unit 6
A patient is scheduled for cryoablation for cervical cancer and tells the nurse, "I am not exactly sure what the surgeon is going to do." What is the best response by the nurse? "The surgeon is going to use medication to inject the area." "The surgeon is going to use liquid nitrogen to freeze the area." "The surgeon is going to use a laser to remove the area." "The surgeon is going to use radiofrequency to ablate the area."
"The surgeon is going to use liquid nitrogen to freeze the area."
Which should a nurse thoroughly evaluate before a bone marrow transplant (BMT) procedure? Family history Drug history Blood studies Allergy history
Blood studies
Surgical removal of the thyroid gland is the treatment of choice for thyroid cancer. During the immediate postoperative period, the nurse knows to evaluate serum levels of __________ to assess for a serious and primary postoperative complication of thyroidectomy. Sodium Calcium Potassium Magnesium
Calcium
What foods should the nurse suggest that the patient consume less of in order to reduce nitrate intake because of the possibility of carcinogenic action? Eggs and milk Fish and poultry Ham and bacon Green, leafy vegetables
Ham and bacon
The nurse is caring for a client in acute kidney injury. Which of the following complications would most clearly warrant the administration of polystyrene sulfonate? Hypernatremia Hypomagnesemia Hyperkalemia Hypercalcemia
Hyperkalemia
When the nurse is caring for a patient with type 1 diabetes, what clinical manifestation would be a priority to closely monitor? Hypoglycemia Hyponatremia Ketonuria Polyphagia
Hypoglycemia
Which combination of adverse effects should a nurse monitor for when administering IV insulin to a client with diabetic ketoacidosis? Hypokalemia and hypoglycemia Hypocalcemia and hyperkalemia Hyperkalemia and hyperglycemia Hypernatremia and hypercalcemia
Hypokalemia and hypoglycemia
A client with a 20-year history of hypothyroidism who has not been compliant with taking thyroid replacement therapy is brought into the ED with a diagnosis of myxedema coma. What client symptoms are consistent with this life-threatening event? Select all that apply. Tachycardia Hypothermia Hypotension Hypoventilation Hyperactivity
Hypothermia Hypotension Hypoventilation
The nurse is caring for a patient after kidney surgery. What major danger should the nurse closely monitor for? Abdominal distention owing to reflex cessation of intestinal peristalsis Hypovolemic shock caused by hemorrhage Paralytic ileus caused by manipulation of the colon during surgery Pneumonia caused by shallow breathing because of severe incisional pain
Hypovolemic shock caused by hemorrhage
The nurse is caring for a client who is to begin receiving external radiation for a malignant tumor of the neck. While providing client education, what potential adverse effects should the nurse discuss with the client? Impaired nutritional status Cognitive changes Diarrhea Alopecia
Impaired nutritional status
The nurse is caring for a client undergoing an incisional biopsy. Which statement does the nurse understand to be true about an incisional biopsy? It is used to remove cancerous cells using a needle. It removes an entire lesion and the surrounding tissue. It removes a wedge of tissue for diagnosis. It treats cancer with lymph node involvement.
It removes a wedge of tissue for diagnosis.
A client has been experiencing severe pain and hematuria and is hardly able to ambulate into the physician's office. The physician suspects kidney stones and orders diagnostic tests to confirm. What test would physician order? KUB ultrasound CT MRI
KUB kidney urether vladder xray
One of the most frequently occurring complications (55% occurrence) of primary hyperparathyroidism is: Kidney stones. Pancreatitis. Pathologic fractures. Peptic ulcer.
Kidney stones.
A decrease in circulating white blood cells (WBCs) is referred to as Granulocytopenia Thrombocytopenia Leukopenia Neutropenia
Leukopenia
The nurse is assessing the diet of a female client. To decrease the risk of cancer in general, the nurse instructs the client to Decrease cigarette smoking from one pack/day to 1/2 pack/day. Limit alcohol ingestion to one drink per day. Ingest two to three servings of fruits and vegetables each day. Include at least 6 ounces of meat in meals every day.
Limit alcohol ingestion to one drink per day.
Which type of insulin acts most quickly? Regular NPH Lispro Glargine
Lispro
For a client with Graves' disease, which nursing intervention promotes comfort? Restricting intake of oral fluids Placing extra blankets on the client's bed Limiting intake of high-carbohydrate foods Maintaining room temperature in the low-normal range
Maintaining room temperature in the low-normal range
Which is a growth-based classification of tumors? Sarcoma Carcinoma Malignancy Leukemia
Malignancy
The nurse assesses a patient who has been diagnosed with Addison's disease. Which of the following is a diagnostic sign of this disease? Potassium of 6.0 mEq/L Sodium of 140 mEq/L Glucose of 100 mg/dL A blood pressure reading of 135/90 mm Hg
Potassium of 6.0 mEq/L
A nurse is teaching a diabetic support group about the causes of type 1 diabetes. The teaching is determined to be effective when the group is able to attribute which factor as a cause of type 1 diabetes? Presence of autoantibodies against islet cells Obesity Rare ketosis Altered glucose metabolism
Presence of autoantibodies against islet cells
The nurse is preparing to collect an ordered urine sample for urinalysis. The nurse should be aware that this test will include what assessment parameters? Select all that apply. Specific gravity of the client's urine Testing for the presence of glucose in the client's urine Microscopic examination of urine sediment for RBCs Microscopic examination of urine sediment for casts Testing for BUN and creatinine in the client's urine
Specific gravity of the client's urine Testing for the presence of glucose in the client's urine Microscopic examination of urine sediment for RBCs Microscopic examination of urine sediment for casts
A young client has been diagnosed with cancer that has metastasized to the lungs. During client education, the client's mother asks about tumor staging and its relation to her child's condition. What stage would the nurse expect this client's tumor to be assigned? Stage IV Stage III Stage I Stage 0
Stage IV
The nurse on the telemetry floor is caring for a patient with long-standing hypothyroidism who has been taking synthetic thyroid hormone replacement sporadically. What is a priority that the nurse monitors for in this patient? Symptoms of acute coronary syndrome Dietary intake of foods with saturated fats Symptoms of pneumonia Heat intolerance
Symptoms of acute coronary syndrome
What nursing action best demonstrates primary cancer prevention? Encouraging yearly Pap tests Teaching testicular self-examination Teaching clients to wear sunscreen Facilitating screening mammograms
Teaching clients to wear sunscreen
A nurse is preparing to administer two types of insulin to a client with diabetes mellitus. What is the correct procedure for preparing this medication? The short-acting insulin is withdrawn before the intermediate-acting insulin. The intermediate-acting insulin is withdrawn before the short-acting insulin. Different types of insulin are not to be mixed in the same syringe. If administered immediately, there is no requirement for withdrawing one type of insulin before another.
The short-acting insulin is withdrawn before the intermediate-acting insulin.
A client has been diagnosed with acute glomerulonephritis. This condition causes: proteinuria. pyuria. polyuria. No option is correct.
proteinuria.
A nurse should expect a client with hypothyroidism to report: increased appetite and weight loss. puffiness of the face and hands. nervousness and tremors. thyroid gland swelling.
puffiness of the face and hands.
The nurse is caring for a client with a benign breast tumor. The tumor may have which characteristic? Ability to invade other tissues Slow rate of growth Causes generalized symptoms Undifferentiated cells
Slow rate of growth
Which class of antineoplastic agents is cell cycle-specific? Antimetabolites (5-FU) Antitumor antibiotics (bleomycin) Alkylating agents (cisplatin) Nitrosoureas (carmustine)
Antimetabolites (5-FU)
A client receives a diagnosis of chondrosarcoma. This means that the client has a: malignant tumor. benign tumor of the cartilage. tumor that originated in the bone. tumor that originated in the smooth muscle.
malignant tumor.
A newly admitted client with type 1 diabetes asks the nurse what caused her diabetes. When the nurse is explaining to the client the etiology of type 1 diabetes, what process should the nurse describe? "The tissues in your body are resistant to the action of insulin, making the glucose levels in your blood increase" "Damage to your pancreas causes an increase in the amount of glucose that it releases, and there is not enough insulin to control it." "The amount of glucose that your body makes overwhelms your pancreas and decreases your production of insulin." "Destruction of special cells in the pancreas causes a decrease in insulin production. Glucose levels rise because insulin normally breaks it down."
"Destruction of special cells in the pancreas causes a decrease in insulin production. Glucose levels rise because insulin normally breaks it down."
A nurse is caring for a client who is receiving chemotherapy and has a platelet count of 30,000/mm3. Which statement by the client indicates a need for additional teaching? "I floss my teeth every morning." "I use an electric razor to shave." "I take a stool softener every morning." "I removed all the throw rugs from the house."
"I floss my teeth every morning."
A nurse is conducting a class on how to self-manage insulin regimens. A client asks how long a vial of insulin can be stored at room temperature before it "goes bad." What would be the nurse's best answer? "If you are going to use up the vial within 1 month it can be kept at room temperature." "If a vial of insulin will be used up within 21 days, it may be kept at room temperature." "If a vial of insulin will be used up within 2 weeks, it may be kept at room temperature." "If a vial of insulin will be used up within 1 week, it may be kept at room temperature."
"If you are going to use up the vial within 1 month it can be kept at room temperature."
During a client's examination and consultation, the physician keeps telling the client, "You have an abdominal neoplasm." Which statements accurately paraphrase the physician's statement? Select all that apply. "You have a new growth of abnormal tissue in your abdomen." "You have an abdominal tumor." "You have an abdominal malignancy." "You have abdominal cancer."
"You have a new growth of abnormal tissue in your abdomen." "You have an abdominal tumor."
A client has received a diagnosis of type 2 diabetes. The diabetes nurse has made contact with the client and will implement a program of health education. What is the nurse's priority action? Ensure that the client understands the basic pathophysiology of diabetes. Identify the client's body mass index. Teach the client "survival skills" for diabetes. Assess the client's readiness to learn.
Assess the client's readiness to learn.
An oncology client has begun to experience skin reactions to radiation therapy, prompting the nurse to make the diagnosis Impaired Skin Integrity: erythematous reaction to radiation therapy. What intervention best addresses this nursing diagnosis? Apply an ice pack or heating pad PRN to relieve pain and pruritis Avoid skin contact with water whenever possible Apply phototherapy PRN Avoid rubbing or scratching the affected area
Avoid rubbing or scratching the affected area
A client undergoes a biopsy of a suspicious lesion. The biopsy report classifies the lesion according to the TNM staging system as follows: Tis, N0, M0. What does this classification mean? No evidence of primary tumor, no abnormal regional lymph nodes, and no evidence of distant metastasis Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis Can't assess tumor or regional lymph nodes and no evidence of metastasis Carcinoma in situ, no demonstrable metastasis of the regional lymph nodes, and ascending degrees of distant metastasis
Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis
The hospice nurse has just admitted a new client to the program. What principle guides hospice care? Care addresses the needs of the client as well as the needs of the family. Care is focused on the client centrally and the family peripherally. The focus of all aspects of care is solely on the client. The care team prioritizes the client's physical needs and the family is responsible for the client's emotional needs.
Care addresses the needs of the client as well as the needs of the family.
A nurse is planning care for a client in acute addisonian crisis. Which nursing diagnosis should receive the highest priority? Risk for infection Decreased cardiac output Impaired physical mobility Imbalanced nutrition: Less than body requirements
Decreased cardiac output
What intervention should the nurse provide to reduce the incidence of renal damage when a patient is taking a chemotherapy regimen? Encourage fluid intake to dilute the urine. Take measures to acidify the urine and prevent uric acid crystallization. Withhold medication when the blood urea nitrogen level exceeds 20 mg/dL. Limit fluids to 1,000 mL daily to prevent accumulation of the drug's end products after cell lysis.
Encourage fluid intake to dilute the urine.
A patient will be having an endoscopic procedure with a diagnostic biopsy. What type of biopsy does the nurse explain will remove an entire piece of suspicious tissue? Excisional biopsy Incisional biopsy Needle biopsy Punch biopsy
Excisional biopsy
A health care provider suspects that a thyroid nodule may be malignant. The nurse knows to prepare information for the patient based on the usual test that will be ordered to establish a diagnosis. What is that test? Serum immunoassay for TSH Fine-needle biopsy of the thyroid gland Free T4 analysis Ultrasound of the thyroid gland
Fine-needle biopsy of the thyroid gland
A patient is to receive Bacille Calmette-Guerin (BCG), a nonspecific biologic response modifier. Why would the patient receive this form of treatment? For cancer of the bladder For cancer of the breast For cancer of the lungs For skin cancer
For cancer of the bladder
The most common type of goiter is caused by lack of which of the following? Iodine Calcium Potassium Sodium
Iodine
Which of the following is a characteristic of a malignant tumor? It gains access to the blood and lymphatic channels. It demonstrates cells that are well differentiated. It is usually slow growing. It grows by expansion.
It gains access to the blood and lymphatic channels.
A client receiving thyroid replacement therapy develops influenza and forgets to take her thyroid replacement medicine. The nurse understands that skipping this medication puts the client at risk for developing which life-threatening complication? Exophthalmos Thyroid storm Myxedema coma Tibial myxedema
Myxedema coma
Which of the following assessments should the nurse perform to determine the development of peptic ulcers when caring for a patient with Cushing's syndrome? Observe the color of stool. Monitor bowel patterns. Monitor vital signs every 4 hours. Observe urine output.
Observe the color of stool.
A client undergoes renal angiography. The nurse prepares the client for the test and provides postprocedure care. Which intervention should the nurse provide to the client after renal angiography? Encourage the client to void Monitor the client for signs and symptoms of pyelonephritis Palpate the pulses in the legs and feet Assess for signs of electrolyte and water imbalance
Palpate the pulses in the legs and feet
A client with recurrent urinary tract infections has just undergone a cystoscopy and reports slight hematuria during the first void after the procedure. What is the nurse's most appropriate action? Administer a STAT dose of vitamin K, as prescribed. Reassure the client that this is not unexpected and then monitor the client for further bleeding. Promptly inform the health care provider of this assessment finding. Position the client supine and insert a Foley catheter, as prescribed.
Reassure the client that this is not unexpected and then monitor the client for further bleeding.
Lispro (Humalog) is an example of which type of insulin? Rapid-acting Intermediate-acting Short-acting Long-acting
Rapid-acting
What is the only insulin that can be given intravenously? Regular NPH Lantus Ultralente
Regular
Laboratory studies indicate a client's blood glucose level is 185 mg/dl. Two hours have passed since the client ate breakfast. Which test would yield the most conclusive diagnostic information about the client's glucose use? Fasting blood glucose test 6-hour glucose tolerance test Serum glycosylated hemoglobin (Hb A1c) Urine ketones
Serum glycosylated hemoglobin (Hb A1c)
A client is admitted to the health care facility for evaluation for Addison's disease. Which laboratory test result best supports a diagnosis of Addison's disease? Blood urea nitrogen (BUN) level of 12 mg/dl Blood glucose level of 90 mg/dl Serum sodium level of 134 mEq/L Serum potassium level of 5.8 mEq/L
Serum potassium level of 5.8 mEq/L
The nurse is caring for a client with an advanced stage of breast cancer and the client has recently learned that her cancer has metastasized. The nurse enters the room and finds the client struggling to breathe and the nurse's rapid assessment reveals that the client's jugular veins are distended. The nurse should suspect the development of what oncologic emergency? Increased intracranial pressure Superior vena cava syndrome (SVCS) Spinal cord compression Metastatic tumor of the neck
Superior vena cava syndrome (SVCS)
The nursing instructor is discussing the difference between normal cells and cancer cells with the pre-nursing class in pathophysiology. What would the instructor cite as a characteristic of a cancer cell? Malignant cells contain more fibronectin. The cell membrane of malignant cells contains proteins called tumor-specific antigens. Chromosomes are commonly found to be strong. Nuclei of cancer cells are large and regularly shaped.
The cell membrane of malignant cells contains proteins called tumor-specific antigens.
A client receives a daily injection of glargine insulin at 7:00 a.m. When should the nurse monitor this client for a hypoglycemic reaction? Between 8:00 and 10:00 a.m. Between 4:00 and 6:00 p.m. Between 7:00 and 9:00 p.m. This insulin has no peak action and does not cause a hypoglycemic reaction.
This insulin has no peak action and does not cause a hypoglycemic reaction.
A nurse is preparing a client diagnosed with benign prostatic hyperplasia (BPH) for a lower urinary tract cystoscopic examination. The nurse should caution the client about what common temporary complication of this procedure? Urinary retention Bladder perforation Hemorrhage Nausea
Urinary retention
Which of the following would be consistent with a benign neoplasm? Usually progressive and slow Grows by invasion Gains access to the blood and lymph channels to metastasize Cells are undifferentiated
Usually progressive and slow
A client has been asked to provide a clean-catch midstream urine specimen. It is important that the instructions are clear and that things are done in the proper order. Select the proper sequence of events for obtaining a specimen from a client.
Wash hands and remove the lid from the specimen container without touching the inside of the lid. Open the antiseptic towelette package and cleanse the urethral area. Begin voiding into the toilet. Void 30 to 50 mL of the midstream urine into the collection container, taking care not to contaminate the container. Carefully replace the lid, dry the container if necessary, and wash hands.
Which of the following is the most accurate indicator of fluid loss or gain? Weight Urine output Caloric intake Body temperature
Weight
A client without symptoms receives a diagnosis of prostate cancer after a routine physical. What factors contributed to this diagnosis? Select all that apply. client history risk factors tumor markers use of sunscreen
client history risk factors tumor markers
A visiting nurse is setting up an insulin schedule for an older adult who has diabetes mellitus. What should the nurse consider when determining the dosing time? client's eating and sleeping habits client's ability to self-administer insulin cognitive problems client's history
client's eating and sleeping habits
An older adult's most recent laboratory findings indicate a decrease in creatinine clearance. When performing an assessment related to potential causes, the nurse should: confirm all of the medications and supplements normally taken. assess the client's usual intake of sodium. confirm which beverages the client normally consumes. palpate the client's bladder before and after voiding.
confirm all of the medications and supplements normally taken.
A client with ovarian cancer is ordered hydroxyurea, an antimetabolite drug. Antimetabolites are a diverse group of antineoplastic agents that interfere with various metabolic actions of the cell. What mechanism of action do antimetabolites interferes with? cell division or mitosis during the M phase of the cell cycle normal cellular processes during the S phase of the cell cycle the chemical structure of deoxyribonucleic acid (DNA) and chemical binding between DNA molecules (cell cycle-nonspecific) one or more stages of ribonucleic acid (RNA) synthesis, DNA synthesis, or both (cell cycle-nonspecific)
normal cellular processes during the S phase of the cell cycle
The nurse is caring for a client who reports orange urine. The nurse suspects which factor as the cause of the urine discoloration? phenazopyridine hydrochloride infection phenytoin metronidazole
phenazopyridine hydrochloride
A young client has a significant height deficit and is to be evaluated for diagnostic purposes. What could be the cause of this client's disorder? pituitary disorder thyroid disorder parathyroid disorder adrenal disorder
pituitary disorder
When caring for a client with diabetes insipidus, the nurse expects to administer: vasopressin. furosemide. regular insulin. 10% dextrose.
vasopressin.
The nurse at the clinic explains to the patient that the surgeon will be removing a mole on the patient's back that has the potential to develop into cancer. The nurse informs the patient that this is what type of procedure? Diagnostic Palliative Prophylactic Reconstructive
Prophylactic
A client with a history of progressively worsening fatigue is undergoing a comprehensive assessment which includes test of renal function relating to erythropoiesis. When assessing the oxygen transport ability of the blood, the nurse should prioritize the review of what blood value? Hematocrit Hemoglobin Erythrocyte sedimentation rate (ESR) Serum creatinine
hemoglobin
An incoherent client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and periorbital area. Knowing that these findings suggest severe hypothyroidism, the nurse prepares to take emergency action to prevent the potential complication of: thyroid storm. cretinism. myxedema coma. Hashimoto's thyroiditis.
myxedema coma.
A client has been recently diagnosed with type 2 diabetes, and reports continued weight loss despite increased hunger and food consumption. This condition is called: polyphagia. polydipsia. polyuria. anorexia.
polyphagia. excessive or extreme hunger.
Which of the following would be inconsistent as a common side effect of chemotherapy? Weight gain Alopecia Myelosuppression Fatigue
Weight gain
A client with adrenal insufficiency is gravely ill and presents with nausea, vomiting, diarrhea, abdominal pain, profound weakness, and headache. The client's family reports that the client has been doing strenuous yard work all day and was sweating profusely. Nursing management of this client would include observation for signs of: hyponatremia and hyperkalemia. hyponatremia and hypokalemia. hypernatremia and hyperkalemia. hypernatremia and hypokalemia.
hyponatremia and hyperkalemia.
A nurse is teaching a client about the rationale for administering allopurinol with chemotherapy. Which example would be the bestteaching by the nurse? It stimulates the immune system against the tumor cells. It treats drug-related anemia. It prevents alopecia. It lowers serum and uric acid levels.
It lowers serum and uric acid levels.
A client newly diagnosed with diabetes mellitus asks why he needs ketone testing when the disease affects his blood glucose levels. How should the nurse respond? "The spleen releases ketones when your body can't use glucose." "Ketones will tell us if your body is using other tissues for energy." "Ketones can damage your kidneys and eyes." "Ketones help the physician determine how serious your diabetes is."
"Ketones will tell us if your body is using other tissues for energy."
An agitated, confused client arrives in the emergency department. The client's history includes type 1 diabetes, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting: 2 to 5 g of a simple carbohydrate. 10 to 15 g of a simple carbohydrate. 18 to 20 g of a simple carbohydrate. 25 to 30 g of a simple carbohydrate.
10 to 15 g of a simple carbohydrate.
An elderly client with diabetes comes to the clinic with her daughter. The nurse reviews foot care with the client and her daughter. Why would the nurse feel that foot care is so important to this client? An elderly client with foot ulcers experiences severe foot pain due to the diabetic polyneuropathy. Avoiding foot ulcers may mean the difference between institutionalization and continued independent living. Hypoglycemia is linked with a risk for falls; this risk is elevated in older adults with diabetes. Oral antihyperglycemics have the possible adverse effect of decreased circulation to the lower extremities.
Avoiding foot ulcers may mean the difference between institutionalization and continued independent living.
A client receiving external radiation to the left thorax to treat lung cancer has a nursing diagnosis of Risk for impaired skin integrity.Which intervention should be part of this client's care plan? Avoiding using soap on the irradiated areas Applying talcum powder to the irradiated areas daily after bathing Wearing a lead apron during direct contact with the client Removing thoracic skin markings after each radiation treatment
Avoiding using soap on the irradiated areas
Insulin is secreted by which of the following types of cells? Beta cells Melanocytes Neural cells Basal cells
Beta cells
Mrs. Unger is a 53-year-old woman who was diagnosed with breast cancer following a process that began with abnormal screen mammography results. Mrs. Unger, her oncologist, and surgeon have agreed on a mastectomy as treatment and have discussed the importance of rigorously assessing whether her cancer has metastasized. What action will best detect possible metastasis of Mrs. Unger's breast cancer? Serial bone marrow biopsies Biopsy of the axillary lymph nodes Careful grading of the tumor cells Gauging her response to radiation therapy
Biopsy of the axillary lymph nodes
The nurse is providing education to a client with cancer radiation treatment options. The nurse determines that the client understands the teaching when the client states that which type of radiation aims to protect healthy tissue during the treatment? Proton therapy Teletherapy Brachytherapy External
Brachytherapy
A client has presented with signs and symptoms that are characteristic of acute kidney injury, but preliminary assessment reveals no obvious risk factors for this health problem. The nurse should recognize the need to interview the client about what topic? Typical diet Allergy status Psychosocial stressors Current medication use
Current medication use
An older adult client with type 2 diabetes is brought to the emergency department by his daughter. The client is found to have a blood glucose level of 600 mg/dL (33.3 mmol/L). The client's daughter reports that the client recently had a gastrointestinal virus and has been confused for the last 3 hours. The diagnosis of hyperglycemic hyperosmolar syndrome (HHS) is made. What nursing action would be a priority? Administration of antihypertensive medications Administering sodium bicarbonate intravenously Reversing acidosis by administering insulin Fluid and electrolyte replacement
Fluid and electrolyte replacement
The nurse analyzes a urinalysis report. He is aware that the presence of this substance in the urine indicates a blood level that exceeds the kidney's reabsorption capacity. Select the substance. Sodium Bicarbonate Creatinine Glucose
Glucose
The nurse is caring for a client suspected of having renal dysfunction. When reviewing laboratory results for this client, the nurse interprets the presence of which substances in the urine as most suggestive of pathology? Potassium and sodium Bicarbonate and urea Glucose and protein Creatinine and chloride
Glucose and protein
Chemotherapeutic agents have which effect associated with the renal system? Hypokalemia Increased uric acid excretion Hypophosphatemia Hypercalcemia
Increased uric acid excretion
The nurse is caring for a client who has just been told that her stage IV colon cancer has recurred and metastasized to the liver. The oncologist offers the client the option of surgery to treat the progression of this disease. What type of surgery does the oncologist offer? Palliative Reconstructive Salvage Prophylactic
Palliative
A client with status asthmaticus requires endotracheal intubation and mechanical ventilation. Twenty-four hours after intubation, the client is started on the insulin infusion protocol. The nurse must monitor the client's blood glucose levels hourly and watch for which early signs and symptoms associated with hypoglycemia? Sweating, tremors, and tachycardia Dry skin, bradycardia, and somnolence Bradycardia, thirst, and anxiety Polyuria, polydipsia, and polyphagia
Sweating, tremors, and tachycardia
Dilutional hyponatremia occurs in which disorder? Diabetes insipidus (DI) Syndrome of inappropriate antidiuretic hormone secretion (SIADH) Pheochromocytoma Addison disease
Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Which of the following insulins has the longest onset of action? Ultralente Humalog Regular NPH
Ultralente
During which step of cellular carcinogenesis do cellular changes exhibit increased malignant behavior? Promotion Initiation Prolongation Progression
Progression
Following a renal biopsy, a client reports severe pain in the back, the arms, and the shoulders. Which intervention should be offered by the nurse? Assess the patient's back and shoulder areas for signs of internal bleeding. Distract the client's attention from the pain. Provide analgesics to the client. Enable the client to sit up and ambulate.
Assess the patient's back and shoulder areas for signs of internal bleeding.
An obese Hispanic client, age 65, is diagnosed with type 2 diabetes. Which statement about diabetes mellitus is true? Nearly two-thirds of clients with diabetes mellitus are older than age 60. Diabetes mellitus is more common in Hispanics and Blacks than in Whites. Type 2 diabetes mellitus is less common than type 1 diabetes mellitus. Approximately one-half of the clients diagnosed with type 2 diabetes are obese.
Diabetes mellitus is more common in Hispanics and Blacks than in Whites.
A client is diagnosed with metastatic adenocarcinoma of the stomach. The physician orders mitomycin and other chemotherapeutic agents for palliative treatment. How does mitomycin exert its cytotoxic effects? It inhibits deoxyribonucleic acid (DNA) synthesis. It inhibits ribonucleic acid (RNA) synthesis. It's cell cycle-phase specific. It inhibits protein synthesis.
It inhibits deoxyribonucleic acid (DNA) synthesis.
A client was diagnosed with cancer several weeks ago and family members describe him as "utterly distraught." The client has fully withdrawn from social and family contact. What is the nurse's bestaction? Reassure the client and the family that these types of responses to cancer are common. Refer the client to the appropriate mental health provider. Educate the client about the mental health benefits of exercise. Reassure the family that the client is grieving and will eventually come to terms with the diagnosis.
Refer the client to the appropriate mental health provider.
A nurse educator been invited to local seniors center to discuss health-maintaining strategies for older adults. The nurse addresses the subject of diabetes mellitus, its symptoms, and consequences. What should the educator teach the participants about type 1 diabetes? The participants are unlikely to develop a new onset of type 1 diabetes. New cases of diabetes are highly uncommon in older adults. New cases of diabetes will be split roughly evenly between type 1 and type 2. Type 1 diabetes always develops before the age of 20.
The participants are unlikely to develop a new onset of type 1 diabetes.
A young female client has received chemotherapeutic medications and asks about any effects the treatments will have related to her sexual health. The most appropriate statement by the nurse is "You will need to practice birth control measures." "You will continue having your menses every month." "You will experience menopause now." "You will be unable to have children."
"You will need to practice birth control measures."
A client is experiencing some secretion abnormalities, for which diagnostics are being performed. Which substance is typically reabsorbed and not secreted in urine? glucose potassium creatinine chloride
glucose
The nurse is working with a client who has had an allo-hematopoietic stem cell transplant (HSCT). The nurse notices a diffuse rash and diarrhea. The nurse contacts the physician to report that the client has symptoms of nadir. graft-versus-host disease. metastasis. acute leukopenia.
graft-versus-host disease
Retention of which electrolyte is the most life-threatening effect of renal failure? Calcium Sodium Potassium Phosphorous
potassium
A 60-year-old client comes to the ED reporting weakness, vision problems, increased thirst, increased urination, and frequent infections that do not seem to heal easily. The physician suspects that the client has diabetes. Which classic symptom should the nurse watch for to confirm the diagnosis of diabetes? Numbness Increased hunger Fatigue Dizziness
Increased hunger
A diabetes nurse educator is teaching a group of clients with type 1 diabetes about "sick day rules." What guideline applies to periods of illness in a diabetic client? Do not eliminate insulin when nauseated and vomiting. Report elevated glucose levels greater than 150 mg/dL (8.3 mmol/L). Eat three substantial meals a day, if possible. Reduce food intake and insulin doses in times of illness.
Do not eliminate insulin when nauseated and vomiting.
Following a bone marrow transplantation (BMT), the patient should be monitored for at least: 3 months 3 days 4 weeks 5 months
3 months
x A nurse has been caring for a client newly diagnosed with diabetes mellitus. The client is overwhelmed by what he's facing and not sure he can handle giving himself insulin. This client has been discharged and the charge nurse is insisting the nurse hurry because she needs the space for clients being admitted. How should the nurse handle the situation? Suggest the client find a supportive friend or family member to assist in his care. Ask the physician to delay the discharge because the client requires further teaching. Tell the charge nurse she doesn't believe this client will be safe and refuse to rush. Ask the physician for a referral for a diabetes nurse-educator to see the client before discharge.
Ask the physician to delay the discharge because the client requires further teaching.
Which type of vaccine uses the client's own cancer cells, which are killed and prepared for injection back into the client? Autologous Prophylactic Therapeutic Allogeneic
Autologous
A woman with a progressively enlarging neck comes into the clinic. She mentions that she has been in a foreign country for the previous 3 months and that she didn't eat much while she was there because she didn't like the food. She also mentions that she becomes dizzy when lifting her arms to do normal household chores or when dressing. What endocrine condition should the nurse expect the health care provider to diagnose? Diabetes mellitus Goiter Diabetes insipidus Cushing's syndrome
Goiter
The home care nurse is conducting client teaching with a client on corticosteroid therapy. To achieve consistency with the body's natural secretion of cortisol, when should the home care nurse instruct the client to take the corticosteroids? In the evening between 4 PM and 6 PM Prior to going to sleep at night At noon every day In the morning between 7 AM and 8 AM
In the morning between 7 AM and 8 AM
A patient with a history of hypothyroidism is admitted to the intensive care unit unconscious and with a temperature of 95.2ºF. A family member informs the nurse that the patient has not taken thyroid medication in over 2 months. What does the nurse suspect that these findings indicate? Thyroid storm Myxedema coma Diabetes insipidus Syndrome of inappropriate antidiuretic hormone (SIADH)
Myxedema coma
The nurse is preparing to administer intermediate-acting insulin to a patient with diabetes. Which insulin will the nurse administer? NPH Iletin II Lispro (Humalog) Glargine (Lantus)
NPH
According to the tumor-node-metastasis (TNM) classification system, T0 means there is No evidence of primary tumor No regional lymph node metastasis No distant metastasis Distant metastasis
No evidence of primary tumor
The nurse is caring for a patient with hyperparathyroidism and observes a calcium level of 16.2 mg/dL. What interventions does the nurse prepare to provide to reduce the calcium level? Select all that apply. Administration of calcitonin Administration of calcium carbonate Intravenous isotonic saline solution in large quantities Monitoring the patient for fluid overload Administration of a bronchodilator
Administration of calcitonin Intravenous isotonic saline solution in large quantities Monitoring the patient for fluid overload
The nurse is caring for a client who has returned to the postsurgical suite after postanesthetic recovery from a nephrectomy. The nurse's most recent hourly assessment reveals a significant drop in level of consciousness and BP as well as scant urine output over the past hour. What is the nurse's best response? Assess the client for signs of bleeding and inform the primary provider. Monitor the client's vital signs every 15 minutes for the next hour. Reposition the client and reassess vital signs. Palpate the client's flanks for pain and inform the primary provider.
Assess the client for signs of bleeding and inform the primary provider.
An oncology client has just returned from the postanesthesia care unit after an open hemicolectomy. This client's plan of nursing care should prioritize which of the following? Assess the client hourly for signs of compartment syndrome. Assess the client's fine motor skills once per shift. Assess the client's wound for dehiscence every 4 hours. Maintain the client's head of bed at 45 degrees or more at all times.
Assess the client's wound for dehiscence every 4 hours.
A patient is suspected of having a pheochromocytoma and is having diagnostic tests done in the hospital. What symptoms does the nurse recognize as most significant for a patient with this disorder? Blood pressure varying between 120/86 and 240/130 mm Hg Heart rate of 56-64 bpm Shivering Complaints of nausea
Blood pressure varying between 120/86 and 240/130 mm Hg
A client with chronic renal failure (CRF) is admitted to the urology unit. Which diagnostic test results are consistent with CRF? Increased pH with decreased hydrogen ions Increased serum levels of potassium, magnesium, and calcium Blood urea nitrogen (BUN) 100 mg/dL and serum creatinine 6.5 mg/dL Uric acid analysis 3.5 mg/dL and phenolsulfonphthalein (PSP) excretion 75%
Blood urea nitrogen (BUN) 100 mg/dL and serum creatinine 6.5 mg/dL
Accidental removal of one or both parathyroid glands can occur during a thyroidectomy. Which of the following is used to treat tetany? Calcium gluconate Synthroid Propylthiouracil (PTU) Tapazole
Calcium gluconate
Your patient has recently completed her first round of chemotherapy in the treatment of lung cancer. When reviewing this morning's blood work, what findings would be suggestive of myelosuppression? Decreased sodium levels and decreased potassium levels Increased creatinine and blood urea nitrogen (BUN) Decreased platelets and red blood cells Increased white blood cells and c-reactive protein (CRP)
Decreased platelets and red blood cells
chemotherapy in the treatment of lung cancer. When reviewing this morning's blood work, what findings would be suggestive of myelosuppression? Decreased sodium levels and decreased potassium levels Increased creatinine and blood urea nitrogen (BUN) Decreased platelets and red blood cells Increased white blood cells and c-reactive protein (CRP)
Decreased platelets and red blood cells
A patient with uterine cancer is being treated with internal radiation therapy. What would the nurse's priority responsibility be for this patient? Explain to the patient that she will continue to emit radiation while the implant is in place. Maintain as much distance as possible from the patient while in the room. Alert family members that they should restrict their visiting to 5 minutes at any one time. Wear a lead apron when providing direct patient care.
Explain to the patient that she will continue to emit radiation while the implant is in place.
A client presents to the clinic reporting symptoms that suggest diabetes. What criteria would support checking blood levels for the diagnosis of diabetes? Fasting plasma glucose greater than or equal to 126 mg/dL (7.0 mmol/L) Random plasma glucose greater than 150 mg/dL (8.3 mmol/L) Fasting plasma glucose greater than 116 mg/dL (6.4 mmol/L) on two separate occasions Random plasma glucose greater than 126 mg/dL (7.0 mmol/L)
Fasting plasma glucose greater than or equal to 126 mg/dL (7.0 mmol/L)
A client with acute renal failure progresses through four phases. Which describes the onset phase? It is accompanied by reduced blood flow to the nephrons. Fluid volume excess develops, which leads to edema, hypertension, and cardiopulmonary complications. The excretion of wastes and electrolytes continues to be impaired despite increased water content of the urine. Normal glomerular filtration and tubular function are restored.
It is accompanied by reduced blood flow to the nephrons.
Urine specific gravity is a measurement of the kidney's ability to concentrate and excrete urine. The specific gravity measures urine concentration by measuring the density of urine and comparing it with the density of distilled water. Which is an example of how urine concentration is affected? On a hot day, a person who is perspiring profusely and taking little fluid has low urine output with a high specific gravity. On a hot day, a person who is perspiring profusely and taking little fluid has high urine output with a low specific gravity. A person who has a high fluid intake and who is not losing excessive water from perspiration, diarrhea, or vomiting has scant urine output with a high specific gravity. When the kidneys are diseased, the ability to concentrate urine may be impaired and the specific gravity may vary widely.
On a hot day, a person who is perspiring profusely and taking little fluid has low urine output with a high specific gravity.
Which type of surgery is used in an attempt to relieve complications of cancer? Palliative Prophylactic Reconstructive Salvage
Palliative
A client with a diagnosis of gastric cancer has been unable to tolerate oral food and fluid intake and her tumor location rules out the use of enteral feeding. What intervention will best meet this client's nutritional needs? Administration of parenteral feeds via a peripheral IV Parenteral nutrition given via a peripherally inserted central catheter Insertion of an NG tube for administration of feeds Maintaining NPO status and IV hydration until treatment completion
Parenteral nutrition given via a peripherally inserted central catheter
Which clinical characteristic is associated with type 1 diabetes (previously referred to as insulin-dependent diabetes mellitus)? Presence of islet cell antibodies Obesity Rare ketosis Requirement for oral hypoglycemic agents
Presence of islet cell antibodies
A client with a brain tumor is undergoing radiation and chemotherapy for treatment of cancer. The client has recently reported swelling in the gums, tongue, and lips. Which is the most likely cause of these symptoms? Neutropenia Extravasation Nadir Stomatitis
Stomatitis
A nurse is administering a peripheral chemotherapeutic agent. What nursing actions are used for extravasation of a chemotherapeutic agent? Select all that apply. Stop the medication infusion at the first sign of extravasation Aspirate any residual drug from the IV line Administer an antidote, if indicated Apply warm compresses to the irritated site to encourage healing Schedule the client for implanted device
Stop the medication infusion at the first sign of extravasation Aspirate any residual drug from the IV line Administer an antidote, if indicated
A client with type 2 diabetes normally achieves adequate glycemic control through diet and exercise. Upon being admitted to the hospital for a cholecystectomy, however, the client has required insulin injections on two occasions. The nurse would identify what likely cause for this short-term change in treatment? Alterations in bile metabolism and release have likely caused hyperglycemia. Stress has likely caused an increase in the client's blood sugar levels. The client has likely overestimated her ability to control her diabetes using nonpharmacologic measures. The client's volatile fluid balance surrounding surgery has likely caused unstable blood sugars.
Stress has likely caused an increase in the client's blood sugar levels.
When teaching a client diagnosed with hypothyroidism about medical intervention, which is important for the nurse to communicate? TH may decrease blood glucose concentrations. TH may increase the effect of digitalis preparation. Normal dosages of sedative agents are prescribed. Increased resorption occurs with TH.
TH may increase the effect of digitalis preparation
The most recent blood work of a client with a long-standing diagnosis of type 1 diabetes has shown the presence of microalbuminuria. What is the nurse's most appropriate action? Teach the client about actions to slow the progression of nephropathy. Ensure that the client receives a comprehensive assessment of liver function. Determine whether the client has been using expired insulin. Administer a fluid challenge and have the test repeated.
Teach the client about actions to slow the progression of nephropathy.
What should the nurse tell a client who is about to begin chemotherapy and is anxious about hair loss? The client should consider getting a wig or cap prior to beginning treatment. Alopecia related to chemotherapy is relatively uncommon. The hair will grow back within 2 months post therapy. The hair will grow back the same as it was before treatment.
The client should consider getting a wig or cap prior to beginning treatment.
The physician is attending to a 72-year-old client with a malignant brain tumor. The physician recommends immediate radiation therapy. What is a reason for the physician's recommendation? To remove the tumor from the brain To prevent the formation of new cancer cells To analyze the lymph nodes involved To destroy marginal tissues
To prevent the formation of new cancer cells
Which instructions are necessary for a client receiving systemic internal radiation therapy who is being discharged? Select all that apply. Wash hands carefully following toileting. Avoid all physical contact with family members. Use separate towels. Drink only clear fluids and water. Wash laundry separately.
Wash hands carefully following toileting. Use separate towels. Wash laundry separately.
The nurse is caring for a client with a history of systemic lupus erythematosus who has been recently diagnosed with end-stage kidney disease (ESKD). The client has an elevated phosphorus level and has been prescribed calcium acetate to bind the phosphorus. The nurse should teach the client to take the prescribed medication at what time? Only when needed Daily at bedtime First thing in the morning With each meal
With each meal