Exam 3 NUR 201

The nurse is performing an admission assessment of a client with a possible right colon tumor. Which sign or symptom should the nurse anticipate the client may report? a. Frequent diarrhea b. Crampy gas pains c. Flat, ribbon-like stools d. Dull abdominal pain exacerbated by walking

d. Dull abdominal pain exacerbated by walking

The nurse has provided instructions to a client receiving external radiation therapy. Which client statement would indicate a need for further instruction regarding self-care related to the radiation therapy? a."I need to eat a high-protein diet." b."I need to avoid exposure to sunlight." c."I need to wash my skin with a mild soap and pat dry." d."I need to apply pressure on the irritated area by wearing snug clothing to prevent bleeding."

d."I need to apply pressure on the irritated area by wearing snug clothing to prevent bleeding."

The nurse teaches skin care to a client receiving external radiation therapy. Which client statement indicates the need for further instruction? a."I will handle the area gently." b."I will wear loose-fitting clothing." c."I will avoid the use of deodorants." d."I will limit sun exposure to 1 hour daily."

d."I will limit sun exposure to 1 hour daily."

The nurse is caring for a client on the oncology unit who has developed stomatitis during chemotherapy. The nurse should plan which measure to treat this complication? a. Rinse the mouth with diluted baking soda or saline. b. Use lemon and glycerin swabs liberally on painful oral lesions. c. Brush the teeth and use non-waxed dental floss at least twice a day. d. Place the client on NPO (nothing by mouth) status for 12 hours, and then resume liquids.

a. Rinse the mouth with diluted baking soda or saline.

The nurse has provided discharge instructions to a client who underwent a right mastectomy with axillary lymph node dissection. Which statement made by the client indicates a need for further instruction regarding home care measures? a."It is all right to use a straight razor to shave under my arms." b."I must be sure to use thick potholders when I am cooking." c."I must be sure not to have blood pressures taken or blood drawn from my right arm." d."I should inform all of my other health care providers that I have had this surgical procedure."

a."It is all right to use a straight razor to shave under my arms."

The nurse is teaching a client about the risk factors associated with colorectal cancer. The nurse determines that further teaching is necessary related to colorectal cancer if the client identifies which item as an associated risk factor? a.Age younger than 50 years b.History of colorectal polyps c.Family history of colorectal cancer d.Chronic inflammatory bowel disease

a.Age younger than 50 years

The nurse has admitted a client to the clinical nursing unit after undergoing a right mastectomy. The nurse should plan to place the right arm in which position? a.Elevated on a pillow b.Level with the right atrium c.Dependent to the right atrium d.Elevated above shoulder level

a.Elevated on a pillow

The nurse is caring for a client with lung cancer and bone metastasis. What signs and symptoms would the nurse recognize as indications of a possible oncological emergency? Select all that apply. a.Facial edema in the morning b.Weight loss of 20 lb (9 kg) in 1 month c.Serum calcium level of 12 mg/dL (3.0 mmol/L) d.Serum sodium level of 136 mg/dL (136 mmol/L) e.Serum potassium level of 3.4 mg/dL (3.4 mmol/L) f.Numbness and tingling of the lower extremities

a.Facial edema in the morning c.Serum calcium level of 12 mg/dL (3.0 mmol/L) f.Numbness and tingling of the lower extremities

A woman has just been told by the health care provider that she has breast cancer. The woman responds, "Oh, no! Does this mean I'm going to die?" The nurse interprets the woman's initial reaction as which response? a.Fear b.Rage c.Denial d.Anxiety

a.Fear

A client with carcinoma of the lung develops syndrome of inappropriate antidiuretic hormone (SIADH) as a complication of the cancer. The nurse anticipates that the health care provider will request which prescriptions? Select all that apply. a.Radiation b.Chemotherapy c.Increased fluid intake d.Decreased oral sodium intake e.Serum sodium level determination f.Medication that is antagonistic to antidiuretic hormone

a.Radiation b.Chemotherapy e.Serum sodium level determination f.Medication that is antagonistic to antidiuretic hormone

The community health nurse is preparing an educational session for a group of women and will be discussing the primary prevention strategies and treatment measures for breast cancer. What information should the nurse include in the educational session? a.Older women are more likely to get mammograms. b.Treatment decisions are based on a woman's overall health. c.Women younger than age 65 are more likely to get breast cancer. d.A woman's age is the main factor used to decide which screening methods to use.

b.Treatment decisions are based on a woman's overall health

The nurse is caring for a client undergoing external radiation. The client has developed a dry desquamation of the skin in the treatment area, and the nurse is teaching about management of the skin reaction. Which comment made by the client suggests understanding of the instructions? a. "I don't need to stay out of the sun or put on sunscreen." b. "I can use ice packs to relieve itching in the treatment area." c. "When bathing I will use lukewarm water on the affected area." d. "I can lubricate the irritated area with an ointment like bacitracin."

c. "When bathing I will use lukewarm water on the affected area."

The nurse is caring for a client with cancer of the prostate who has undergone a prostatectomy. Which action should the nurse include in discharge instructions? a. Avoid driving the car for a few days. b. Restrict fluid intake to prevent incontinence. c. Avoid lifting objects heavier than 20 lb (9 kg) for at least 6 weeks. d. Notify the health care provider if small blood clots are noticed during urination.

c. Avoid lifting objects heavier than 20 lb (9 kg) for at least 6 weeks.

The nurse is assigned to care for a client with metastatic breast cancer who is taking tamoxifen citrate. The nurse plans to monitor for which changes in laboratory values for this client? Select all that apply. a. Increase in lipase level b. Increase in blood glucose level c. Increase in serum calcium level d. Increase in serum potassium level e. Decrease in low-density lipoprotein levels

c. Increase in serum calcium level e. Decrease in low-density lipoprotein levels

The nurse monitoring an oncological client assesses for which early sign of vena cava syndrome? a. Cyanosis b. Arm edema c. Periorbital edema d. Mental status changes

c. Periorbital edema

The nurse in the health care provider's office is performing a postoperative assessment of a client who underwent mastectomy of her right breast 2 weeks ago. The client tells the nurse that she is very concerned because she has numbness in the area of the surgery and along the inner side of the arm from the armpit to the elbow. The nurse should provide which information to the client about her complaint? a. These sensations are signs of a complication. b. These sensations probably will be permanent. c. These sensations dissipate over several months and usually resolve after 1 year. d. It is nothing to worry about because most women who have this type of surgery experience this problem.

c. These sensations dissipate over several months and usually resolve after 1 year.

The nurse has instructed the client in the correct technique for breast self-examination (BSE). For a portion of the examination, the client will lie down. The nurse should teach the client to put the pillow in which location for self-examination of the right breast? a. Under the left scapula b. Under the left shoulder c. Under the right shoulder d. Under the small of the back

c. Under the right shoulder

A client calls the ambulatory care clinic and tells the nurse that she found an area that looks like the peel of an orange when performing breast self-examination (BSE) but found no other changes. What is the nurse's best response to this client? a."Good job performing your BSE. I am sure that is nothing to be concerned about." b."Make sure you tell the health care provider about your finding at the next regularly scheduled visit." c."I am glad you called to report this finding. Can you come to the clinic to see your health care provider tomorrow?" d."Do you have a thermometer? You need to take your temperature and call back if you have a fever over 101°F/38.3°C."

c."I am glad you called to report this finding. Can you come to the clinic to see your health care provider tomorrow?"

The nurse is providing instructions to the client who is receiving external radiation therapy. Which statement, if made by the client, indicates the need for further instruction? a."I will dry affected areas with patting motions." b."I will wear soft clothing over the affected site." c."I will use a washcloth to wash the affected area." d."I need to make sure I carry my purse on the unaffected side."

c."I will use a washcloth to wash the affected area."

As part of chemotherapy education, the nurse teaches a female client about the risk for bleeding and self-care during the period of greatest bone marrow suppression (the nadir). The nurse understands that further teaching is needed if the client makes which statement? a."I should avoid blowing my nose." b."I may need a platelet transfusion if my platelet count is too low." c."I'm going to take aspirin for my headache as soon as I get home." d."I will count the number of pads and tampons I use when menstruating."

c."I'm going to take aspirin for my headache as soon as I get home."

Tamoxifen citrate is prescribed for a client with metastatic breast carcinoma. The client asks the nurse if her family member with bladder cancer can also take this medication. The nurse most appropriately responds by making which statement? a."This medication can be used only to treat breast cancer." b."Yes, your family member can take this medication for bladder cancer as well." c."This medication can be taken to prevent and treat clients with breast cancer." d."This medication can be taken by anyone with cancer as long as their health care provider approves it."

c."This medication can be taken to prevent and treat clients with breast cancer."

A clinic nurse prepares a teaching plan for a client receiving an antineoplastic medication. When implementing the plan, the nurse should make which statement to the client? a."You can take aspirin as needed for headache." b."You can drink beverages containing alcohol in moderate amounts each evening." c."You need to consult with the health care provider (HCP) before receiving immunizations." d."It is fine to receive a flu vaccine at the local health fair without HCP approval because the flu is so contagious."

c."You need to consult with the health care provider (HCP) before receiving immunizations."

Which interventions are the most appropriate for a client who is experiencing thrombocytopenia? Select all that apply. a.Use a straight-edge razor for shaving. b.Obtain a rectal temperature every 8 hours. c.Check secretions for frank or occult blood. d.Give vitamin K by the intramuscular route. e.Encourage fluid intake to avoid constipation. f.Provide oral sponges or a soft toothbrush for oral care

c.Check secretions for frank or occult blood. e.Encourage fluid intake to avoid constipation. f.Provide oral sponges or a soft toothbrush for oral care

Chemotherapy dosage is frequently based on total body surface area (BSA), so it is important for the nurse to perform which assessment before administering chemotherapy? a.Measure the client's abdominal girth. b.Calculate the client's body mass index. c.Measure the client's current weight and height. d.Ask the client about his or her weight and height.

c.Measure the client's current weight and height

The nurse is caring for a client with metastatic breast cancer. The client describes a new and sudden sharp pain in the back. Based on this assessment finding, which is the priority nursing intervention? a.Document the findings. b.Administer pain medication. c.Notify the health care provider (HCP). d.Place a heating pad on the client's back.

c.Notify the health care provider (HCP).

The nurse is monitoring a client for signs and symptoms related to superior vena cava syndrome. Which is an early sign of this oncological emergency? a.Cyanosis b.Arm edema c.Periorbital edema d.Mental status changes

c.Periorbital edema

The nurse is caring for a client with prostate cancer who is being treated with a hormone therapy. What should the nurse monitor for in order to evaluate the effect of this treatment? a. An increase in testosterone levels b. An increase in prostaglandin levels c. An increase the amount of circulating androgens d. A decline in the amount of circulating androgens

d. A decline in the amount of circulating androgens

The nurse is caring for a client receiving combination chemotherapy. Which nursing intervention is the most appropriate? a. Give 2 agents from the same medication class. b. Give 2 agents with like nadirs at the same time. c. Test the client's knowledge about each agent's nadir. d. Avoid giving agents with the same nadirs and toxicities at the same time.

d. Avoid giving agents with the same nadirs and toxicities at the same time.

The nurse is providing care to a client who has undergone modified right mastectomy for the treatment of breast cancer. Which activity should the nurse incorporate into the plan of care? a.Keep suction drains fully inflated to provide adequate suction. b.Perform venipunctures and blood pressures on the operative side only. c.Inform the client that drains will be removed on the second postoperative day. d.Maintain head of the bed elevation at 30 degrees with the right arm elevated on a pillow.

d.Maintain head of the bed elevation at 30 degrees with the right arm elevated on a pillow.

The client has undergone mastectomy. The nurse determines that the client is making the best adjustment to the loss of the breast if which behavior is observed? a.Refusing to look at the wound b.Reading the postoperative care booklet c.Asking for pain medication when needed d.Participating in the care of the surgical drain

d.Participating in the care of the surgical drain

The home care nurse visits a client who has just returned home from the hospital after a mastectomy with a suction drain in place. Which observed client behavior requires a need for further teaching? a.Empties the drain to prevent infection b.Elevates the arm when lying and sitting c.Applies lotion to the area after the incision heals d.Performs full range-of-motion exercises to the upper arm

d.Performs full range-of-motion exercises to the upper arm

The nurse is participating in a health screening clinic and is preparing teaching materials about colorectal cancer. Which risk factor for colorectal cancer should the nurse include? a.High-fiber, low-fat diet b.Age older than 30 years c.Distant relative with colorectal cancer d.Personal history of ulcerative colitis or gastrointestinal polyps

d.Personal history of ulcerative colitis or gastrointestinal polyps

A client receiving chemotherapy is experiencing mucositis. The nurse should advise the client to use which item as the best substance to rinse the mouth? a.Alcohol-based mouthwash b.Hydrogen peroxide mixture c.Lemon-flavored mouthwash d.Weak salt and bicarbonate mouth rinse

d.Weak salt and bicarbonate mouth rinse

The nurse is caring for a chemotherapy client with a low platelet aggregation level. Which likely caused this decreased platelet production? a. Anemia b. Thrombocytopenia c. Bone marrow suppression d. Low hemoglobin and hematocrit (H&H) counts

C. Bone marrow Suppression

The nurse has provided teaching for an adult client about screening for a colon cancer. Which statement by the client indicates that education was effective? a. "I should have an annual fecal occult blood test." b. "I should have an annual colonoscopy when I become 60." c. "I will have a colonoscopy before the fecal occult blood test." d. "I will not need to have further fecal occult blood tests after a colonoscopy."

a. "I should have an annual fecal occult blood test."

A client who is receiving chemotherapy for breast cancer develops myelosuppression. Which instructions should the nurse include in the client's discharge teaching plan? Select all that apply. a. Avoid contact sports. b. Wash hands frequently. c. Increase intake of fresh fruits and vegetables. d. Avoid crowded places such as shopping malls. e. Treat a sore throat with over-the-counter products. f. Avoid people who have received live attenuated vaccines.

a. Avoid contact sports. b. Wash hands frequently. d. Avoid crowded places such as shopping malls. f. Avoid people who have received live attenuated vaccines.

A client with a medical diagnosis of breast cancer is undergoing chemotherapy. The client complains to the nurse about losing her hair and severe fatigue from the treatment. Which interventions should the nurse implement for this client? Select all that apply. a. Review side effects of chemotherapy and treatment with the client. b. Teach the client how to resolve specific concerns of her personal life. c. Teach the client to pace activities with rest so as to maintain strength. d. Offer information on available counseling services and support groups. e. Tell the client about some other clients who have had breast cancer treatment. f. Inquire how the cancer diagnosis and treatment affect the client's normal routine.

a. Review side effects of chemotherapy and treatment with the client. c. Teach the client to pace activities with rest so as to maintain strength. d. Offer information on available counseling services and support groups. f. Inquire how the cancer diagnosis and treatment affect the client's normal routine.

The nurse is monitoring the intravenous (IV) infusion of an antineoplastic medication. During the infusion, the client complains of pain at the insertion site. On inspection of the site, the nurse notes redness and swelling and that the infusion of the medication has slowed in rate. The nurse suspects extravasation and should take which actions? Select all that apply. a.Stop the infusion. b.Notify the health care provider (HCP). c.Prepare to apply ice or heat to the site. d.Restart the IV at a distal part of the same vein. e.Prepare to administer a prescribed antidote into the site. f.Increase the flow rate of the solution to flush the skin and subcutaneous tissue

a.Stop the infusion. b.Notify the health care provider (HCP). c.Prepare to apply ice or heat to the site. e.Prepare to administer a prescribed antidote into the site.

The home health care nurse is visiting a client who has undergone a mastectomy. The nurse determines that the client demonstrates greatest adjustment to the loss of the breast if which behavior is noted? a.The client looks at the surgical site. b.The client performs the prescribed arm exercises. c.The client takes the pain medication as prescribed. d.The client has read all of the postoperative materials provided by the hospital nurse.

a.The client looks at the surgical site.

A client is having a diagnostic workup for colorectal cancer. Which factors in the client's history place the client at increased risk for this type of cancer? Select all that apply. a. A high-fiber diet b. A diet high in fats c. Minimal alcohol intake d. A diet high in carbohydrates e. A history of inflammatory bowel disease f. A maternal grandfather who had a history of heart disease

b. A diet high in fats d. A diet high in carbohydrates e. A history of inflammatory bowel disease

A 27-year-old client is undergoing evaluation of lumps in her breasts. In determining whether the client could have fibrocystic breast disorder, the nurse should ask her whether the breast lumps seem to become more prominent or troublesome at which time? a. After menses b. Before menses c. During menses d. At any time, regardless of the menstrual cycle

b. Before menses

The nurse has conducted a cancer prevention seminar for clients in an ambulatory setting. The nurse determines that teaching was effective if the clients select which food item on the menu? a. Broiled beef, canned corn, rice b. Broccoli, baked fish, mashed potato c. Bacon, scrambled eggs, french fries d. Bologna, canned asparagus, white bread

b. Broccoli, baked fish, mashed potato

A client has undergone abdominal perineal resection for a bowel tumor. The nurse interprets that the client's colostomy is beginning to function if which sign is noted? a. Absent bowel sounds b. The passage of flatus c. Blood drainage from the colostomy d. The client's ability to tolerate food

b. The passage of flatus

The nurse is reviewing the preoperative prescriptions for a client with a colon tumor who is scheduled for abdominal perineal resection and notes that the health care provider has prescribed neomycin for the client. After discussing a prescription for neomycin with the nursing student who is caring for the client, the nurse determines that the student understands the rationale for administration if which statement is made? a."The client is allergic to penicillin." b."It will help to decrease the bacteria in the bowel." c."It is given to prevent an immune dysfunction postoperatively." d."It is given because the client has an infection that must be treated prior to surgery."

b."It will help to decrease the bacteria in the bowel."

A client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication? a.Glucose level b.Calcium level c.Potassium level d.Prothrombin time

b.Calcium level

The community health nurse is creating a poster for an educational session for a group of women and will be discussing the risk factors associated with breast cancer. Which risk factors for breast cancer should the nurse list on the poster? Select all that apply. a.Multiparity b.Early menarche c.Early menopause d.Family history of breast cancer e.High-dose radiation exposure to chest f.Previous cancer of the breast, uterus, or ovaries

b.Early menarche d.Family history of breast cancer e.High-dose radiation exposure to chest f.Previous cancer of the breast, uterus, or ovaries

The nurse is caring for a client following a mastectomy. Which nursing intervention would assist in preventing lymphedema of the affected arm? a.Placing cool compresses on the affected arm b.Elevating the affected arm on a pillow above heart level c.Avoiding arm exercises in the immediate postoperative period d.Maintaining an intravenous site below the antecubital area on the affected side

b.Elevating the affected arm on a pillow above heart level

A client is diagnosed as having a bowel tumor. The nurse should monitor the client for which complications of this type of tumor? Select all that apply. a.Flatulence b.Peritonitis c.Hemorrhage d.Fistula formation e.Bowel perforation f.Lactose intolerance

b.Peritonitis c.Hemorrhage d.Fistula formation e.Bowel perforation

The nurse is caring for a client with leukemia who is receiving intravenous chemotherapy. The nurse reviews the laboratory results and notes that the white blood cell count is 2000 mm3 (2 × 109/L), the platelet count is 150,000 mm3 (150 × 109/L), the clotting time is 10 minutes, and the ammonia level is 20 mcg/dL (12 mcmol/L). Which nursing action would be appropriate? a.Place the client on bleeding precautions. b.Place the client on neutropenic precautions. c.Remove the rectal thermometer from the client's room. d.Instruct the dietary department to eliminate all proteins from the client's diet.

b.Place the client on neutropenic precautions.

The nurse is reviewing the laboratory test results for a client receiving chemotherapy. The nurse notes that the white blood cell count is extremely low and places the client on neutropenic precautions. Which interventions are components of these types of precautions? Select all that apply. a.Allowing only fresh fruits in the client's room b.Removing fresh-cut flowers from the client's room c.Encouraging the client to eat any types of fresh vegetables d.Instructing family members on the proper technique for hand washing e.Instructing family members to wear a mask when entering the client's room

b.Removing fresh-cut flowers from the client's room d.Instructing family members on the proper technique for hand washing e.Instructing family members to wear a mask when entering the client's room