312 Exam #2 Probability
The nurse is caring for a patient receiving intravesical bladder chemotherapy. The nurse should monitor for which adverse effect?
Hematuria
A patient with leukemia is considering whether to have hematopoietic stem cell transplantation (HSCT), The nurse will include which information in the patient's teaching plan?
Hospitalization will be required for several weeks after the stem cell transplant procedure is performed.
The home health nurse cares for a patient who has been receiving biologic therapy for the treatment of cancer. Which statement by the patient indicates a need for further assessment?
I rarely have the energy to get out of bed
The nurse provides discharge teaching for a 61 year old patient who has had a left modified radical mastectomy and lymph node dissection. Which statement by the patient indicates that teaching has been successful?
I will avoid reaching over the stove with my left hand
The nurse teaches a postmenopausal patient with stage III breast cancer about the expected outcomes of cancer treatment. Which patient statement indicates that the teaching has been effective?
I will need to have follow up examinations for many years after I have treatment before I can be considered cured
What is the underlying cause of lymphadenopathy, splenomegaly, and hepatomegaly in leukemia?
Infiltrates of the organs by increased numbers of WBCs in the blood
A patient with acute myelogenous leukemia is considering a hematopoietic stem cell transplant and asks the nurse what is involved. What is the best response b=the nurse can give the patient?
Leukemic cells and bone marrow stem cells are eliminated with chemotherapy and/or total-body radiation, and new bone marrow cells from a donor are infused
A patient who is scheduled for a right breast biopsy asks the nurse the difference between a benign tumor and a malignant tumor. Which answer by the nurse is correct?
Malignant tumors may spread to other tissues or organs
The nurse has obtained the health history, physical assessment data, and laboratory results shown in the accompanying image data for a patient admitted with aplastic anemia. Which information is most important to communicate to the health care provider?
Neutropenia
The nurse initiates a blood transfusion and monitors the patient for signs of a transfusion reaction. Five minutes into the transfusion, which would be a cause for concern?
Patient complains of flank pain and chills
Which collaborative problem will the nurse include in a care plan for a patient admitted to the hospital with idiopathic aplastic anemia?
Potential complication: infection
a patient receiving head and neck radiation for larynx cancer has ulcerations over the oral mucosa and tongue and thick, ropey saliva. Which instructions should the nurse give to this patient?
Rinse the mouth before and after each meal and at bedtime with a saline solution
A patient with a breast biopsy positive for cancer tells the nurse that she read about tamoxifen on the Internet and asks about its use. The best response by the nurse includes which information?
Tamoxifen is the treatment of choice if the tumor has receptors for estrogen on its cells
A 30 year old man with acute myelogenous leukemia develops an absolute neutrophil count of 850 uL while receiving outpatient chemotherapy. Which action by the outpatient clinic nurse is most appropriate?
Teach the patient to administer filgrastim (Neupogen) injections.
A 30-year old man with acute myelogenous leukemia develops an absolute neutrophil count of 850/uL while receiving outpatient chemotherapy. Which action by the outpatient clinic nurse is most appropriate?
Teach the patient to administer filgrastim (Neupogen) injections.
Which finding is most important for the nurse to communicate to the health care provider about a patient who received a liver transplant 1 week ago?
Temperature 100.8F
Ten days after receiving a bone marrow transplant, a patient develops a skin rash. What would the nurse suspect is the cause of this patient's skin rash?
The donor T cells are attacking the patient's skin cells
Which descriptions are characteristic of iron deficiency anemia?
The most common type of anemia, may occur with the removal of the duodenum, associated with chronic blood loss
A patient who has severe pain associated with terminal pancreatic cancer is being cared for at home by family members. Which finding by the nurse indicates that teaching regarding pain management has been effective?
The patient takes opioids around the clock on a regular schedule and uses additional doses when breakthrough pain occurs.
A patient with a large stomach tumor that is attached to the liver is scheduled to have a debulking procedure. Which information should the nurse teach the patient about the outcome of this procedure?
Tumor size will decrease and this will improve the effects of other therapy
A nurse is teaching a group of women about the risk factors for the development of breast cancer. Which statement is true regarding breast cancer risk?
Women who have never had biological children have a greater risk fo breast cancer than women who have biological children
A patient is being worked up for probable acute myeloid leukemia and is being prepped for a bone marrow biopsy. What lab test result would indicate that it is not safe to perform the procedure?
...
How long should the nurse stay with the patient after initiating a blood transfusion?
15 minutes
A 56 year old woman who has a diagnosis of advanced breast cancer recently completed her third course of aggressive chemotherapy. She presents to the emergency department with a temperature of 38.6 C. The nurse calculates the patient's ANC using these laboratory results. What is the correct ANC for this patient?
2064 cells/mcl
Which characteristics are related to an acute hemolytic transfusion reaction?
Acute kidney injury, ABO incompatibility, destruction of donor RBCs
A nurse is speaking to a patient about preventative health care. The patient is confused about the recommendations for mammography. What is the recommended mammography screening timetable for a person with an average risk for breast cancer?
Annually, beginning at 40 years old
A 50 year old man with no risk factors asks the nurse about the recommended frequency for prostate cancer screening. What should the nurse tell him is the recommended interval?
Annually, beginning at 50 years old
During the immediate postoperative period following a modified radical mastectomy, the nurse initially institutes which exercises for the affected arm?
Ask the patient to flex and extend the fingers and wrist of the operative side
a patient who is being treated for advanced prostate cancer tells the nurse about new-onset back pain. Which action should the nurse take first?
Assess for sensation and strength in the legs.
A patient with continuous bladder irrigation following a prostatectomy tells the nurse that he has bladder spasms and leaking of urine around the catheter. What should the nurse do first?
Assess the patency of the catheter
A student nurse prepares a list of teaching topics for a patient with a new diagnosis of breast cancer. Which item should the charge nurse suggest that the student nurse omit from the teaching topic about breast cancer diagnostic testing?
CA 15-3 level testing
An older adult patient who is having an annual check up tells the nurse. "I feel fine, and I don't want to pay for all these unnecessary cancer screening tests!" Which information should the nurse plan to share with the patient?
Consequences of aging on cell-mediated immunity
A patient is being worked up for probably non-Hodgkins lymphoma. What clinical manifestations indicates a poor prognosis?
Fever, night sweats, weight loss
The nurse would be most concerned when the patient's breast examination reveals which finding?
an immobile, hard, non-tender lesion in the upper outer quadrant
Which anemia is manifested with pancytopenia?
aplastic anemia
RM is a 58 year old African American male who was recently been diagnosed with metastatic lung cancer to the bone. He is status post initial treatment with chemotherapy through a peripherally inserted central venous catheter and is currently Day 7 of Cycle 1 of chemotherapy. He has returned to the outpatient clinic for his first follow up appointment. What nursing assessments will identify from this (BP: 98/58, RR: 20, HR: 94) complication early if it develops?
assess temperature, assess CVAD site for signs of infection, assess for altered mental status, assess for persistent cough
Sodium polystyrene sulfonate (Kayexalate) is ordered for a patient with hyperkalemia. Before safely administering the medication, the nurse should assess the:
bowel sounds
A patient asks the nurse about screening tests for colon cancer. The nurse explains that beginning at 50 years old, persons who have an average risk for colon cancer should have a colonoscopy. How often is a colonoscopy recommended for this population?
every 10 years
Which type of transfusion reaction occurs with leukocyte or plasma protein incompatibility and may be avoided with leukocyte reduced blood products?
febrile, nonhemolytic reaction
What is the most common cause of death in patients with a hematological cancer?
hemorrhage
A 53 year old man is scheduled for an annual physical exam. The nurse will plan to teach the patient about the purpose of..
prostate specific antigen (PSA) testing
a patient who has severe pain associated with terminal pancreatic cancer is being cared for at home by family members. Which finding by the nurse indicates that teaching regarding pain management has been effective?
the patient takes opioids around the clock on a regular schedule and uses additional dose when breakthrough pain occurs
The nurse determines that teaching about pernicious anemia has been effective when the patient says
this condition can kill me unless I take injections/nasal spray of the vitamin for the rest of my life
