Test #2 COTAC 2
A. Bed rest
A cervical radiation implant is placed in the client for treatment of cervical cancer. The nurse initiates what most appropriate activity order for this client? A. Bed rest B. Out of bed ad lib C. Out of bed in a chair only D. Ambulation to the bathroom only
C. Sore throat
The male client is receiving external radiation to the neck for cancer of the larynx. The most likely side effect to be expected is: A. Dyspnea B. Diarrhea C. Sore throat D. Constipation
D) Avoid using soap on the treatment area.
An oncology nurse is caring for a client who has developed erythema following radiation therapy. What should the nurse instruct the client to do? A) Periodically apply ice to the area. B) Keep the area cleanly shaven. C) Apply petroleum jelly to the affected area. D) Avoid using soap on the treatment area.
d)3 feet
Radiation protection is very important to implement when performing nursing procedures. When the nurse is not performing any nursing procedures what distance should be maintained from the client? a)1 feet b)2 feet c)2.5 feet d)3 feet
C) Teaching clients to wear sunscreen
What nursing action best demonstrates primary cancer prevention? A) Encouraging yearly Pap tests B) Teaching testicular self-examination C) Teaching clients to wear sunscreen D) Facilitating screening mammograms
c)Uterine prolapse
When examining a female client, the nurse observes tissue protruding from the vaginal opening. The nurse checks the medical record for a documented history of which of the following disorders? a)Rectocele b)Cystocele c)Uterine prolapse d)Vaginal infection
D. Sarcoma
Mr. Miller has been diagnosed wiht bone cancer. What type of cancer does Mr. Miller have? A. Melanoma B. Carcinoma C. Lymphoma D. Sarcoma
Patient Education
_______________ is an essential part of nursing care of a patient with a genital herpes infection.
C. The test can detect early evidence of cervical cancer.
The school nurse is presenting a class on female reproductive health. The nurse should describe what aspect of Pap smears? A. The test may be performed at any time during the client's menstrual cycle. B. The smear should be done every 2 years. C. The test can detect early evidence of cervical cancer. D. False-positive Pap smear results often occur from not douching before the examination.
St. John's Wort
A nurse is teaching a group of young women about the use of oral contraceptives. The nurse should teach that taking which of the following herbal preparations reduces the effectiveness of this birth control method? a)Ginseng b)Gingko biloba c)St. John's wort d)Saw palmetto
A. Tumor lysis syndrome (TLS)
The home health nurse is performing a home visit for an oncology client discharged 3 days ago after completing treatment for non-Hodgkin's lymphoma. The nurse's assessment should include examination for the signs and symptoms of what complication? A. Tumor lysis syndrome (TLS) B. Syndrome of inappropriate antidiuretic hormone (SIADH) C. Disseminated intravascular coagulation (DIC) D. Hypercalcemia
D. Frequent douching
The nurse is teaching a client preventative measures regarding vaginal infections. The nurse should include which of the following as an important risk factor? A. High estrogen levels B. Late menarche C. Caucasian ethnicity D. Frequent douching
A. A nonhealing sore C. Change in moles D. Change in bowel patterns E. Nagging cough
A nurse is teaching a client about the seven warning signs of cancer. Which of the following signs should the nurse include as manifestations of cancer? (select all that apply) A. A nonhealing sore B. weight gain C. Change in moles D. Change in bowel patterns E. Nagging cough F. Bloating
1) Apply hydrating lotions.
After radiation treatment, a client reports dryness, redness, and scaling of his skin occurring within the designated radiation treatment markings. The nurse should instruct the client to take which of the following actions? 1) Apply hydrating lotions. 2) Apply moist heat. 3) Sit in the sun for 10 min per day. 4) Wash with plain soap and water.
C. Breast cancer D. Cardiovascular disease E. Venous thromboembolism
A 48-year-old woman presenting for care is seeking information about hormone therapy (HT) for the treatment of her perimenopausal symptoms. The client's need for relief from hot flashes and other symptoms will be weighed carefully against the increased risks of what complications of HT? Select all that apply. A. Anaphylaxis B. Osteoporosis C. Breast cancer D. Cardiovascular disease E. Venous thromboembolism
D. Vitamin supplements
A 51-year-old woman has come to the OB/GYN clinic for her annual physical. She tells the nurse that she has been experiencing severe hot flashes, but that she is reluctant to begin hormone therapy (HT). What potential solution should the nurse discuss with the client? A. Sodium restriction B. Adopting a vegan diet C. Massage therapy D. Vitamin supplements
C. Constipation
A client had undergone radiation therapy (external). The expected side effects include the following apart from: A. Hair loss B. Ulceration of oral mucous membranes C. Constipation D. Headache
C) "You are anxious about the surgery. Do you see smoking as helping?"
A client has been hospitalized for a wedge resection of the left lower lung lobe after a routine chest x-ray shows carcinoma. The client states that he is anxious and asks if he can smoke. Which statement by the nurse would be most therapeutic? A) "Smoking is the reason you are here." B) "The doctor left orders for you not to smoke." C) "You are anxious about the surgery. Do you see smoking as helping?" D) "Smoking is OK right now, but after your surgery it is contraindicated."
B) Nausea and vomiting
A client newly diagnosed with cancer is scheduled to begin chemotherapy treatment and the nurse is providing anticipatory guidance about potential adverse effects. When addressing the most common adverse effect, what should the nurse describe? A) Pruritus (itching) B) Nausea and vomiting C) Altered glucose metabolism D) Confusion
D. A selective serotonin reuptake inhibitor (SSRI)
A client states that PMS is significantly disrupting her quality of life and that conservative management has failed to produce relief. What pharmacologic treatment may benefit this client? A. An opioid analgesic B. A calcium channel blocker C. A monoamine oxidase inhibitor (MAOI) D. A selective serotonin reuptake inhibitor (SSRI)
d)Breasts can be examined in the shower with soapy hands.
A community health nurse is developing a pamphlet about breast self-examination (BSE) for a local health fair. Which of the following instructions should the nurse include? a)Expect some breast dimpling or discharge with age. b)For those who have a menstrual cycle, perform a BSE every month, 2 or 3 days before menstruation. c)Using the palm of the hand, feel for lumps using a circular motion. d)Breasts can be examined in the shower with soapy hands.
A. Liver
A female client with cancer is being evaluated for possible metastasis. Which of the following is one of the most common metastasis sites for cancer cells? A. Liver B. Colon C. Reproductive tract D. White blood cells (WBCs)
C. fatigue.
A female client with cancer is scheduled for radiation therapy. The nurse knows that radiation at any treatment site may cause a certain adverse effect. Therefore, the nurse should prepare the client to expect: A. hair loss. B. stomatitis. C. fatigue. D. vomiting.
B. Pick up the implant with long-handled forceps and place it in a lead-lined container.
A male client is in isolation after receiving an internal radioactive implant to treat cancer. Two hours later, the nurse discovers the implant in the bed linens. What should the nurse do first? A. Stand as far away from the implant as possible and call for help. B. Pick up the implant with long-handled forceps and place it in a lead-lined container. C. Leave the room and notify the radiation therapy department immediately. D. Have the client pick it up and put it in the lead container
d)Dysmenorrhea that is unresponsive to NSAIDs.
A nurse in a clinic is interviewing a client who has a possible diagnosis of endometriosis. Which of the following findings in the client's history should the nurse recognize as consistent with a diagnosis of endometriosis? a)A history of pelvic inflammatory disease (PID). b)Abdominal bloating starting several days before menses. c)An atypical Papanicolaou smear at her last clinic visit. d)Dysmenorrhea that is unresponsive to NSAIDs.
A. High-absorbency tampons
A nurse in a college health clinic is speaking to a group of adolescents about toxic shock syndrome (TSS). Which of the following should the nurse include in the teaching as increasing the risk for contracting TSS? A. High-absorbency tampons B. Mosquito bites C. Travel to foreign countries D. Multiple sexual partners
a)Isosorbide
A nurse in a provider's clinic is caring for a client who reports erectile dysfunction and requests a prescription for sildenafil. Which of the following medications currently prescribed for the client is a contraindication to taking sildenafil? a)Isosorbide b)Phenytoin c)Metronidazole d)Prednisone
b)Glucose
A nurse in a provider's office is planning care for a client who has a new diagnosis of polycystic ovarian syndrome. The nurse should plan to monitor which of the following laboratory values? a)BUN b)Glucose c)Liver function d)Thyroid-stimulating hormone
A. hoarseness
A nurse is assessing a client who has a long history of smoking and is suspected of having laryngeal cancer. The nurse should anticipate that the client will report that her earliest manifestation was which of the following symptoms? A. hoarseness B. dyspnea C. dysphagia D. weight loss
b)A Papanicolaou test
A nurse is caring for a client who asks to be screened for cervical cancer because a relative has been diagnosed with it. Which of the following tests should the nurse expect the provider to use? a)A serum prolactin level b)A Papanicolaou test c)A vaginal ultrasound d)An endometrial biopsy
b)"Do you have a cell phone you can talk to friends and family on?"
A nurse is caring for a client who is being treated with a cesium implant. The client tells the nurse, "I feel so isolated and alone in this room." After acknowledging the client's feelings of loneliness, which of the following responses should the nurse provide? a)"I will come and sit with you for 10 minutes each hour." b)"Do you have a cell phone you can talk to friends and family on?" c)"I'll ask the charge nurse to admit someone to your room for company." d)"You're scheduled for discharge in 2 days so this isolation will be over soon."
b)History of breast cancer
A nurse is caring for a client who is experiencing menopausal symptoms and asks the nurse about menopausal hormone therapy (HT). The nurse should inform the client that HT is not recommended due to which of the following findings in the client's medical history? a)History of dermatitis b)History of breast cancer c)Multiple hospitalizations for COPD d)Concurrent treatment for GERD
"Many herbal products have not undergone long-term testing for safety and efficacy."
A nurse is caring for a client who is menopausal and asks the nurse about the use of herbal therapies to reduce her discomfort. Which of the following statements should the nurse make? "Many herbal products have not undergone long-term testing for safety and efficacy." "Herbal therapies have no benefits and will not help your discomfort." "You should begin immediately as they will help you." "There are no ill effects associated with the use of herbal therapies."
d)Take blood pressures on the client's non-affected arm.
A nurse is caring for a client who is postoperative following a right-sided mastectomy and has a drain connected to a portable drainage evacuator. Which of the following actions should the nurse? a)Dangle the operative limb for 5 min every hour. b)Place the head of the client's bed at a 15° angle. c)Keep the wound drain evacuator fully expanded at all times. d)Take blood pressures on the client's non-affected arm.
b)Observe for signs of infection.
A nurse is caring for a client who is receiving radiation therapy to treat lung cancer. Which of the following actions should the nurse take? a)Review laboratory test results for low hemoglobin. b)Observe for signs of infection. c)Monitor the mouth for signs of xerostomia. d)Examine the skin for generalized urticaria.
d)Colposcopy
A nurse is caring for a client whose Papanicolaou (Pap) test cytology results are abnormal. Which of the following procedures should the nurse anticipate for this client? a)Rectovaginal palpation by the provider b)Dilation and curettage c)Human chorionic gonadotropin (hCG) test d)Colposcopy
b)Influenza-like symptoms
A nurse is caring for a male client who has a new diagnosis of genital herpes (HSV 2). Which of the following findings should the nurse expect? a)Anuria b)Influenza-like symptoms c)White- or flesh-colored papillary growths in the genital area d)Green penile discharge
B. Client is 5 feet 6 inches, and weighs 112 kg. (246 lbs) C. The client has a finger stick blood glucose of 198
A nurse is caring for a newly admitted client who is being admitted for testing for infertility. The client explains she has polycystic ovariy syndrome. What assessment factors noted by the nurse might have an impact on fertility? A. The client denies any moodiness or irritability B. Client is 5 feet 6 inches, and weighs 112 kg. (246 lbs) C. The client has a finger stick blood glucose of 198 D. Client states her periods are regular E. The client is noted to have acne
1) Keep a body map of skin lesions.
A nurse is developing an education program about skin cancer for a community center. Which of the following instructions should the nurse plan to include? 1) Keep a body map of skin lesions. 2) Examine your body every 2 months for lesions. 3) Avoid the sun after 3 p.m. 4) Limit tanning bed use.
a)Abstain from ejaculation for at least 2 to 5 days prior to the test.
A nurse is instructing a male client about a semen analysis to be done for suspected infertility. Which of the following should be included in the teaching? a)Abstain from ejaculation for at least 2 to 5 days prior to the test. b)Refrigerate the specimen after collection. c)Leave the specimen at room temperature for 3 to 4 hr prior to transport to the laboratory. d)Collect the specimen using a condom with spermicidal lubricant.
d)Limit the number of health care workers entering the room.
A nurse is planning care for a client who has immunosuppression following chemotherapy. Which of the following interventions should the nurse include in the plan of care? a)Insert an indwelling catheter to monitor sediment in the urine. b)Take the client's temperature once per shift. c)Provide the client with fresh fruit to avoid constipation. d)Limit the number of health care workers entering the room.
Remind the client he might feel a constant urge to void.
A nurse is planning care for a client who is 2 hr postoperative following a transurethral resection of the prostate. The client is receiving continuous bladder irrigation. Which of the following interventions should the nurse include? Restrict the client's oral fluid intake. Remind the client he might feel a constant urge to void. Monitor the client's urinary output every 6 hr. Weigh the client every evening.
b)Fresh flowers and potted plants in the room
A nurse is planning care for a client who is being treated with chemotherapy and radiation for metastatic breast cancer, and who has neutropenia. The nurse should include which of the following restrictions in the client's plan of care? a)All visitors from entering the client's room b)Fresh flowers and potted plants in the room c)Oral fluid intake to between meals only d)Activities that could result in bleeding
d)Prevents osteoporotic fractures.
A nurse is presenting educational materials for a group of middle-aged clients about menopausal hormone therapy following total hysterectomy. Which of the following information should the nurse include in the information? a)Take at different times of the day. b)Take an extra dose if missed a day. c)Prevents from having a cerebral hemorrhage. d)Prevents osteoporotic fractures.
1) "Eating a high fiber diet will reduce my risk for developing skin cancer."
A nurse is providing teaching to a client about preventing skin cancer. Which of the following client statements indicates a need for further teaching? 1) "Eating a high fiber diet will reduce my risk for developing skin cancer." 2) "I should check my skin monthly for any changes." 3) "I should avoid the use of tanning booths." 4) "I should use sunscreen even on cloudy days."
b)Artificial lubrication can be used to treat vaginal itching and dryness.
A nurse is providing teaching to a client who has had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for uterine cancer. Which of the following instructions should the nurse include in the teaching? a)A Papanicolaou (Pap) test should be performed every 6 months. b)Artificial lubrication can be used to treat vaginal itching and dryness. c)Increased vaginal drainage typically occurs 5 days following surgery. d)Resume sexual intercourse in 2 to 3 weeks.
a)Before menstruation begins
A nurse is speaking with a 35-year-old client who has fibrocystic disease of the breasts. At which of the following times should the nurse inform the client that manifestations are most evident? a)Before menstruation begins b)After menstruation ends c)During cold weather d)During hot weather
B. having sex with a partner who has or has had multiple sex partners C. being sexually active D. being young E. having multiple sex partners
A nurse is teaching a class about HPV to teens at a youth center Risk factors that would be included in this education would include which of the following? A. using alcohol or illicit drugs B. having sex with a partner who has or has had multiple sex partners C. being sexually active D. being young E. having multiple sex partners F. being older
a)"Transmission of the disease will not occur when my lesions are gone."
A nurse is teaching a client who has a new diagnosis of genital herpes. Which of the following statements by the client indicates the need for further teaching? a)"Transmission of the disease will not occur when my lesions are gone." b)"Abstaining from sexual activity reduces the risk of transmission of the disease." c)"The use of condoms will reduce the risk of transmission." d)"Antiviral medications will not cure the infection."
A. "A CA 125 test is used to monitor a client's progress during treatment of ovarian cancer."
A nurse is teaching a newly licensed nurse about the purpose of a CA 125 test. Which of the following statements should the nurse include in the teaching? A. "A CA 125 test is used to monitor a client's progress during treatment of ovarian cancer." B. "A CA 125 test is used to identify a Bartholin cyst." C. "A CA 125 test is used to confirm a diagnosis of ovarian cancer." D. "A CA 125 test is used to measure testosterone level."
A) Liver function tests (LFTs)
A nurse who works in an oncology clinic is assessing a client who has arrived for a 2-month follow-up appointment following chemotherapy. The nurse notes that the client's skin appears yellow. Which blood tests should be done to further explore this clinical sign? A) Liver function tests (LFTs) B) Complete blood count (CBC) C) Platelet count D) Blood urea nitrogen and creatinine
B) Primary prevention
A public health nurse has formed an interdisciplinary team that is developing an educational program entitled Cancer: The Risks and What You Can Do About Them. Participants will receive information regarding many different types of cancers. This program is an example of what type of health promotion activity? A) Disease prophylaxis B) Primary prevention C) Secondary prevention D) Tertiary prevention
A. Uric acid level
A with tumor lysis syndrome (TLS) is taking allopurinol (Zyloprim). Which laboratory value should the nurse monitor to determine the effectiveness of the medication? A. Uric acid level B. Serum potassium C. Serum phosphate D. Blood urea nitrogen (BUN)
b)Providing a solution of hydrogen
During chemotherapy, an oncology client has a nursing diagnosis of impaired oral mucous membrane related to decreased nutrition and immunosuppression secondary to the cytotoxic effects of chemotherapy. Which nursing intervention is most likely to decrease the pain of stomatitis? a)Recommending that the client discontinue chemotherapy b)Providing a solution of hydrogen peroxide and water for use as a mouth rinse c)Monitoring the client's platelet and leukocyte counts d)Checking regularly for signs and symptoms of stomatitis
2) Basal cell carcinoma
During a routine physical examination, a nurse observes a 1-cm (0.4-in) lesion on a client's chest. The lesion is raised and flesh-colored with pearly white borders. The nurse should recognize that this finding is suggestive of which of the following types of skin cancer? 1) Squamous cell carcinoma 2) Basal cell carcinoma 3) Malignant melanoma 4) Actinic keratosis
B. Tumor, node, metastasis
In staging and grading neoplasm TNM system is used. TNM stands for: A. Time, neoplasm, mode of growth B. Tumor, node, metastasis C. Tumor, neoplasm, mode of growth D. Time, node, metastasis
c)Encapsulated
Neoplasm can be classified as either benign or malignant. The following are characteristics of malignant tumor apart from: a)Metastasis b)Infiltrates surrounding tissues c)Encapsulated d)Poorly differentiated cells
B. Do not allow pregnant women into the client's room
Nurse Joy is caring for a client with an internal radiation implant. When caring for the client, the nurse should observe which of the following principles? A. Limit the time with the client to 1 hour per shift B. Do not allow pregnant women into the client's room C. Remove the dosimeter badge when entering the client's room D. Individuals younger than 16 years old may be allowed to go in the room as long as they are 6 feet away from the client
C. Washing the area with a mild soap and water and patting it dry not rubbing it.
Skin reactions are common in radiation therapy. Nursing responsibilities on promoting skin integrity should be promoted apart from: A. Avoiding the use of ointments, powders and lotion to the area B. Using soft cotton fabrics for clothing C. Washing the area with a mild soap and water and patting it dry not rubbing it. D. Avoiding direct sunshine or cold.
b)Asymmetry
The ABCD method offers one way to assess skin lesions for possible skin cancer. What does the A stand for? a)Actinic b)Asymmetry c)Arcus d)Assessment
B. vaginal smear for syphillis, gonorhrea, or clamydia.
The nurse caring for a client who was diagnosed with Pelvic Inflammatory Disease (PID). What test would the nurse anticipate the provider ordering for this client to identify source of the condition? A. Xray of the pelvis B. vaginal smear for syphillis, gonorhrea, or clamydia. C. MRI of the abdomen D. CBC with differential
A. "Do you ever experience bleeding after intercourse?" B. "How long is your typical cycle?" E. "Do you experience cramps or pain during your cycle?"
The nurse is assessing a 53-year-old woman who has been experiencing dysmenorrhea. What questions should the nurse include in an assessment of the client's menstrual history? Select all that apply. A. "Do you ever experience bleeding after intercourse?" B. "How long is your typical cycle?" C. "Did you have any sexually transmitted infections in early adulthood?" D. "When did your mother and sisters get their first periods?" E. "Do you experience cramps or pain during your cycle?"
A. "You should include weight bearing exercise to your activities" C. "You can spend a few minutes in the sun each day to promote vitamin D production" D. "You can add products high in calcium to your diet" E. "You can add supplemental vitamin D to your diet"
The nurse is caring for a client who is 67 years old and complains of hot flashes and periods of irritability. The client asks how she can prevent early breakdown of bone tissue during menopause without using hormone replacement therapy. The nurse would offer which of the following advise? (Select all that apply) A. "You should include weight bearing exercise to your activities" B. "You should avoid milk products as they inhibit calcium absorption" C. "You can spend a few minutes in the sun each day to promote vitamin D production" D. "You can add products high in calcium to your diet" E. "You can add supplemental vitamin D to your diet"
A. Rate of growth B. Ability to spread D. Ability to cause death
The nurse is describing some of the major characteristics of cancer to a client who has recently received a diagnosis of malignant melanoma. When differentiating between benign and malignant cancer cells, the nurse should explain differences in which of the following aspects? Select all that apply. A. Rate of growth B. Ability to spread C. Cell contents D. Ability to cause death E. Size of cells
D. The bladder must be emptied prior to surgery and a catheter may be placed during surgery.
The nurse is providing preoperative education for a client diagnosed with endometriosis. A hysterectomy has been scheduled. What education topic should the nurse be sure to include for this client? A. Menstrual periods will continue to occur for several months, some of them heavy. B. Normal activity will be permitted within 48 hours following surgery. C. After a hysterectomy, hormone levels remain largely unaffected. D. The bladder must be emptied prior to surgery and a catheter may be placed during surgery.
C. Asking the client's permission to discuss sexuality
The nurse is utilizing the PLISSIT model of sexual health assessment during an interaction with a new client. According to this model, the nurse should begin with what action? A. Conducting a preliminary assessment B. Addressing the client's psychosocial status C. Asking the client's permission to discuss sexuality D. Assessing for physiologic problems
A. Hopelessness related to failed IVF
The nurse is working with a couple who have been unable to conceive despite more than 2 years of trying to get pregnant. The couple has just learned that in vitro fertilization (IVF) was unsuccessful and they are both tearful. What nursing diagnosis is most likely to apply to this couple? A. Hopelessness related to failed IVF B. Acute confusion related to reasons for failed IVF C. Compromised family coping related to unsuccessful IVF D. Moral distress related to unsuccessful IVF
c)"Have you ever used an intrauterine device?"
The nurse should include which of the following questions in a nursing history from a client admitted with pelvic inflammatory disease (PID)? a)"When did you first notice the heavy bleeding with clots?" b)"Do you have spotting after intercourse?" c)"Have you ever used an intrauterine device?" d)"When did you start to have the sudden high fever?"
B) Smoking cessation
The public health nurse is presenting a health-promotion class to a group at a local community center. Which intervention most directly addresses the leading cause of cancer deaths in North America? A) Monthly self breast exams B) Smoking cessation C) Annual colonoscopies D) Monthly testicular exams
3. Faster growing cells are more susceptible to chemotherapy
Which of the following statements is correct about the rate of cell growth in relation to chemotherapy? 1. Faster growing cells are less susceptible to chemotherapy. 2. Non-dividing cells are more susceptible to chemotherapy 3. Faster growing cells are more susceptible to chemotherapy 4. Slower growing cells are more susceptible to chemotherapy.
A) Stopping the administration of the drug immediately
While a client is receiving IV doxorubicin hydrochloride for the treatment of cancer, the nurse observes swelling and pain at the IV site. The nurse should prioritize what action? A) Stopping the administration of the drug immediately B) Notifying the client's physician C) Continuing the infusion but decreasing the rate D) Applying a warm compress to the infusion site
C. Candidiasis
While taking a health history on a 20-year-old female client, the nurse learns that the client is taking miconazole. The nurse is justified in presuming that this client has what medical condition? A. Bacterial vaginosis B. Human papillomavirus (HPV) C. Candidiasis D. Toxic shock syndrome (TSS)