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PN3 EXAM 1 AND STUDY GUIDE 2024-2025/ACTUAL EXAM WITH 100% CORRECT DTAILED ANSWERS/A GRADE, Exams of Nursing

East Coast Polytechnic Institute (ECPI)Nursing

PN3 EXAM 1 AND STUDY GUIDE 2024-2025/ACTUAL EXAM WITH 100% CORRECT DTAILED ANSWERS/A GRADE

Typology: Exams

2024/2025

Available from 12/03/2024

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PN3 EXAM 1 AND STUDY GUIDE 2024-2025/ACTUAL EXAM
WITH 100% CORRECT DTAILED ANSWERS/A GRADE
1. A client informs the nurse that they have been taught in counseling to alter
challenging thoughts after being diagnosed with cancer to improve feelings
and emotions. The nurse realizes this client has been using which of the
following forms of complementary alternative therapy?
a. Music therapy
b. Energy therapy
c. Meditation
d. Cognitive behavioral therapy
2. The UAP informs the nurse that the dying client manifests a death rattle.
Which action would the nurse perform?
a. Turn the client on the side to reduce gurgling
b. Instruct the UAP to initiate postmortem care
c. Notify the family that the patient has died
d. Tell the UAP that this is expected, and nothing can be done
3. A client is diagnosed with metastatic cancer. The family asks the nurse “what
is the difference between hospice and palliative care?” the nurse correctly
responds with which statement?
a. Hospice care allows for continued chemotherapy treatments, and
palliative care doesn’t
b. Hospice is for clients with a prognosis of fewer than 12 months to live
c. Palliative is for clients in any stage of a serious illness
d. Palliative care requires revaluation every 30-60 days
4. The nurse is concerned that a hospice client is approaching death when the
following is assessed?
a. Blood pressure 110/60
b. Periods of wakefulness are greater than periods of sleep
c. Respiratory rate of 16 per minute and regular
d. Restless, irritability, and anxiety
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Download PN3 EXAM 1 AND STUDY GUIDE 2024-2025/ACTUAL EXAM WITH 100% CORRECT DTAILED ANSWERS/A GRADE and more Exams Nursing in PDF only on Docsity!

PN3 EXAM 1 AND STUDY GUIDE 2024- 2025 /ACTUAL EXAM

WITH 100% CORRECT DTAILED ANSWERS/A GRADE

  1. A client informs the nurse that they have been taught in counseling to alter challenging thoughts after being diagnosed with cancer to improve feelings and emotions. The nurse realizes this client has been using which of the following forms of complementary alternative therapy? a. Music therapy b. Energy therapy c. Meditation d. Cognitive behavioral therapy
  2. The UAP informs the nurse that the dying client manifests a death rattle. Which action would the nurse perform? a. Turn the client on the side to reduce gurgling b. Instruct the UAP to initiate postmortem care c. Notify the family that the patient has died d. Tell the UAP that this is expected, and nothing can be done
  3. A client is diagnosed with metastatic cancer. The family asks the nurse “what is the difference between hospice and palliative care?” the nurse correctly responds with which statement? a. Hospice care allows for continued chemotherapy treatments, and palliative care doesn’t b. Hospice is for clients with a prognosis of fewer than 12 months to live c. Palliative is for clients in any stage of a serious illness d. Palliative care requires revaluation every 30 - 60 days
  4. The nurse is concerned that a hospice client is approaching death when the following is assessed? a. Blood pressure 110/ b. Periods of wakefulness are greater than periods of sleep c. Respiratory rate of 16 per minute and regular d. Restless, irritability, and anxiety
  1. What comfort measures can be performed by a nurse instead of a UAP, for a client who returned from a left modified radical mastectomy? a. Supporting the left arm during the clients first time ambulating after surgery b. Assess under the skin flaps and surgical site c. Elevating the left arm on a pillow d. Placing the HOB in semi- fowlers
  2. A client is receiving radiation treatments by teletherapy. Which of the following is a correct statement of external radiation teletherapy? a. The client is radioactive for 48 - 72 hours after treatment b. The client is not radioactive, and there are no hazards c. The client is radioactive until the radioactive isotope seeds pass d. The client is radioactive for the first 24 - 48 hours after treatments
  3. The nurse is being trained in hospice care. Which is the most compatible with the goals surrounding end of life care? a. Administer influenza and pneumococcal vaccinations b. Encourage client to consent to a feeding tube if the appetite decreases c. Allow a client with COPD to have a cigarette d. Perform ROM to prevent contractures
  4. The nurse would incorporate which of the following in the plan of care as secondary prevention strategy for a client to reduce their risk of cancer? a. Removal of “at risk” tissues known for developing specific type of cancer b. Colonoscopy at the age of 50 then every 10 years c. Receiving HPV vaccine as a teen d. Use of chemoprevention to disrupt one or more steps important to cancer development
  5. The nurse is developing a plan of care for the client experiencing neutropenia secondary to chemo. Which of the following is a nurse’s priority to include in the clients plan of care? a. Ensure good hand hygiene before anyone has contact with the client

b. report any signs or symptoms of bleeding or bruising to the health care provider c. provide frequent episodes of rest d. avoid eating hard food

  1. A client with cancer is admitted to a short-term rehab facility. The nurse prepares to administer the client’s oral chemotherapy medications. What action by the nurse is most appropriate? a. Wear PPE when handling the medications b. crush the medications that the client cannot swallow c. no special precautions are needed d. give one medication at a time with a full glass of water
  2. Which of the following should the nurse identify as a common physical sign and symptoms of approaching death and a terminally ill client? SATA a. alert and oriented times 4 b. irregular breathing patterns with gurgling and congestion c. slowing of a circulation coolness of the extremities d. genitourinary function changes such as incontinence e. disorientation and restlessness
  3. The client in the medical surgical unit has a platelet count of less than 50,000. Which of the following is the most important to include in the client’s education? a. Use a standard safety electric razor for shaving b. Use a soft bristly toothbrush to prevent bleeding c. Notify the health care provider of injuries with persistent bleeding d. Take stool softeners as prescribed to avoid straining during a bowel movement
  4. A nurse is completing a medication reconciliation review with the client on admission. Which teaching strategy should the nurse prepare to discuss with a lung cancer client wishing to use clinical aromatherapy to help early symptoms of chemotherapy induced nausea and vomiting? a. Explain to the client that health care providers did not incorporate such treatments as aromatherapy

b. Tell the client not to use aromatherapy for nausea c. Explain to the client that the health care providers are not prepared to recommend an monitor aromatherapy treatment d. Reinforce to the client to follow up with the health care provider before using aromatherapy to assess and monitor for allergies and bronchospasms

  1. While collecting a health history on a client admitted for colon cancer which of the following questions would be appropriate for the nurse to ask this client? a. Have you experienced nausea b. do you have back pain c. happy notice any swelling in your abdomen d. have you noticed any blood in your stool
  2. The nurse is caring for an end of life terminally ill client experiencing very shallow and rapid breaths with periods of apnea. After evaluating the client which action by the nurse would be the most appropriate? a. Reoriented the client as needed b. place the client in a supine position c. elevate the client head of the bed d. reduce the number of people into client’s room
  3. The client asked the nurse how does chemotherapy work? How does the nurse respond to this client? a. Chemotherapy kills cancer cells b. chemotherapy kills cancer cells and disrupts their cellular regulation c. chemotherapy treats the exposed area only with high energy rays d. chemotherapy agents are implanted in an area to inhibit cancer growth
  4. Hydromorphone 2mg IV for pain q 4hr Available is 4mg/mL
  5. A nurse is caring for a client who has named a person to serve as her health care proxy. Which statement made by the client indicates a need for further education?

b. clients with a family history of benign fibroid tumor c. clients with family histories of cancer d. clients with poor immune function

  1. After cancer chemotherapy a client develops chemotherapy induced nausea and vomiting. For this client the nurse should give priority to which action in the plan of care? a. Administering Zofran or ondansetron as prescribed b. serving small portions of bland food c. withholding fluids for the first four to six hours after chemotherapy administration d. encouraging rhythmic breathing exercises
  2. A client ask a nurse what they can do to prevent the onset of cancer. Which of the following are modifiable risk that contributes to development of care? SATA a. tobacco use b. environmental exposure to carcinogens c. excessive alcohol consumption d. genetic predisposition e. advancing age
  3. A nurse is caring for a client who has chemotherapy induced peripheral neuropathy. The nurse should expect the client to report having experience with which of the following symptoms? a. Jerking movements of extremities b. spasms of the extremities c. tingling feeling in the extremities d. extremities that turned blue when exposed to cold
  4. Which of the following statements made by a client after receiving instructions regarding internal radiation would indicate that teaching has been successful? a. I will be sharing a room near the nurse’s station b. my young children can come visit after school c. the hospital staff will limit the amount of time in my room

d. individuals will need to keep at least two feet away when possible

  1. A nurse conducted an admission review of the medication record with the client to an oncology unit. Which of the following complementary alternative therapies is the nurse’s priority to address? a. Aroma therapy to reduce nausea b. Reiki to promote physical healing mental emotional and spiritual balance c. Tai chi to improve relaxation d. herbal preparation to treat hypertension
  2. The client is experiencing dyspnea in their last moments of life. Which intervention will the nurse complete first? a. Administer a bronchodilator b. administer an intravenous (IV) opioid c. perform nasopharyngeal suctioning d. apply oxygen
  3. A client has been placed on estrogen therapy period. when reviewing the client told medication reconciliation the nurse instructs the client to stop taking which supplement? a. St. John’s wort b. Saw Palmetto c. Feverfew d. black cohosh
  4. A client's tumor was staged using the TNM system. The tumor was staged as TIS, N1, M0. The nurse understands that this staging means which of the following. a. Tumor in situ minimal node involvement no presence of metastasis b. Large tumor multiple node involvement presence of metastasis c. small tumor multiple nodes involvement no presence of metastasis d. large tumor no node involvement presence of metastasis
  5. A Hospice nurse is caring for a Catholic client at the end of life. Which of the following would the nurse identify as a death ritual with this religion?

would the nurse correctly identify to decrease nausea associated with chemotherapy induced nausea and vomiting? a. Ginger b. Ginkgo c. Garlic d. Bilberry

  1. A terminally ill client is experiencing restlessness, which complementary alternative therapy intervention can the nurse provide to calm this client? a. Apply met restraints to hands to avoid pulling out IV b. place a client in supine position c. hold sedation as this may increase restlessness d. play soothing music for the client
  2. A nurse is teaching at a health fair about early warning signs of cancer. Which of the following would the nurse include is an early sign? SATA a. Unusual bleeding or discharge b. change in bladder or bowel habits c. obvious changes in a mole d. sore that does not heal e. nagging cough
  3. Which client scenario describes the best example of professional collaboration? a. the nurse and physician discuss the clients muscle weakness and initiate referral for PT b. the nurse physician and PT all visited separately with the client c. the nurse physical therapist and physician have all developed separate care plans for the client d. the nurse mentions to the physical therapist that the client may benefit from muscle strength evaluation
  4. A nurse is providing education on the benefits of massage. which of the following would the nurse implement in the client's teaching on this complementary alternative therapy? SATA a. Promote spiritual life force chi, qi, and yin- yang flow

b. reduce cortisol levels and improves anxiety c. relaxes muscles d. promote circulation e. reduces pain

  1. Which laboratory report is of the nurse’s highest concern to monitor for client with bone marrow suppression after receiving chemotherapy? a. Serum prostate specific antigen b. white blood cell count c. triglycerides d. urine specific gravity
  2. The nurse would incorporate which of the following primary prevention strategies in the client's plan of care? a. Yearly PSA and digital rectal exam for men aged 50 and over b. yearly mammograms for women aged 40 years and older c. administering HPV vaccine to teens d. colonoscopy at age 50 and every 10 years as follow up
  3. A nurse is completing education about advance directives with the client on admission. Which of the following statements evaluates the client understands the purpose and procedure for advanced directives? a. An advance directive will specify what,if any extraordinary actions that I would want when I am no longer able to make decisions about personal health care b. an advance directive will allow me to keep my money out of reach of my family c. an advanced directive will be completed as soon as I am incapacitated and cannot think for myself d. an advance directive will keep my children from selling my home when I am old
  4. Order 2mg IV Available is 10 mg/mL

the nurse administer per dose?(Record answer to the nearest tenth,one decimal place.Use a leading zero if it applies.Do not use a trailing zero Answer: Aromatherapy is the best for nausea ALTERNATIVE THERAPY Reiki can help emotional balance of the patient with cancer Tai chi helps relax the patient.

Signs and symptoms of impending death

Death rattle, cool clammy skin, mottling, gurgling and congestion,

incontinent, involuntary bowel and bladder movement, disorientation,

waxy, restlessness

Radiation therapy is a permanent hair loss

Chemotherapy , hair is temporally destroyed

Hospice is comfort care only, pain and anxiety control, less than 6 month

Brachial therapy is internal radiation, it is radioactive, their body fluids

are also radioactive, led container, tongs, radioactive sign outside of the

door, anyone that enter must have decimeter on, time, distance, shield

Tele therapy not radioactive, very skin damaging, no lotion

Administer epoetin Alfa when hemoglobin is less than 10 , when less

than 6 administer transfusion

PPE for chemotherapy mask ,shield, gown and 2 pairs of purple chemo

gloves

Treatment for nausea and vomiting including alternative therapies

Ginger

Zofran or ondansetron

Wen diet

Aromatherapy

cold foods

Marinol

Acupuncture

TIS means tumor in situ meaning the tumor is totally encapsulated

T is tumor size

T1, T2 , T3 which is like enlarging

T1 - slow tumor

T2- medium tumor

T3- A large tumor

T4- Extra-large tumor

N- nodes

N0 – no node involvement

N1, N2 , N

N1 – one nodes involve

N2 – two nodes involve

N3 – three or more nodes involve

M is either M0 or Mx

M0 means there is no metastasis that they have found

Mx means they have found metastasis

The higher the tumor number, the worse the cancer

The higher the nodes number, mean multiple nodes are involve

The patient has to protect their skin for one year after radiation treatment PN3 EXAM 1 REVIEW- WITH ELLIOT ⟶ Elliot review https://drive.google.com/file/d/13AYu2OVtlVSU8YLRFm3XyCntPmKSj0oa/view?usp=drivesdk

  • Modifiable risk factors for cancer
  • Most common physical sing & symptoms of approaching death o Pallor o Decrease appetite o Restlessness o Modeling o Cool extremities o Gurgling o Shallow/ irregular breathing pattern o Disorientation o Incontinence
  • How does chemotherapy work? o Prevents cellular replication and mutation. o Kills bad and good cells
  • Nurse caring for patients who had terminal illness walk in and find they are comatose, who would take over decisions for patient o Health care power of attorney (health care proxy). Health care proxy, care agent, or surrogate decision maker will make decisions only when the person lacks the capacity to make decisions on their own o 2 days later the patient is fully alert- The patient becomes in charge of their own decisions.
  • Patient on estrogen therapy for cancer- what supplement should NOT be used?

o Black cohosh

o

  • What type of patient therapy is done through counseling and helps patient with cancer deal with emotions/feeling?

o Cognitive behavioral therapy.

  • Difference between hospice vs palliative

o Hospice - diagnosis less that 6 months to live, consume all medical care.

o Palliative - any stage of serious illness. Can still see physician and receive

treatment no time frame.

  • Patient is dying, notice they are becoming dyspneic in last moments of life what does nurse do? o Administer morphine for air hunger (Air hunger, a primal sensation, alerts us to a failure to meet an urgent homeostatic need maintaining gas exchange. It is often experienced by hospice patients; oxygen is rarely effective at this stage.)
  • Brachytherapy INTERNAL radiation, ARE radioactive 48 - 72hrs. Cervical, endometrial, seed in prostate or iodine for thyroid. Isotope seeds implanted in the tumor.

o Markings o Do not use lotion o Protect from sunlight exposure and UV exposure. o Patient is NOT radioactive o No biohazards that go along with this type of radiation treatment.

  • Concerns of patient whose platelet count in under 40, o BLEEDING (normal 150,000-450,000) (low=bleeding)
  • Cancer patient has hemoglobin of 7. What medication can be ordered? o Epoetin alpha.
  • What helps patient with cancer that have had chemo and developed chemo brain? o Reorientation o Cognitive retraining (word searches, memory reminiscing)
  • Giving patient Fosamax (chemo drug) how should it arrive from pharmacy? and what do you need to do to protect yourself? Comes in yellow bag (biohazard) o Wear chemo rated gloves and full PPE. (b/c it is radioactive drug)
  • Herbs that can treat nausea o Ginger
  • Tumor staging
  • Cultures and end of life. o Roman Catholic tradition encourages people to receive Sacrament of the Sick, administered by a priest at any point during an illness. This sacrament may be administered more than once. Not receiving this sacrament will not prohibit them from entering heaven after death. o People may be baptized as Roman Catholics in an emergency situation (e.g., person is dying) by a layperson. Otherwise, they are baptized by a priest. o Hispanic client end of life importance- The spirit may get lost if the client dies in the hospital, and it will not be able to find its way home. They want the client to die at home.