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1. Mr. Smith has laryngeal carcinoma with regional recurrence. During a routine physical exam you notice he is experiencing stridor. This is most likely an indication of which of the following? a. Extrathoracic airway obstruction b. Intrathoracic airway obstruction c. Tumor d. a and c 2. Which of the following is the most accurate measure of dyspnea in the individual with cancer? a. Respiratory rate b. Oxygen saturation c. Arterial Blood Gas level d. Patient self-report 3. A patient who just been diagnosed with lung cancer denies the diagnosis and refuses to hear about it. The patients denial behaviour is a. Adaptive b. Maladaptive c. Value neutral d. None of the above Which 4. Support of loss and grief in the person suffering from cancer is primarily concerned with which of the following? a. How to manage symptoms of cancer b. How to increase masked grief c. How to identify and aware of losses d. How to use denial to cope with impending loss 5. Which of the following symptoms is least diagnostic of anxiety in the person with cancer? a. Anxiety b. Distractibility c. Worry d. Restlessness 6. When standardized psychiatric interviews and research diagnostic criteria are used, the prevalence of anxiety among cancer patients is approximately which of the following? 7. Early-stage prostate cancer commonly involves surgery or radiation therapy. Diagnostic transurethral resection of the prostate (TURP) commonly causes retrograde ejaculation and may be associated with erectile dysfunction what percentage of the time? a. 10% b. 25% c. 35% d. 50% 8. Chemotherapy agents damage the hair most when it is in which phase of hair growth? a. Anagen b. Catagen c. Telogen d. Transitional 9. Which of the following chemotheraphy agents is least likely to cause hair loss? a. Cyclophosphamide b. Docetaxel c. Vinorelbine d. Etoposide 10. Which of the following is leading cause of cancer death in women in developing counties such as Thailand, Vietnam and Columbia? a. Ovarian Cancer b. Cervical Cancer c. Breast Cancer d. Gastrointestinal Cancer 11. In the Asian culture illnesses such as cancer are believed to be due to which of the following? a. 0.5-10% b. 10-30% c. 30-50% d. 50-
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24. A program that regards rehabilitation in cancer care as a dynamic rather than a passive process is most likely to emphasize both ongoing reassessment and a. Customary convalescence b. A hospital or community base c. Redefinition of goals d. Frequent nursing referrals 25. Which of the following factors have been found to be most closely related to rehabilitation needs of the cancer patient?
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50. The nurse is caring for a client who has undergone vaginal hysterectomy. The nurse avoids which of the following in the care of this client? a) elevating the knee on the bed b) assisting with range-of-motion leg exercises c) removal of antiembolism stockings twice a day d) checking placement of pneumatic compression boots 51. The nurses assesses that the client with cancer is not ready for teaching when the client asks: 1. Am I going to loose my hair? 2. Should I get a second opinion? 3. Will this make me really sick? 4. Will I have to stop exercising at the gym? 52. Knowing that chemotherapy affects the taste buds, the nurse would have the client 1. Increase the amount of spices in the food. 2. Avoid red meats. 3. Medicate with Compazine before meals. 4. Eat foods that are hot in temperature. 53. In planning care for a client with a platelet count of 8000 and a WBC of 8000 the nurse can expect to: 1. Remove flowers from the room. 2. Encourage fruits and vegetables. 3. Use strict hand washing technique. 4. Take temperature frequently. 54. The nurse is teaching a client with a WBC of 2000. Which statement the client makes indicates an understanding of the teaching?
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76. The nurse is taking the vital signs of the client admitted with cancer of the pancreas. The nurse is aware that the fifth vital sign is: a. Anorexia b. Pain c. Insomia d. Fatigue 77. The nurse is assessing the client admitted for possible oral cancer. The nurse identifies which of the following to be to a late-occuring sx. of oral cancer? a. Warmth
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101. A 35 years old client with ovarian cancer is prescribed hydroxyurea (Hydrea), an antimetabolite drug. Antimetabolites are a diverse group of antineoplastic agents that interfere with various metabolic actions of the cell. The mechanism of action of antimetabolites interferes with: a. cell division or mitosis during the M phase of the cell cycle. b. normal cellular processes during the S phase of the cell cycle. c. the chemical structure of deoxyribonucleic acid (DNA) and chemical binding between DNA molecules (cell cycle nonspecific). d. one or more stages of ribonucleic acid (RNA) synthesis, DNA synthesis, or both (cell cyclenonspecific).
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161. 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. 162. Nausea and vomiting is an expected side effect of chemotherapeutic drug use. Which of the following drug should be administered to a client on chemotherapy to prevent nausea and vomiting? a. Metochlopramide (Metozol) b. Succimer (Chemet) c. Anastrazole (Arimidex) d. Busulfan (Myleran) 163 Radiation protection is very important to implement when performing nursing procedures. hen the nurse is not performing any nursing procedures what distance should be maintained fromthe client? a. 1 feet b. 2 feet c. 2.5 feet d. 3 feet 164. The following are teaching guidelines regarding radiation therapy except: a. The therapy is painless b. To promote safety, the client is assisted by therapy personnel while the machine is in operation. c. The client may communicate all his concerns or needs or discomforts while the machine is operating. d. Safety precautions are necessary only during the time of actual irradiation. 165. Contact of client on radiation therapy should be limited only to how many minutes to promote safety of the therapy personnel? a. 1 minute b. 3 minutes c. 5 minutes d. 10 minutes 166. Nurse Joy is caring for a client with an internal radiation implant. When caring for the 1client, the nurse should observe which of the following principles?
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192. Levothyroxine (Synthroid) is the drug of choice for thyroid replacement therapy in patients with hypothyroidism because: A. it is chemically stable, nonallergenic, and can be administered orally once a day. B. it is available in a single 25mg tablet making dosing simple. C. it is not a prodrug. D. it has a short half-life. 193. Your patient has been on a narcotic analgesic for chronic pain from cancer. The dose she has been receiving is no longer bringing about the same pain relief as it once did. The patient asks you why the medicine doesn't work anymore. You explain to her about: A. tolerance. B. potency. C. receptor agonists.
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204. Client complains of sporadic epigastric pain, yellow skin, nausea, vomiting, weight loss and fatigue. Suspecting gallbladder disease, the physian orders a diagnostic workup, which reveals gallbladder cancer. Which nursing diagnosis may be appropriate for this client? a. b. c. d. Anticipatory grieving Impaired swallowing Disturbed body image Chronic low self -esteem
205.What is the most important postoperative instruction the nurse must give a client who has just returned from the operating room after receiving a subarachnoid block? a. b. c. d. Avoid drinking liquids until the gag reflex returns Avoid eating milk products for 24 hours Notify a nurse if you experience blood in your urine Remain supine for the time specified by the physician
206 A client with colon cancer requires a permanent colostomy because of the tumor. After surgery, the client must learn how to irrigate the colostomy. When irrigating, how far into the stoma should the client insert the lubricated catheter?
203.A client with uterine cancer asks the nurse, Which is the most common type of cancer in women? The nurse
207.During the breast examination , which finding more strongly suggests that the client has breast cancer?
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212.Which action, displayed by a grieving husband over his dying wife, would cause the nurse to suggest counselling? a. b. He takes out wedding pictures and memorabilia to show you He refuses to acknowledge his wifes family and blames them for the clients current health problem He has already planned his wifes funeral He is planning to give away his wifes treasured items to family members
208.After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention? a. b. c. d. Serving small portions of bland food Encouraging rhythmic breathing exercise Administering metoclopramide (Reglan) and Dexamethasone(Decadron) as prescribed Withholding fluids for the first 4 to 6 hours after chemotherapy administration
c. d.
209.A client receiving chemotherapy to treat breast cancer. Which assessment finding indicates a fluid and electrolyte imbalance induced by chemotherapy?
213.The physician orders cystoscopy and random biopsies of the bladder for a client who reports painless hematuria. Test results reveal carcinoma in the situ in several bladder regions. To treat bladder cancer, the client will have a series or intravesical instillations of bacillus CalmetteGuerin (BCG), administered 1 week apart, when teaching a client about BCG, the nurse should mention that this drug commonly causes: a. b. c. d. Renal calculi Hematuria Delayed ejaculation Impotence
a. b. c. d.
Urine output of 400 ml in 8 hours Serum potassium level of 3.6 mEq/L Blood pressure of 120/64 to 130/72 mm Hg Dry oral mucus membrane and cracked lips
210Which nursing intervention is most appropriate for a client with multiple myeloma? a. Monitoring respiratory status b. Balancing rest and activity c. Restricting fluid intake d. Preventing bone injury 211. An oncology nurse educator is speaking to a womens group about breast cancer. Questions and comments from the audience reveal a misunderstanding of the aspects of the disease . Various members of the audience have made all of the following statements. Which one is accurate? a. Mammography is the most reliable method for detecting breast cancer b. Breast cancer is the leading killer of women of childbearing age c. Breast cancer requires a mastectomy
214.A client with suspected lung cancer is suspected lung cancer is scheduled for thoracentesis as a part of the diagnostic workup. The nurse reviews the clients history for conditions that might contra indicate this procedure. Which condition is contraindication for thoracentesis? a. b. c. d. A seizure disorder Chronic obstructive pulmonary disease Anemia A bleeding disorder
215.A client is receiving the cell cycle- nonspecific alkylating agent thiootepa(Thioplex), 60 mg weekly for weeks by the bladder instillation as part of a chemotherapeutic regimen to treat bladder cancer. The client asks the nurse how the drug works. How does thiotepa exert its therapeutic effects?
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216.A home care nurse assesses for disease complications in a client with bone cancer. The nurse knows that cone cancer may cause which electrolyte disturbances? a. b. c. d. Hyperkalemia Hyperkalemia Htperkalemia Hyperkalemia
217.After being in remission from Hodgkins disease for 18 months, a client develops a fever of unknown origin. The physician orders a blind liver biopsy to rule out advancing Hodgkins disease and infection. Twenty four hours after biopsy , the client has a fever, complains of severe abdominal pain and seems increasing confuse. The nurse suspects that this findings result from: a. b. c. d. Bleeding in the liver caused by the liver biopsy Perforation of the colon caused by the liver biopsy An allergic reaction to the contrast media used during the liver biopsy Normal post-procedural pain with the chnag ewith the level of conscoiysness resulting from the pre existing fever.
221.A client is hoispitalized with cell carcinoma of the lung. To manage severe pain , the physicians prescribed a continous IV infusion of morphine. Which formula should the nurse use to check that the morphine dose is appropriate for the client? a. b. c. d. 1 mg/ kg of body weight 5 mg/ kg of body weight 5 mg/ 70 kg of body weight 10 mg/ 70 kg of body weight
222.The nurse is providing best cancer education at the community facility. The American cancer society recommends that women get mammograms: aYearly after age 40 b After the birth of the first child and every two years there after. C After the first menstrual period and annually there after. dEvery three years between ages 20 and 40 and annually there after. 223.The nurse is caring for a patient with a long term central venous catheter. Which care principle is correct? aUse clean technique when assessing the port with a needle
218.After the physicians explain the risk and benifits of a clinical trial to a client, the client agrees to participate. Later that day, the client request clarification of the process involved in the clinical trial. As the member of the multi-disciplinary team, how should the nurse respond? a. b. c. d. Provide the information requested Encourage the client to withdarw from the trial Not provide the information because its bearing in the scope of nursing practice. Tell the client that the information should come from the physician that first presented it to him
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234.Shelley Nordant is scheduled for surgery to remove a cancerous tumor. She remarks to the nurse, Why have surgery? I am going to have chemotherapy just same. The most appropriate response by the nurse is to: a. b. c. d. Tell Mrs. Nordant that surgery must be performed Encouraged her to confer with the surgeon and the oncologist about the surgery Tell her that the combination of surgery and radiation may lead to a cure Document her concerns and give her reassurance
238. George Houng is receiving combination therapy of alpha-interferon with another chemotherapeutic agent. Which statement indicates that the client and family further teaching from the nurse? a. b. c. d. I will observe my husband for any changes in his mental status. I understand how to give the drug subcutaneously. I can have severe flulike symptoms while taking these drugs. I will limit my fluid intake.
235.Which of the following statements best describes brachytherapy? a. b. c. d. Brachytherapy involves placing radioactive materials at some distance from the tumor Brachytherapy involves placing radioactive materials directly into the tumor site Brachytherapy is a holistic, nontradional cancer treatment Brachythaerapy is also referred to as teletherapy
239.Stuart Eggleton, a client with prostate cancer, is trembling and is pacing in his room. His blood pressure and pulse are slightly elevated. Mr. Eggleton may be experiencing: a. b. c. d. Some type of drug reaction Anxiety Body image disturbance Fear of unknown
236.Which of the following nursing actions is most appropriate when caring for a client with unsealed implanted radioisotope? a. b. c. d. Wear an abdominal apron Have the other client in the room wear a monitoring device to measure exposure Pick up any dislodged implants found in the bed linen with your sterile gloved hand Dispose of clients body fluids in specially marked containers
240. Which of the following statements indicates that the client has misunderstood client-teaching about alopecia from chemotherapy? a. b. c. d. I can wear a colorful scarf or turban. I have already bought a wig. My neighbor will be driving me to the look good, feel better program. After the chemotherapy is finished, my hair will grow back the same as it was before the treatments.
237 Which of the following statement indicates that the client-teaching prior to an external radiation was successful? a. b. if I have pain at my treatment site, I will apply an ice pack. I will not have any intimate sexual contact while I am receiving treatments.
241. The partner of a client with cancer has been provided with guidelines regarding when to call for help. Which of the following statements by the clients partner indicates that further teaching about the guidelines is needed? a. b. Ill contact the physician if I see any new bleeding from her rectum. If her oral temperature is 100 F, Ill notify the physician.
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c. d.
242. Which of the following nursing assessments would indicate an improvement in a cancer client with nursing diagnosis altered nutrition: less than body requirements? a. b. c. d. Serum albumin less than 3.0 A PPD response of more than 5 mm of induration A decrease in urinary creatinine level An anthropometric measurement of 75% of the standard
246. Which strategy would not be recommended to a cancer client with problems eating? a. b. Eat icy- cold foods semisoft and liquid foods Eat frequent, small meals spicy, warm foods c. eat d. eat
243. Which of the following nursing interventions would be most helpful in managing the nausea and vomiting of a client with cancer? a. b. c. d. Instruct the client to drink plenty of fluids with each meal Instruct the client to lie down for an hour after eating Encourage the client to eat dry foods Instruct the client to follow a high-fat food plan
247. Dana Biencarz has lung cancer and is experiencing facial and arm edema. The nurse should suspect that Mrs.Biencarz has: a. b. Allergic drug reaction c. sepsis Pericardial effusion superior vena cava syndrome
d.
244. Which of the following nursing actions is contraindicated for the client with leukemia? a. b. c. d. Assess the clients oral mucous membranes daily Instruct the client to brush and floss the teeth three ties per day Prevent dry mouth by using moisturizing agents such as blistex Teach client to use smooth rather than sharp utensils for eating
248. Rita Lopez has metastatic breast cancer and is admitted to the hospital for pain management. During the night she becomes incontinent, which has never occurred before. The appropriate action by the nurse is to: a. b. c. d. Recognize that the incontinence occurred as a result of over sedation Notify the physician that spinal cord compression is suspected Realize that incontinence can occur in metastatic bone disease Wait until the morning to see if the incontinence recur
245. The doctor has told Javier Rodriguez and his family that he has about 6 to 9 months to live. The family asks the nurse about making funeral arrangements ahead of time. The most appropriate response by the nurse is: a. Many people do make arrangements ahead, but you might upset Mr. Rodriguez if you tell him about the plans.
249..The nurse is caring for a client who has just a modified radical mastectomy with immediate reconstruction. Shes in her 30s and has two young children. Although she worried abot her future, she seems to be adjusting well to her diagnosis what should the nurse do to support her coping? a. Tell the client spouse or partner to be supportive while she recover
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250. Which lab test is it most important to monitor for a client with lung cancer that has ectopic sites? a. T3 b. T4 d. blood culture c. serum glucose
SITUATION; Nurse Tin-Tin is entrusted with the task of promoting nursing care in client with various surgical conditions. 251. Physical preparation for a client schedule for cystectomy and ilial conduit includes the administration of? A. B. C. D. Intravenous vitamins C Neomycin sulfate Bladder analgesic Urinary antibiotic
SITUATION; A nurse is providing care to clients with acquired immune deficiency syndrome. 256. The treatment of AIDS involves a palliative approach. what does this approach means? A. Curing the disease B. Relieving the clients discomfort C. Providing rehabilitative support to the clients family D. Promoting recovery 257. A positive diagnosis for HIV infection is made based on the result of which of the following test? A. B. C. D. E. F. G. H. ELISA Western blot WBC count CD4 cell count A and C A and B A,B and C A, B and D
252. Which of the following methods of assessment is correct to assess distention in a post operative client? A. B. C. D. Palpate the perineal area Palpate the epigastric area Percuss and palpate the lower abdomen Percuss and palpate the upper abdomen
253. After thyroidectomy, which of the following intervention is the highest priority of the nurse? A. Monitor the clients vital signs every 4h. B. Observe the dressing at the back of the neck for the presence of blood C. press gently around the incision to assess for subcutaneous emphysema D. positon the client laterally to promote drainage of secretions from the mouth 254. Following cataract extraction, which client activity is allowed?
258. Which principles of isolation should the nurse implement when obtaining the blood pressure of a client who has AIDS? A. Use of mask B. Wearing clean gloves C. Hand washing D. Use of clean gown 259. Which of the following practices limits a clients exposure to thehuman immunodeficiency virus?
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260. Which of the following symptoms are most commonly seen in clients with AIDS? A. B. C. D. Low-grade fever and persistent diarrhea Cough and abdominal pain Projectile vomiting and jaundice Headache and rash
SITUATION; The nurse is expected to perform her function in the operating room with outmost care. 261. A client is to undergo an exploratory laparotomy for vague abdominal discomforts that his lead to abdominal rigidity and severe pain. As the surgeon opens the clients abdomen, which of the following instruments shoul the nurse anticipate the surgeon to use? A. B. C. D. Kocher Mixtner Kelly Army navy
262. Surgical closure of the skin surfaces usually involes the nurse of which type of needle? A. B. C. D. Straight needle Curved needle Rounded needle eye less needle
263. The surgeon closes the clients abdominal tissue layer. The nurse knows that closure of the abdominal tissue layers begins with the peritoneum, extra peritoneal fat, transversalis facia,followed by? A. B. C. D. Deep facia, muscle subcutaneous tissue ,skin Muscle, deep facia, subcutaneous tissue, skin Subcutaneous tissue, deep facia, muscle, skin Skin, muscle, subcutaneous tissue deep facia
264. Following cataract surgery, which aspect of nursing care is the highest priority of the nurse? A. Nutrition B. Airway
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270. Which of the following interventions take priority in a client with pheochromocytoma? A. Counting the respiratory rate for one full minute B. Monitoring the blood pressure C. measuring the urine output in 24h D. Obtaining the axillary temperature every hour SITUATION; Care of client with TURP. 271. To promote bladder decompression and to prevent bladder decompression after transurethral resection of the prostate, which intervention should be the nurses priority? A. B. C. D. Monitoring the client for signs of hemorrhage Maintaining patency of the cystostomy tube Assessing the client for signs of infection Ensuring patency of the continuous bladder irrigation
275. Which of the following manifestations should the nurse instruct the client to report to the physician immediately after undergoing TURP A. B. C. D. Burning on urination Decreased urinary stream Pink- tinged urine on initial voiding Urine output of 30ml/h
SITUATION: Mr. Jeremy Pontanes, R.N., is entrusted with the task of promoting nursing care in client with disturbance in the cardiovascular system. 276. Which of the following characteristic of pain will help differentiate angina pectoris from myocardial infarction in terms of management? A. B. C. D. Duration Location Severity Cause
272. How should the nurse determine the urine outputof a client on continuous bladder irrigation? A. Deduct the amount of the irrigation solution instilled from the total amount of output B. Deduct the amount of IV fluid infusion from the total fluid intake of the client C. Add the amount of all fluid intake then deduct all the amount of output D. Measure amount of output from the bladder irrigation 273. Which of the following is most common complication of transurethral resection of the prostate in the early post operative period. A. B. C. D. Impotence Infection Bleeding Urinary retention
277. Which of the following is an early sign of heart failure? A. B. C. D. Neck vein distention Ankle edema Dsypnea Hepatomegaly
278. In a client with myocardial infarction, activity is gradually increased based on which of the following factors? A. B. C. D. Amount of weight loss Severity of dsypnea Degree of edema Presence of absence of cyanosis
279. A client with history of myocardial infarction was admitted due to dsypnea. The serum potassium level is
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280. The client is placed on a moderate sodium restricted diet, which of the following food is allowed? A. B. C. D. French fries Ice cream Catsup Apples
SITUATION; Nurse Henry is entrusted with the task of promoting nursing care in client with disturbances in the gastrointestinal tract. 281. Cholangiography allows for the visualization of? A. B. C. D. Pancreas and large intestine Liver and gallbladder Pancreatic duct and hepatic duct Common bile duct and hepatic duct
287. Which the following equipment does now interfere with eating or talking and can best deliver oxygen in a hypoxic client.? A. B. C. D. Oxygen tent Oxygen mask Nasal cannula Endotracheal tube
282. Which of the following beverages should the nurse instruct a client who has been hospitalized due to peptic ulcer disease to avoid? A. B. C. D. Mineral water Apple juice Wine Milk
288. Which reading of pulmonary capillary wedge pressure (in mmHg) needs to be reported to the physician immediately? A. B. C. D. 5-10 15-20 25-30 35-40
283. The most serious complication of the use of a nasogastric tube is? A. B. C. D. Fluid and electrolyte imbalance Ulceration Aspiration pneumonia Constipation
289. Which of the following client is at most risk for tuberculosis? A. B. C. D. A 35 year old newly married A 68-year old client A 12 year-old child A 17 year-old adolescent
284. Which statement made by a client with ulcer indicates an understanding of the need for ulcer medications? A. Anatacids can be taken with other drugs B. Tagament will decrease the acid in my stomach C. Maalox will coat my stomach D. I can take my antacids with aspirin 285. Which nursing action is of the highest priority in a client with nasogastric tube after gastric surgery?
290. Which of the following statement best describes the primary purpose of pursed-lip breathing? A. B. C. D. increase oxygen inhalation Maximize diaphragmatic extension Facilitate inhalation of carbon dioxide Minimize the use of intercostals muscles
SITUATION; Mr. Ronald is entrusted with the task of promoting nursing care in client with disturbances in the biliary system.
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292. Which of the following aspect of care should have the highest priority for a client admitted due to cholecystitis? A. B. C. D. Comfort Hydration Health instruction Obtaining thorough history
293. Which of the following laboratory values is NOT expected in a client with pancreatitis? A. B. C. D. Serum magnesium 3.2mEq/L Serum glucose 45mg/dl Serum potassium 5.5mEq/L Serum calcium 8mg/dl
294. Which client is the best candidate for the use of insulin pump? A. B. C. D. A 42 year-old businessman A 35 year-old working single mother A 12 year-old mentally retarded An 82 year-old cognitively impaired
295. Which statement by a client with ulcer indicates understanding of the medication therapy? A. B. C. D. Antacids can be taken with other drugs Tagamet will decrease the acid in my stomach Maalox will coat my stomach I can take my antacid with asprin
300. Which of the following complications can result from the use of general anesthesia during surgery? A. B. C. D. Fluid loss Peripheral retention Atelectasis Muscle rigidity
SITUATION; Nurse jethro is entrusted with the task of promoting nursing care in client undergoing surgery. 296. To decrease the anxiety of the client and his/her family about an impending surgery, the nurse should? A. Describe the details of the surgery to the client and family B. Provide general information and answer appropriate question of the client and family C. Empower the client to make decision by obtaining the clients consent D. Give full reassurance that the surgical team is experienced to handle the surgery
SITUATION; Nurse Santini is taking care of Jay, a client who underwent nephrectomy. 301. Which of the following observation is expected in a post nephrectomy client? A. B. C. D. Urine output is 20ml/h Drak red urine on the third post operative day Urine specific gravity: 1.003 Urinary drainage from the surgical wound a week after surgery
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303. Hourly monitoring of the clients urine in essential following nephrectomy to assess a common signs of kidney transplant rejection which is? A. B. C. D. abdominal pain decreased urine output Decreased blood pressure Anemia
309. When communicating with the client with asthma and Wernickes aphasia, the nurse should? A. Provide adequate time for the client to respond B. Face the client and speak loudly C. Use short and simple words and sentences D. Provide a pencil and writing pad for the client 310. While performing respiratory assessment among elderly clients, the nurse was able to obtain cues and possible cases of elderly abuse. Which client is most at risk for elderly abuse? A. A 68 year-old cognitively impaired male living alone B. A 72 year-old female living with her spouse and children C. A 65 year-old male living with the household help D. A 67 year-old female living on her own SITUATION; The following question pertain to clients with tubes. 311. A client just underwent choledoccholithotomy and has a T-tube in place. She calls the nurse and complains that the skin around the T-tube is excruciated. The nurse should assess the skin and? A. B. C. D. Reinforce the dressing Apply antiseptic solution Change the dressing Use a skin barrier around the t-tube site
304. Which of the following laboratory data indicates the adverse effect of anti kidney rejection medication administered to a client A. B. C. D. Platelet count 200,00/mm3 WBC count 3,800/mm3 RBC count 5.1 million/mm3 Hemoglobin 14mg/dL
305. Which of the following laboratory data is the most accurate blood test for determining dehydration? A. B. C. D. Urine specific gravity Urine osmolarity Creatinine clearance BUN
SITUATION: Care of client with respiratory disorders. 306. Oseltamivir (tamiflu) is most effective if Tken within how many hours after the onset of the symptoms off influenza AH1N1? A. B. C. D. 48 h 72h 96h 100h
307. The priority goal of therapy for a client with chronic obstructive pulmonary disease is to? A. Limit fluid administration B. Provides higher concentration of oxygen
312. To promote continuous and proper functioning of chest tube attached to a client, the nurse should keep the collection device?
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313. After receiving the end shift report that a clients Ttube has a total drainage of 120 ml in 24h, which of the following intervention is the highest priority of the nurse? A. Refer the situation to the physician immediately B. document the amount on the clients kardex C. Check the tube for the kinks and proper placement of the drainage bag D. Empty the drainage bag and observe the client further. 314. Following the surgical creation of a permanent colostomy, the client call the nurse and ask why there is no drainage from the colostomy. Which nursing intervention is priority at this time? A. Call the operating room and schedule the client for repeat surgery. B. Notify the physician immediately C. Check the colostomy for obstruction D. Explain to the client that this is expected in the next 2-3 days 315. Which of the following characteristic of pain indicates gallbladder disease? A. Left epigastria pain with cullens sing B. Right lower quadrant pain with bloody diarrhea C. Right upper quadrant pain that radiate to the shoulder blade D. Lower sterna pain that resembles indigestion. SITUATION; Mr jose dela cruz, age 68mis admitted to the hospital due to fever, cough and dyspnea. His medical history reveals long standing COPD. 316. The caregiver of a client with COPD ask the nurse Why cant we just increase the clients oxygen to help her breath easily the appropriate response of the nurse is? A. let me notify the physician first B. Increasing oxygen levels may decrease the clients urge to breath
319. To limit the clients oxygen needs,a client with COPD should be? A. B. C. D. Served three large meals a day Given six small meal a day Forced to drink large amount of fluid Instructed to immediately sleep after meal
320. The nurse is providing care to a client with a tracheostomy tube in place. The nurse notes that his/her breathing has become noisy. Which intervention in a nursing priority? A. B. C. D. Adjust the cuff pressure Reposition the client Suction the tracheostomy Notify the physician
SITUATION; Several clients are undergoing diagnostic procedures. 321. A client scheduled for electroencephalogram (EEG) is being served breakfast. On her tray are the following: scrambled egg, fried rice, dried fish and cup of coffee. What should the nurse do? A. Withhold the meal
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323. A client has a Glasgow coma scale score of 4. This is interpreted to mean that the client is? A. B. C. D. Awake Lethargic Oriented Unresponsive
328. There are 300 TB clients enrolled for DOTS in the municipality. What is the best sampling method to use? A. B. C. D. Simple random Network Purposive Cluster
324. Which of the following diagnostic test does NOT require informed consent? A. B. C. D. Colonoscopy Electromyelography Electro encephalography Liver biopsy
329. If another researcher would like to do the same study, which of the following is correct? A. He/she should do a meta analysis B. He/she should just barrow the review of literature part of the proposal to save time C. He/she can replicate the study D. It is not ethical to be copying somebodys study 330. If the department of health (DOH) would like to do a similar study on a national scale, what would be the most appropriate sampling strategy? A. B. C. D. Probability Simple Cluster Stratified
325. Which client does NOT have any risk from undergoing MRI? A. B. C. D. A 35 year-old with insulin pump A 55 year-old with cardiac pacemaker A 28 year-old who weighs 310lbs A 19 year-old with pierced ear
SITUATION; A major concern in the public health is the development of resistant strain of TB bacteria. Mila, a public health nurse, will conduct a research on the compliance of TB clients and will look into the reasons why many clients drop out of the short-course chemotherapy. 326. To meet the aim of the study- to identify the factors that affect TB clients compliance to therapy- the researcher should? A. Determine the purpose of the study B. Acknowledgement the limitations of the study C. Interview clients who have problem in complying
SITUATION; Mr. Mike Delos Reyes, R.N., is assigned to the medical ward. Severeal clients are admitted for treatment ofvarious conditions. 331. The hallmark sign for the diagnosis of diabetes mellitus (DM) is the presence of? A. B. C. D. Ketonuria Acetone odor of breath Kussmauls breathing Hyperglycemia
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333. Which of the following methods as best to obtain the accurate amount of residual urine? A. remove the catheter slowly to ensure drainage of the urine near the exit of the bladder B. Press the lower abdomen while withdrawing the catheter C. Quickly full the catheter so any residual urine is excreted abruptly D. Slowly move the catheter in and out of the bladder 334. Which of the following manifestation is most definitive of pheochromocytoma? A. B. C. D. Headache Hypertension Hyperglycemia Hypermetabolism
338. A client with myasthenia gravis was admitted due to muscle weakness and bradycardia. Which drug will the nurse anticipate the doctor to order? A. B. C. D. Atropine sulfate Neostigmine Pyridostigmine Diazepam ( Valium)
339. Muscle weakness also occurs in client with multiple sclerosis. Following treatment with steroid, an assessment finding in a client with multiple sclerosis that indicates a positive response to therapy is decreased: A. Mood swing B. Muscle rigidity C. Pain in the lower extremities D. Visual problem 340. Mask-like faces occurs in clients with myasthenia gravis nd Parkinson disease. which of the following nursing diagnosis us the highest priority for a client with Parkinsons disease? A. B. C. D. Altered nutrition; Less than body requirement Risk for injury Risk for aspiration Altered bowel elimination
335. Which of the following characteristic of pain indicates gall bladder disease? A. Left epigastric pain with Cullens sign B. Right lower quadrant pain with bloody diarrhea C. Right upper quadrant pain that radiates to the shoulder blade D. Lower sterna pain that resembles indigestion SITUATION; Mrs. Maria Delos Angeles, 45 years- old was admitted due ti sudden weakness of the lower extremities. The nurse is assessing the client. 336. How should the nurse assess the trigeminal nerve/ A. Ask the client to say ah and assess the swallowing ability B. Used a needle to assess for facial sensation
SITUATION; In the emergency department, thenurse is obtaining the history of several clients lined up for admission. 341. While playing in the garden, a 10 year-old boy had a foreign object stuck in his left eye. which is intervention is appropriate? A. immediately irrigate the eye with warm water
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348.Cancer death are most likely to occur in which group? a. b. c. d. Children and adults Young adults Middle adults Older adults
349.Which of the following statements applies to all of the present theories about the etiology of cancer? a. b. c. d. Cancer occurs only in young people There is impairment of the immune system with cancer In cancer, proteins inhibit the growth of cells In cancer, the actions of oncogenes are repressed
343. The client has been receiving one liter of 5% dextrose in normal saline. The total amount of this solution provides how many calories? A. B. C. D. 100 200 350 370
344. Which nursing diagnosis is of highest priority for a client with osteoarthritis? A. B. C. D. Impaired verbal communication ineffective breathing pattern Risk for injury Impaired nutrition: less than body requirement
350.Mare Larrabee has cervical cancer. She asks the nurse if it is possible that the cancer was caused by a virus. The correct answer by the nurse is: a. b. c. d. Probably not, that is only one many theories. All cancers have a viral etiology I am not sure- you will have to ask your doctor. Some cancers such as yours have a strong association of viruses.
345. Which question is most appropriate to ask a client to obtain information about his/her chest pain? A. B. C. D. Do you feel some pain Do you feel some throbbing Tell me about your pain Were you doing something when the pain is started
351.In which of the following cancer is heredity not recognized as a risk factor? a. b. c. d. Breast cancer Colon cancer Malignant melanoma Brain cancer
346. Cancer occurs when: a. b. c. d. Normal cells multiple abnormally Normal cells mutate into abnormal cells Abnormal cells become tumor cells Abnormal cells are exposed to toxins
352.Which of the following clients probably has the least occupational risk of developing cancer? a. b. c. d. A coal miner A carpenter An oncology nurse An English teacher
347. During the past 20 years which type of cancer has had an increase in mortality rate?
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354.Tina Blackey was recently diagnosed with breast cancer. She ask the nurse what steps she can take to boost her immune system. The response by the nurse is: a. b. c. d. Refuse chemotherapy; it weakness the immune system Learn techniques to relieve or manage stress more effectively Ask your doctor to prescribe an antidepressant Research herbal remedies
359.In the TNM classification system, the N stands for: a. b. c. d. No metastasis Node involvement Numerical grade Name
360.Which of the following explanations should the nurse utilize regarding the magnetic resonance imaging test used to diagnose a suspected brain tumor? a. b. This test uses sound waves Before this test, , the physician will inject you with a radiopaque dye and then films will be taken The machine for this test is like a tube, and you will lie inside. It may make thumping noises You must drink a radioactive substance before this test
355.Joan Shipleys breast cancer has metastasized to lymph nodes. Which statement is correct regarding this condition? a. b. c. d. Metastasis means that Ms. Shipley will eventually die from cancer The cancer has spread only to the lymph nodes Chemotherapy and radiation will be only palliative in this situation Aggressive treatment may reduce risks of further spread of the cancer
c.
d.
356.Which lab test is it most important to monitor for a client with lung cancer that has ectopic sites? a. b. c. d. T3 T4 Serum glucose D. blood culture
361.A client sys, The doctor explained so many things to me that I forgot what she said about the endoscopy test Im having tomorrow. The nurse should explain that in this test there is a direct visualization of the: a. b. c. d. Sigmoid colon Upper gastrointestinal tract Urethra Tracheobronchial tree
357.Which statement about cancer is false? a. b. c. d. Chronic cancer pain maybe treated-related Fear and hopelessness maybe contribute to suffering of the client with cancer Chronic cancer pain may affect objective manifestations Pain relief is not a goal of cancer care
362.Jean Lawrence is undergoing diagnostic testing as a part of the staging process. She tells the nurse, I am so worried they will find cancer everywhere: what will happen if I die before my children are grow up? The most appropriate response by the nurse is: a. b. c. d. There is no way of knowing what the future holds. No matter what happens, your children will be fine. You sound like you are afraid. Dont worry until you know the results.
358.The MD has told a client that the results of the biopsy reveal a papilloma. This statement means that the client has:
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364.Which of the following are is true about the cell-kill hypothesis? a. b. c. d. It explains the bodys mechanism of protection fro carcinogens It forms the basis of selecting specific classes of chemotherapeutic drugs It accounts the severity of side effects. It is the reason why several courses of chemotherapy are given.
369.Marlene Marrison is scheduled to start chemotherapy. Which statement by Mrs. Marrison indicates the need for further client-teaching? a. b. c. d. I will have to drink plenty of fluids each day. Visits from my school-aged grandchildren will help my spirits. I will need extra rest during this period of time. I may need a extra help at home to clean and prepare meals.
365.An example of a chemotherapy catheter that is tunneled under the skin on the chest into the subclavian vein is: a. b. c. d. Hickman Peripherally inserted central catheter (PICC) Mediport Port-a-cath
370.Shelley Nordant is scheduled for surgery remove a cancerous tumor. She remarks to the nurse, Why have surgery? I am going to have a chemotherapy just the same. The most appropriate response by the nurse is to: a. b. c. d. Tell Mrs. Nordant that surgery must be performed. Encourage her to confer with the surgeon and the oncologist about the surgery Tell her that the combination of surgery and radiation may lead to cure Document her concerns and give her reassurance
366.Which of the following nursing interventions is contraindicated for a client receiving Cytoxan (cycloplasphamide) a. b. c. d. Monitor clients WBC, BUN, and liver enzyme lab data Teach client about ways to manage hair loss Restrict daily fluid intake to 1L during treatment Encourage the client to use relaxation techniques
367.Assessing for arrythmiasis, gallops, and congestive heart failure is an especially important nursing intervention for a client receiving: a. b. c. d. Vinblastin (Velban) Doxuribican (Adriamycin) 5-Fluorouracil (5-FU) Vincristine (Onvocin)
371. Jeovina, with advanced breast cancer is prescribed tamoxifen (Nolvadex). When teaching the client about this drug, the nurse should emphasize the importance of reporting which adverse reaction immediately? a. Vision changes b. Hearing loss c. Headache d. Anorexia 372. 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
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376.
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Because of ineffective breathing pattern, how would you improve his respiratory status: A. Conserve his strength B. Maintain the desired position C. Elevate foot of bed D. Assist him after the paracentesis
D.
384.. A male client is receiving the cell cyclenonspecific alkylating agent thiotepa (Thioplex), 60 mg weekly for 4 weeks by bladder instillation as part of a chemotherapeutic regimen to treat bladder cancer. The client asks the nurse how the drug works. How does thiotepa exert its therapeutic effects? a. It interferes with deoxyribonucleic acid (DNA) replication only. b. It interferes with ribonucleic acid (RNA) transcription only. c. It interferes with DNA replication and RNA transcription. d. It destroys the cell membrane, causing lysis. 385.. The nurse is instructing the 35 year old client to perform a testicular self-examination. The nurse tells the client: a. To examine the testicles while lying down b. That the best time for the examination is after a shower c. To gently feel the testicle with one finger to feel for a growth d. That testicular self-examination should be done at least every 6 months 386. A female client with cancer is receiving chemotherapy and develops thrombocytopenia. The nurse identifies which intervention as the highest priority in the nursing plan of care? a. Monitoring temperature b. Ambulation three times daily c. Monitoring the platelet count d. Monitoring for pathological fractures 387. The nurse knows that a dying patient should be encouraged to talk about death and dying. The therapeutic approach is to: A. Confront Mrs. M with the facts about her illness and impending death to open discussion
388. Mrs. M begins to deteriorate markedly. She requires frequent pain medication and her oldest daughter, Izza age 20, walks out of the room and crying and says to the nurse, I can not take this anymore. What would be the most appropriate response of the nurse? A. I hope your mother didnt hear you. She needs your support right now. B. It is really difficult to see someone you love suffer. Let us go outside and talk about how you are feeling. C. You say that you dont take it anymore. You should also considered what she is feeling. D. She will probably die soon. She is getting weaker everyday. 389.. The nurse performs one of there roles when she listens to Mrs. M and his family: A. Parent surrogate C. Socializing agent B. Teacher D. Counselor
390. Gian, a community health nurse is instructing a group of female clients about breast self-examination. The nurse instructs the client to perform the examination: a. At the onset of menstruation b. Every month during ovulation c. Weekly at the same time of day d. 1 week after menstruation begins 391.. Nurse Cecilia is caring for a client who has undergone a vaginal hysterectomy. The nurse avoids which of the following in the care of this client? a. Elevating the knee gatch on the bed b. Assisting with range-of-motion leg exercises c. Removal of antiembolism stockings twice daily d. Checking placement of pneumatic compression boots
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397.. A female client diagnosed with multiple myeloma and the client asks the nurse about the diagnosis. The nurse bases the response on which description of this disorder? a. Altered red blood cell production b. Altered production of lymph nodes c. Malignant exacerbation in the number of leukocytes d. Malignant proliferation of plasma cells within the bone 398.. Nurse Bea is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which of the following would the nurse expect to note specifically in this disorder? a. Increased calcium b. Increased white blood cells c. Decreased blood urea nitrogen level d. Decreased number of plasma cells in the bone marrow 399.. Vanessa, a community health nurse conducts a health promotion program regarding testicular cancer to community members. The nurse determines that further information needs to be provided if a community member states that which of the following is a sign of testicular cancer? a. Alopecia b. Back pain c. Painless testicular swelling d. Heavy sensation in the scrotum 400 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 401. 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 clients room c. Remove the dosimeter badge when entering the clients room
395.
396..
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402. Which of the following statements best describes therapy? a. Bradytherapy involves placing radioactive materials at some distance from the tumor b. Bradytherapy involves placing radioactive materials directly into tumor site c. Bradytherapy is a holistic, nontraditional cancer treatment d. Bradytherapy is also referred to teletherapy 403. Which of the following nursing actions is most appropriate when caring for client with unsealed implanted radioisotope? a. Wear an abdominal apron b. Have the other client in the room wear monitoring device to measure exposure c. Pick up any dislodged implants found in bed linen with your sterile gloved hand d. Dispose of clients body fluid in specially marked containers
404. Which of the following statements indicates that the client-teaching prior to an external radiation was successful? a. If I have pain at my treatment site, I will apply an ice pack. b. I will not have any intimate sexual contact while Im receiving treatment. c. I should protect my skin from sun exposure during treatments. d. I will wash the skin in the treatment area daily using soap and hot water 405. George Houng is receiving combination therapy of alpha-interferon with another chemotherapeutic agent. Which statement indicates that the client and family require further teaching from the nurse/
a. I will observed my husband for any chances of mental status. b. I understand how to give the drug subcutaneously. c. I can have serve flulike symptoms while taking these drugs. d. I will limit my fluid intake. 406. A nurse using the Karnofsky scale to assess a client with cancer is evaluating the client: a. Amount of pain b. Stress level c. Performance status d. Nutritional intake 407. Which finding would support a diagnosis of poor nutrition/ a. Oral mucous membranes pink-red and moist b. Tongue bright to dark red and swollen c. Slight hair loss d. Acne 408. Stuart Eggleton, a client with prostate cancer, is trembling and is pacing his room. His blood pressure and pulse are slightly elevated. Mr. Eggleton may be experiencing: a. Some type of drug reaction b. Anxiety c. Body image disturbance d. Fear of the unknown 409. Which of the following statements indicates that the client has misunderstood client-teaching about alopecia from chemotherapy? a. I can wear a colorful scarf of turban. b. I have already bought a wig. c. My neighbor will be driving me to the Look Good, Feel Better program. d. After the chemotherapy is finished, my hair will grow back as the same it was before the treatment. 410. Which finding indicates a possible infection in the client with cancer who is immunosuppressed? a. A decreased respiratory rate b. A decreased pulse rate Page 41
421.. 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 422.. A female client is hospitalized for insertion of an internal cervical radiation implant. While giving care, the nurse finds the radiation implant in the bed. The initial action by the nurse is to: a. Call the physician b. Reinsert the implant into the vagina immediately c. Pick up the implant with gloved hands and flush it
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434. The nurse recognizes which of the following statements as accurately reflecting a risk factor for breast cancer? a. Mother affected by cancer before 60 years of age b. Onset of menses before 14 years of age c. Multiparity d. No alcohol consumption 435. The nurse is teaching a client about the risk factors associated with colorectal cancer. The nurse determines that further teaching related to colorectal cancer is necessary if the client identifies which of the following 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 435. Answer: A Rationale: Colorectal cancer risk factors include age older than 50 years, a family history of the disease, colorectal polyps, and chronic inflammatory bowel disease. 436. When teaching a client about the signs of colorectal cancer, Nurse Trish stresses that the most common complaint of persons with colorectal cancer is: a. Abdominal Pain b. Hemorrhoids c. Change in caliber of stools d. Change in bowel habits 436. Answer: D Rationale: Constipation, diarrhea, and/or constipation alternating with diarrhea are the most common symptoms of colorectal cancer
431. The nurse is admitting a client with laryngeal cancer to the Nursing unit. The nurse assesses for which most common risk factor for this type of cancer? a. Alcohol abuse b. Cigarette smoking c. Use of chewing tobacco d. Exposure to air pollutants 432. The nurse recognizes which of the following statements as accurately reflecting a risk factor for breast cancer? a. Mother affected by cancer before 60 years of age b. Onset of menses before 14 years of age c. Multiparity d. No alcohol consumption 433. Ductal lavage is used for
438. The nurse is teaching a client about the risk factors associated with colorectal cancer. The nurse determines that further teaching related to colorectal cancer is
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439. The 85-year-old male client diagnosed with cancer of the colon asks the nurse, Why did I get this cancer? Which statement is the nurses best response? a. Cancer of the colon is associated with a lack of fiber in the diet. b. Cancer of the colon has a greater incidence among those younger than age 50 years. c. Cancer of the colon has no known risk factors. d. Cancer of the colon is rare among male clients. 439. Answer: A Rationale: A long history of low-fiber, high-fat, high protein diets results in a prolonged transit time. This allows the carcinogenic agents in the waste products to have a greater exposure to the lumen of the colon.
442. The 33-year-old client diagnosed with Stage IV Hodgkins lymphoma is at the five (5)- year remission mark. Which information should the nurse teach the client? a. Instruct the client to continue scheduled screenings for cancer. b. Discuss the need for follow-up appointments every five (5) years. c. Teach the client that the cancer risk is now the same as for the general population. d. Have the client talk with the family about funeral arrangements. 442. Answer: A Rationale: The five (5)-year mark is a time for celebration for clients diagnosed with cancer, but the therapies can cause secondary malignancies and there may be a genetic predisposition for the client to develop cancer. The client should continue to be tested regularly.
440. The nurse has been giving instructions to Mrs. S., a c5-year-old white female, about preventing skin cancer. Which statement best indicates Mrs. S.s understanding of skin cancer risk factors? a. My father was treated for melanoma, but my mom says not to worry. b. I really need to use sunscreeneven in winter. c. I guess because I am dark complected I will be more prone to developing skin cancer. d. I used to lay in the sun all the timenow I just go to the tanning bed. 440. Correct Answer: B Rationale: Almost all cases of basal and squamous cell skin cancer diagnosed each year in the United States are considered to be sun-related.
443.Which clinical manifestation of Stage I nonHodgkins lymphoma would the nurse expect to find when assessing the client? a. Enlarged lymph tissue anywhere in the body. b. Tender left upper quadrant. c. No symptom in this stage. d. Elevated B cell lymphocytes on the CBC.
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445. A client admitted with newly diagnosed with Hodgkins disease. Which of the following would the nurse expect the client to report? a. Lymph node Pain b. Weight gain c. Night sweats d. Headache 446. he client is diagnosed with Cancer of the head of the Pancreas. When assessing the patient, which signs and symptoms would the nurse expect to find? a. Clay-colored stools and dark urine. b. Night sweats and fever. c. Left lower abdominal cramps and tenesmus. d. Nausea and coffee-ground emesis. 447. The nurse is planning a program for clients at a health fair regarding the prevention and early Detection of Cancer of the Pancreas. Which self-care activity should the nurse teach that is an example of primary Nursing care? a. Monitor for elevated blood glucose at random intervals. b. Inspect the skin and sclera of the eyes for a yellow tint. c. Limit meat in the diet and eat a diet that is low in fats. d. Instruct the client with hyperglycemia about insulin injections. 448. The community nurse is conducting a health promotion program and the topic of the discussion relates to the risk factors for gastric cancer. Which risk factor, if identified by a client, indicates a need for further discussion? a. Smoking b. A high-fat diet c. Foods containing nitrates d. A diet of smoked, highly salted, and spiced food
452. The nurse is reviewing the preoperative orders of a client with a colon tumor who is scheduled for abdominal perineal resection and notes that the physician has prescribed neomycin (Mycifradin) for the client. The nurse determines that this medication has been prescribed primarily: a. To prevent an immune dysfunction b. Because the client has an Infection c. To decrease the bacteria in the bowel d. Because the client is allergic to penicillin The nurse is admitting a male client to a medical floor with a diagnosis of adenocarcinoma of the rectosigmoid colon. Which assessment data support this diagnosis? a. The client reports up to 20 bloody stools per day. b. The client states that he has a feeling of fullness after a heavy meal. c. The client has diarrhea alternating with constipation.
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459. A client with leukemia is undergoing radiation therapy to the brain and spinal cord. In planning care for this client, the nurse would include which Nursing intervention? a. A scalp ointment to prevent dryness b. Avoiding washing off the targets marks c. Not allowing the client to use a hat or scarf d. A dandruff shampoo twice daily Marie with acute lymphocytic leukemia suffers from nausea and headache. These clinical manifestations may indicate all of the following except
456. The client with small cell lung cancer is being treated with etoposide (VePesid). The nurse monitors the client during administration, knowing that which of the following indicates a side effect specific to this medication? a. Alopecia b. Chest Pain c. Pulmonary fibrosis d. Orthostatic hypotension
a. effects of radiation b. chemotherapy side effects c. meningeal irritation d. gastric distension 461. The nurse has reviewed a discharge teaching checklist for a client, a 65-year-old male with chronic lymphocytic leukemia (CLL). Which of the following statements by the client would indicate to the nurse that further review is necessary? a. Im retired, so I can sleep whenever I want. b. Ive got season tickets for all the basketball games. c. Ill call the doctor if I have fever greater than 99F. d. Im going to teach my grandson how to fish. 462. The client is diagnosed with chronic lymphocytic leukemia (CLL) after routine laboratory tests during a yearly physical. Which is the scientific rationale for the random nature of discovering the illness? a. CCL is not serious, and clients die from other causes first. b. There are no symptoms with this form of leukemia. c. This is a childhood illness and is self-limiting. d. In early stages of CLL the client may be asymptomatic.
457. A female client with carcinoma of the breast is admitted to the hospital for treatment with intravenously administered doxorubicin (Adriamycin). The client tells the nurse that she has been told by herfriends that she is going to lose all her hair. The appropriate Nursing response is which of the following? a. Your friends are correct. b. You will not lose your hair. c. Hair loss may occur, but it will grow back just as it is now. d. Hair loss may occur, and it will grow back, but it may have a different color or texture. 458. The client diagnosed with leukemia has central nervous system involvement. Which instructions should the nurse teach?
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469. . Which is an incorrect statement pertaining to the following procedures for cancer diagnostics? A. Biopsy is the removal of suspicious tissue and the only definitive method to diagnose cancer B. Ultrasonography detects tissue density changes difficult to observe by X-ray via sound waves. C. CT scanning uses magnetic fields and radio frequencies to provide cross-sectional view of tumor D. Endoscopy provides direct view of a body cavity to detect abnormality. 470.. A post-operative complication of mastectomy is lymphedema. This can be prevented by
465. Which of the following observations reported by a patient with acute myelogenous leukemia (AML) would the nurse first assess? a. Weakness and fatigue b. Bruising on the arm c. Drainage from a small finger cut d. Mild abdominal Pain 466.. Mr. Perez is in continuous pain from cancer that has metastasized to the bone. Pain medication provides little relief and he refuses to move. The nurse should plan to: A. Reassure him that the nurses will not hurt him B. Let him perform his own activities of daily living C. Handle him gently when assisting with required care D. Complete A.M. care quickly as possible when necessary 467. . A client, who is suspected of having Pheochromocytoma, complains of sweating, palpitation and headache. Which assessment is essential for the nurse to make first? A. Pupil reaction B. Hand grips C. Blood pressure D. Blood glucose 468. . A chemotherapeutic agent 5FU is ordered as an adjunct measure to surgery. Which of the ff. statements
A. ensuring patency of wound drainage tube B. placing the arm on the affected side in a dependent position C. restricting movement of the affected arm D. frequently elevating the arm of the affected side above the level of the heart. .471. Which statement by the client indicates to the nurse that the patient understands precautions necessary during internal radiation therapy for cancer of the cervix? A. I should get out of bed and walk around in my room. B. My 7 year old twins should not come to visit me while Im receiving treatment. C. I will try not to cough, because the force might make me expel the application. D. I know that my primary nurse has to wear one of those badges like the people in the x-ray department, but they are not necessary for anyone else who comes in here. \472.. The laboratory results of the client with leukemia indicate bone marrow depression. The nurse should encourage the client to: A. Increase his activity level and ambulate frequently B. Sleep with the head of his bed slightly elevated C. Drink citrus juices frequently for nourishment
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473. Dennis receives a blood transfusion and develops flank pain, chills, fever and hematuria. The nurse recognizes that Dennis is probably experiencing: A. An anaphylactic transfusion reaction B. An allergic transfusion reaction C. A hemolytic transfusion reaction D. A pyrogenic transfusion reaction
478. In the early postoperative period following a transurethral surgery, the most common complication the nurse should observe for is: A. Sepsis B. Hemorrhage C. Leakage around the catheter D. Urinary retention with overflow
474.. A client jokes about his leukemia even though he is becoming sicker and weaker. The nurses most therapeutic response would be: A. Your laugher is a cover for your fear. B. He who laughs on the outside, cries on the inside. C. Why are you always laughing? D. Does it help you to joke about your illness? 475. n dealing with a dying client who is in the denial stage of grief, the best nursing approach is to: A. Agree with and encourage the clients denial B. Reassure the client that everything will be okay C. Allow the denial but be available to discuss death D. Leave the client alone to discuss the loss 476.. Rene, age 62, is scheduled for a TURP after being diagnosed with a Benign Prostatic Hyperplasia (BPH). As part of the preoperative teaching, the nurse should tell the client that after surgery: A. Urinary control may be permanently lost to some degree B. Urinary drainage will be dependent on a urethral catheter for 24 hours C. Frequency and burning on urination will last while the cystotomy tube is in place D. His ability to perform sexually will be permanently impaired 477. The transurethral resection of the prostate is performed on a client with BPH. Following surgery, nursing care should include:
479.. Following prostate surgery, the retention catheter is secured to the clients leg causing slight traction of the inflatable balloon against the prostatic fossa. This is done to: A. Limit discomfort B. Provide hemostasis C. Reduce bladder spasms D. Promote urinary drainage 480.Twenty-four hours after TURP surgery, the client tells the nurse he has lower abdominal discomfort. The nurse notes that the catheter drainage has stopped. The nurses initial action should be to: A. Irrigate the catheter with saline B. Milk the catheter tubing C. Remove the catheter D. Notify the physician 481. The nurse would know that a post-TURP client understood his discharge teaching when he says I should: A. Get out of bed into a chair for several hours daily B. Call the physician if my urinary stream decreases C. Attempt to void every 3 hours when Im awake D. Avoid vigorous exercise for 6 months after surgery
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487.. A 29-year-old man presents to his primary care physician with a painless testicular mass. Laboratory studies show an elevated serum human chorionic gonadotropin level. Which of the following is the most likely site of nodal metastasis in this tumor? (A) Deep inguinal lymph nodes (B) External iliac lymph nodes (C) Gluteal lymph nodes (D) Para-aortic lymph nodes 488. A 28-year-old woman comes to the physician concerned about an excessive amount of bleeding from her gums when she brushes her teeth. Her laboratory results show an increased partial thromboplastin time and an increased bleeding time, but are otherwise unremarkable. Which of the following treatments will most likely alleviate this patients symptoms? (A) Cryoprecipitate (B) Factor VIII concentrate (C) Fresh frozen plasma( correction : vitamin K) (D) Low-molecular-weight heparin 489. . Nurse Questions about a 29-year-old woman, who is 32 weeks pregnant and has been in the hospital for 3 days because of pyelonephritis, starts oozing blood from her intravenous lines and bleeding from her gums. Petechiae are also noted in her skin. Laboratory tests show a platelet count of 98,000/mm3, hematocrit of 38%, WBC count of 8000/mm3, and a prolonged prothrombin time. What other laboratory anomaly would also be expected? (A) Elevated D-dimer levels
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b. c. d.
499.. Regarding metastases from colorectal cancer and symptomatic management of them: a. b. c. d. Liver metastases are a rare feature. Hyperproteinaemia is common. Liver capsular pain usally responds well to non-steroidal anti-inflammatory drugs. Cerebral metastases are common.
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