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NURS455 Exam 1 Questions With
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A patient has hematuria, abdominal discomfort, and a distended abdomen. Which condition does the patient most likely have, according to these symptoms? a. brain tumor b. bladder cancer c. cervical cancer d. esophageal cancer - ANSWER b. bladder cancer A patient with lung cancer is diagnosed with superior vena cava syndrome. Which action is most appropriate for this patient? a. assessing for signs of fluid overload b. assessing for unsteady gait c. assessing for signs of renal dysfunction d. assessing for signs of respiratory distress - ANSWER d. assessing for signs of respiratory distress Warning signs of cancer (CAUTION) Select all that apply a. Change in bowel habits b. Nagging cough or hoarseness c. alopecia d. obvious change in wart or mole - ANSWER a. Change in bowel habits b. Nagging cough or hoarseness d. obvious change in wart or mole The nurse monitors fluid overload in a patient with cancer-associated syndrome of inappropriate antidiuretic hormone (SIADH). Which condition is the nurse aiming to prevent in this intervention? a. Dyspnea
B. Heart Block c. leukostasis d. HTN - ANSWER d. HTN What is true regarding bowel obstruction in a patient with colon cancer? a. it can happen due to masses in bowel lumen b. it can happen due to internal compression c. it can happen due to excess antidiuretic hormone d. it can happen due to excessive immature WBCs - ANSWER a. it can happen due to masses in bowel lumen A nurse is caring for a patient with acute myelocytic leukemia who has been admitted to the oncology department due to leukostasis. What are the most important nursing interventions for this patient? Select all that apply. a. Monitor white blood cell count. b. Assess for signs of occluded microcirculation. c. Monitor calcium, phosphorous, and renal function. d. Assess for edema of the face and eyes. e. Assess for signs of bleeding. - ANSWER a. Monitor white blood cell count. b. Assess for signs of occluded microcirculation. e. assess for signs of bleeding A nurse is teaching about carcinogens. Which example indicates a need for further teaching? a. HPV b. Tobacco c. Sun exposure d. nonionizing radiation - ANSWER d. nonionizing radiation The nurse is caring for a patient with spinal cord compression. Which symptoms demonstrate late stages? a. back pain b. weakness, numbness, and tingling
Which is most appropriate to teach the family of the child with sickle cell disease (SCD) about preventing infections?
a. get the flu vaccine every 3 years b. have tuberculin skin testing every 6 months c. get pneumococcal vaccine every 2 years d. inspect cuts, sores, and insects bites carefully - ANSWER d. inspect cuts, sores, and insects bites carefully
Which is the most beneficial instruction that the nurse can teach a patient about preventing a sickle cell crisis?
a. refrain from taking too much water b. refrain from traveling in depressurized airplanes c. perform regular workouts and brisk walking d. wear tight-fitting clothes - ANSWER b. refrain from traveling in depressurized airplanes
Which patient is most likely to be affected by sickle cell disease (SCD)?
a. a member of an Indian tribe b. a person of Cuban nationality c. a person of tropical African descent d. an individual of middle eastern origin - ANSWER c. a person of tropical African descent
The nurse is teaching about the most common causes of death in the patient with sickle cell disease (SCD). What should the nurse include? Select all that apply
a. infection b. hypertensive crisis c. stroke d. organ damage - ANSWER a. infection c. stroke d. organ damage
A patient is experiencing an acute episode of sickle cell crisis. What treatments may the nurse request from the healthcare provider? Select all that apply
a. oxygen b. blood transfusion c. opioid pain medication d. IV fluids e. antipyretics - ANSWER a. oxygen b. blood transfusion c. opioid pain medication d. IV fluids e. antipyretics
The parent of a teen in sickle cell crisis asks the nurse about the long-term impact of these acute episodes. What complications are possible? Select all that apply.
a. hand-foot syndrome b. delayed puberty c. cognitive impairment d. diabetes
b. reduction in the number of platelets c. deficiency of vitamin B d. increase in production of RBCs - ANSWER a. depletion of iron in the body
Which assessment findings does the nurse associate with iron deficiency anemia (IDA)? Select all that apply.
a. fatigue b. bradycardia c. glossitis (painful swelling of tongue) d. koilonychias (spoon shaped fingernails) e. pica ( paint, ice, clay, dirt) - ANSWER a. fatigue
c. glossitis (painful swelling of tongue)
d. koilonychias (spoon shaped fingernails)
e. pica ( paint, ice, clay, dirt)
The nurse is caring for a patient with iron deficiency anemia. Which food should the nurse teach the patient to include in his or her daily diet to improve iron absorption?
a. white meat b. citrus fruits c. green leafy vegetables d. iron fortified cereals - ANSWER b. citrus fruits
Which individuals are likely to develop vitamin B12 anemia? Select all that apply.
a. an older adult client b. a premenopausal client c. a patient with recent GI resection d. a patient who is long term vegetarian - ANSWER a. an older adult client
c. a patient with recent GI resection
d. a patient who is long term vegetarian
Which is true regarding pernicious anemia?
a. it is caused by lack of vitamin B b. it is an autoimmune disease c. it is overcome by increase in animal protein d. it stimulates the production of intrinsic factor in the stomach - ANSWER b. it is an autoimmune disease
Which assessment finding is correlated with vitamin B12 deficiency? Select all that apply.
a. pain in joints b. impaired sense of balance c. numbness and tingling in the hands and feet d. sensation of electric chock produced by neck flexion - ANSWER b. impaired sense of balance
c. numbness and tingling in the hands and feet
Which is true regarding the pathophysiology of leukemia?
a. the uncontrollable production of WBC is called apoptosis
b. an unknown stimulus mutates a lymphoid stem cell
c. programmed cell death is called leukocytosis
d. the cloning process the leukemic cell is controllable - ANSWER b. an unknown stimulus mutates a lymphoid stem cell
A nurse is teaching about the epidemiology of leukemia. Which statements indicate a need for further teaching? Select all that apply.
a. leukemia is prevalent in black women older than 50 years of age
b. acute lymphoblastic leukemia is prevalent mainly in older adults.
c. down syndrome is a risk factor for leukemia
d. there are four major types of leukemia - ANSWER a. leukemia is prevalent in black women older than 50 years of age
b. acute lymphoblastic leukemia is prevalent mainly in older adults.
The nurse is caring for a patient with leukemia who is receiving chemotherapy and radiation. Which precautions should the nurse take for this patient? Select all that apply
a. wash hands frequently or use hand sanitizer
b. keep fresh cut flowers in the room
c. instruct the patient to refrain from consuming blackberries and raspberries
d. teach the patient to refrain from meeting very sick people or pets - ANSWER a. wash hands frequently or use hand sanitizer
c. instruct the patient to refrain from consuming blackberries and raspberries
d. teach the patient to refrain from meeting very sick people or pets
Which is most appropriate for the nurse to teach a patient with leukemia who has developed thrombocytopenia? Select all that apply.
a. a soft-bristle toothbrush to clean the teeth
b. use an electric razor on shaving
c. refrain from using stool softener
a. a soft-bristle toothbrush to clean the teeth
b. use an electric razor on shaving - ANSWER a. a soft-bristle toothbrush to clean the teeth
a. place a mask on the client b. request that every leave c. give masks to each visitor d. only allow 1 visitor at a time - ANSWER c. give masks to each visitor
Define: Thrombocytopenia - ANSWER is a reduction in the number of platelets below the avg range 150,000 to 450,000.
Normal platelet range - ANSWER 150,000 to 450,00 mm
What precautions are put in place for a client with thrombocytopenia?
a. airborne b. bleeding c. contact d. neutropenic - ANSWER b. bleeding precautions
Define: Thrombocytosis - ANSWER increased platelet count
Major complication of thrombocytopenia? - ANSWER risk for hemorrhage
_______________ increase platelet count by decreasing the antiplatelet antibody production.
a. antiemetic b. bronchodilators c. glucocorticoids
d. antibiotics - ANSWER c. glucocorticoids
Clinical manifestations: Thrombocytopenia - ANSWER -Ecchymosis (bruise) -Petechiae (brown, purple round spots due to bleeding) -Bleeding: nose, gums, GI tract, -hematuria -black and tarry stools
Assessments: Thrombocytopenia - ANSWER -Platelet count -Ecchymosis (ease of bruising) -Petechiae/purpura (intradermal bleeding, spots) -Frank bleeding (nosebleeds, bleeding gums, black tarry stool, hematuria)
Nursing actions: Thrombocytopenia - ANSWER -Implement bleeding precautions -Minimize blood loss -Avoid IM injections -Avoid rectal temps, enemas, douches, suppositories -Provide a safe environment -Use minimal inflation when assessing BP -Minimize blood draws
Teaching: Thrombocytopenia - ANSWER -Instruct the patient/ family on bleeding precautions -Instruct the patient to avoid sexual intercourse when the platelet count id less than 50,000/mm3. -Frequent CBC and lab tests
Define: COPD - ANSWER -characterized by airflow limitations
Complications: COPD - ANSWER secondary spontaneous pneumothorax (SSP) caused by rupture of alveoli
Assessments: COPD - ANSWER Oxygen saturation (less than 90) Respiratory rate Breath sounds (crackles, wheezing) Pursed lip breathing Cough (cardinal sign of pulmonary disease) temp (increased is a sign of infection) Dyspnea Weight (monitor)
Actions: COPD - ANSWER -Administer bronchodilators -Provide oxygen -Semi fowlers -Small frequent meals
Teaching: COPD - ANSWER -breathing techniques (pursed lip) -smoking cessation -nutritional needs -medication regimen -vaccine prophylaxis -pacing activities
Lasix (furosemide) - ANSWER decreases fluid volume. treats fluid overload.
Epogen (epoetin alfa) - ANSWER stimulates bone marrow production of cells and relieve symptoms. (used with aplastic anemia)
Ferrous sulfate (iron) - ANSWER -promotes hemoglobin formation -cell integrity
Prednisone - ANSWER -anti-inflammatory agents
-Treats underlying dermatitis/inflammation if present from bacterial invasion. Inflammatory response from bacteria may be significant and requires a decrease in inflammation to enhance healing.
-to treat arthritis, bone pain, and painful dermatitis as well as visceral pain conditions, including lupus erythematosus, sarcoidosis, and inflammatory bowel disease.
Nursing considerations: Neutropenia - ANSWER -private room -hand washing -wear a mask -no flowers in room and no strawberries -avoid large crowds -avoid infection -get immunizations -dust free -disinfect room
Prevention measures: Cancer - ANSWER -no tobacco use -HPV immunization
-chest pain -hemoptysis
Lung cancer (later symptoms) - ANSWER -anorexia -n/v -loss of appetite
Priorities: Thoracentesis - ANSWER - don't talk during procedure** -lab values -positioned correctly -can become hypoxic (O2 sats low, chest pain) -Assess lungs -Encourage deep breathing
Nursing priority diagnosis: Lung cancer - ANSWER Ineffective gas exchange.
Ineffective airway clearance. -listen to lung sounds -administer oxygen bronchodilators -incentive spirometer
Internal radiation therapy - ANSWER -During time when the patient is still considered radioactive ( they cannot have family members to minimize exposure staff also must don appropriately).
Chemotherapy destroys - ANSWER bone marrow.
Chemotherapy can cause - ANSWER anemia, thrombocytopenia, and leukopenia.
Risks: Chemotherapy - ANSWER -at risk for infection -monitor RBCs, WBCs, and platelets -Can develop alopecia, dementia, and photosensitivity -dry mouth
Nursing Considerations: Anemia - ANSWER -Monitor HbG and Hct levels -Fatigue, pallor -Monitor for hypoxia
GI disturbances: Chemotherapy - ANSWER - fluids and antiemetic
- small frequent meals
- avoid high processed foods
- high protein diet
- if in pain administer (opioid) -administer antiemetic 30 mins-1 hour before meals -administer pain medication
Expectations: Thoracentesis - ANSWER -diminished lung sounds -blood from the puncture site -SPO2 less than 95% is the most important
Causes of Anemia - ANSWER blood loss, impaired production of erythrocytes, increased destruction of erythrocytes.
Manifestations of Anemia - ANSWER usually asymptomatic.
