for acquired immunodeficiency syndrome (AIDS) will be taught to a client who abused intravenous drugs and was diagnosed with the human immunodeficiency virus (HIV) several years ago? -Contracting HIV-specific antibodies -Development of an acute retroviral syndrome -Is capable of transmitting the virus to others -Has a CD4 + T lymphocyte level of less than 200 cells/micro L
Has a CD4 + T lymphocyte level of less than 200 cells/micro L
During administration of an antibiotic, the client becomes restless and flushed, and begins to wheeze. Which action would the nurse do after stopping the antibiotic infusion? -Checking the client's temperature -Taking the client's blood pressure -Obtaining the client's pulse oximetry -Assessing the client's respiratory status
Assessing the client's respiratory status
The spouse of a client who is receiving chemotherapy for inoperable cancer spends most of the day with the client and asks the nurse, "What can I do to help?" Which nursing intervention would support the client's spouse? -Assist the couple to maintain open communication. -Offer the couple a description of the disease process. -Instruct the spouse about the action of the medications. -Meet privately with the spouse to explore personal feelings.
Assist the couple to maintain open communication.
Which cells would counteract an anaphylactic hypersensitivity reaction experienced by a client who visited the hospital and is reporting sneezing, excessive nasal secretions, and itching eyes? -T cells -B cells -Neutrophils -Macrophages
B cells
While on a hike, a rusty nail pierces the sole of an adolescent's foot, and the adolescent is brought to the emergency department. Tetanus immune globulin is prescribed because the adolescent does not know when the last tetanus immunization was received. Which explanation is given by the nurse as she administers the prescribed dose of tetanus immune globulin? -Lifelong passive immunity -Long-lasting active protection -Immediate passive short-term immunity -Stimulation for the production of antibodies
Immediate passive short-term immunity
Which instruction would the nurse include for a client who is receiving radiation therapy for bone cancer and lives alone and works full time? -Perform regularly scheduled aerobic activity daily. -Take a leave of absence from work when receiving therapy. -Include rest periods during the day while receiving radiation. -Continue the activities usually performed before becoming ill.
Include rest periods during the day while receiving radiation.
Which symptom is a commonly reported clinical finding associated with bladder cancer? -Dysuria -Suprapubic pain -Urinary retention -Painless hematuria
Painless hematuria
Which condition does the nurse suspect in a client with dysuria, hesitancy, urinary urgency, and leaking whose laboratory reports reveal serum prostate-specific antigen (PSA) levels of 5 ng/mL and elevated prostatic acid phosphatase (PAP) levels? -Orchitis -Hydrocele -Prostatitis -Prostate cancer
Prostate cancer
Which contributing factor would the nurse consider when collecting a health history from a client admitted for removal of basal cell carcinoma? -Dietary patterns -Familial tendencies -Amount of tobacco use -Ultraviolet radiation exposure
Ultraviolet radiation exposure
Which action would be the priority in an elderly client undergoing cancer therapy with diffuse redness and large blisters on the skin with evident systemic toxicity? -Discontinue the drug. -Monitor body temperature. -Monitor fluid and electrolyte balance. -Administer topical antibacterial medication.
Discontinue the drug.
The nurse explains to a client scheduled to begin chemotherapy 2 weeks after surgery for colon cancer that it is important to delay instituting the drug therapy because the chemotherapy can have which negative effect? -Interferes with cell growth and delays wound healing -Causes vomiting, which endangers the integrity of the incisional area -Decreases red blood cell production, and the resultant anemia adds to postoperative fatigue -Increases edema in areas distal to the incision by blocking lymph channels with destroyed lymphocytes
Interferes with cell growth and delays wound healing
Which vaccines would a nurse caring for a 26-year-old client recently diagnosed with human immunodeficiency virus (HIV) recommend to comply with the recommended immunization schedule for HIV? -Influenza; measles, mumps, rubella (MMR); varicella; and hepatitis A vaccines -Pneumococcal, MMR, influenza, and varicella vaccines -Diphtheria, tetanus, hepatitis A, and hepatitis C vaccines -Tetanus, hepatitis B, influenza, and pneumococcal vaccines
Tetanus, hepatitis B, influenza, and pneumococcal vaccines
Neomycin 1 g is prescribed preoperatively for a client with cancer of the colon. Which response by the nurse is best when the client asks why this is necessary? -"It is used to prevent you from getting a bladder infection before surgery." -"It will decrease your kidney function and lessen urine production during surgery." -"It will kill the bacteria in your bowel and decrease the risk for infection after surgery." -"It is used to alter the body flora, which reduces spread of the tumor to adjacent organs."
"It will kill the bacteria in your bowel and decrease the risk for infection after surgery."
Which response indicates that the client is having an untoward reaction to the contrast medium in a computed tomography (CT) scan? -Pelvic warmth -Feeling flushed -Shortness of breath -Salty taste in the mouth
Shortness of breath
Which symptom will the nurse look for in a client diagnosed with malignant mesothelioma? -Chest pain -Hemoptysis -Dyspnea on exertion -Wheezing over all lung fields
Dyspnea on exertion
Which stage of infection does the nurse suspect in a client with human immunodeficiency virus (HIV) infection reporting fatigue, fever, and night sweats? -Initial exposure -Early HIV infection -Primary HIV infection -Asymptomatic HIV infection
Early HIV infection
A client is admitted for dehydration, and an intravenous (IV) infusion of normal saline at 125 mL per hour has been started. One hour after the IV initiation, the client begins screaming, "I can't breathe!" Which nursing action is the priority at this time? -Discontinue the IV site and contact the primary health care provider -Elevate the head of the bed and obtain vital signs -Contact the primary health care provider to obtain a prescription for a sedative -Assess for allergies and change the IV to an intermittent infusion device
Elevate the head of the bed and obtain vital signs
Which response would the nurse give to a client who asks, "What is the cause of my psoriasis?" -"The cause of psoriasis is unknown." -"Psoriasis is caused by a fungal infection." -"Coming in contact with a substance you are allergic to will cause psoriasis." -"Psoriasis is an autoimmune disease where your skin cells divide more rapidly than normal."
"Psoriasis is an autoimmune disease where your skin cells divide more rapidly than normal."
After the diagnosis of oral cancer, which statement is best to assess the client's needs? -"Are you having difficulty sleeping?" -"Do feel like your gums are inflamed?" -"How frequently are you seeing the dental office for a cleaning?" -"Have you noticed any change in your eating habits?"
"Have you noticed any change in your eating habits?"
Which response by the nurse is appropriate when a client who is newly diagnosed with cancer of the pancreas is scheduled for surgery and asks, "Wouldn't I be better off with some other treatment instead of surgery?" -"It's a good idea to explore other acceptable treatments for your cancer. There is information available for you." -"Surgery is the recommended approach. Let me contact the health care provider so you can discuss this further with the provider." -"Maybe you will be more comfortable with a second opinion. I think you need a referral to another health care provider." -"With your disease, your prognosis will improve if you follow the suggestion to have the recommended surgery."
"Surgery is the recommended approach. Let me contact the health care provider so you can discuss this further with the provider."
A client is diagnosed as having cancer of the breast and is admitted to the hospital for a lumpectomy to be followed by radiation. The client has tears in her eyes and her chin is quivering. In a shaky voice the client says, "I can't believe this is happening." Which response by the nurse is appropriate? -"You can't believe this is happening?" -"This must be a very scary time for you." -"Do you have any questions at this time?" -"Cancer of the breast has a high cure rate."
"This must be a very scary time for you."
Which response by the nurse is appropriate when the client states, "The doctor told me I have lung cancer. My father died from cancer. I wish I had never smoked"? -"You are concerned about your diagnosis." -"You are feeling guilty about your smoking." -"There have been advances in lung cancer therapy." -"Trust your health care provider, who is very competent in treating cancer."
"You are concerned about your diagnosis."
Which finding is expected by the nurse reviewing blood screening tests of the immune system of a client with acquired immunodeficiency syndrome (AIDS)? -A decrease in CD4 T cells -An increase in thymic hormones -An increase in immunoglobulin E -A decrease in the serum level of glucose-6-phosphate dehydrogenase
A decrease in CD4 T cells
Which symptom would be expected in a client experiencing anaphylactic shock after multiple bee stings? -Respiratory depression and cardiac arrest -Bronchial constriction and decreased peripheral resistance -Decreased cardiac output and dilation of major blood vessels -Constriction of capillaries and decreased peripheral circulation
Bronchial constriction and decreased peripheral resistance
Which factor is causing severe dyspnea in a client with a diagnosis of cancer of the lung? -Abdominal distention or pressure -Bronchial obstruction or pleural effusion -Fluid retention as a result of renal failure -Anxiety associated with pain on inspiration
Bronchial obstruction or pleural effusion
Which factor is the leading cause of lung cancer? -Asbestos -Air pollution -Radioactivity -Cigarette smoking
Cigarette Smoking
Which complication could be prevented by frequent position changes in a client who is receiving palliative care after surgery for lung cancer? -Fever and nausea -Fear related to prognosis -Fear related to treatment -Ineffective airway clearance
Ineffective airway clearance
Which response would a nurse give to a client being prepared for the first radiation treatment for cancer who starts crying and states "I'm so discouraged."? -Allow the client to be alone for a few minutes so the client can regain composure. -Tell the client, "It's difficult to deal with your diagnosis and treatment." -Complete the preparation and tell the client, "We can talk about this later." -Explain the therapy and reinforce that it will only cause a little discomfort.
Tell the client, "It's difficult to deal with your diagnosis and treatment."
Which organism would the nurse explain commonly causes protozoal infections in clients with acquired immunodeficiency syndrome (AIDS)? -Candidiasis -Tuberculosis -Cryptococcosis -Toxoplasmosis
Toxoplasmosis
A nurse is counseling the family of a child with AIDS. Which is the most important concern that the nurse would discuss with the parents? -Possibility of injury -Susceptibility to infection -Inadequate nutritional intake -Altered growth and development
Susceptibility to infection
Which cells are responsible for tissue rejection in a client who underwent liver transplantation and is experiencing chills, body aches, nausea, cough, and shortness of breath? -T cells -B cells -Neutrophils -Macrophages
T cells
