Quiz
Exam 2 Part 4
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Questions in this quiz (126)
1 Which treatment for BPH uses a low-wave radiofrequency to precisely destroy prostate tissue?
- ALaser prostatectomy
- BTransurethral needle ablation (TUNA)
- CTransurethral microwave thermotherapy (TUMT)
- DTransurethral electrovaporization of prostate (TUVP)
2Which characteristics describe transurethral resection of the prostate (TURP) (select all that apply)?
- ABest used for a very large prostate gland
- BInappropriate for men with rectal problems
- CInvolves an external incision prostatectomy
- DUses transurethral incisions into the prostate
- EMost common surgical procedure to treat BPH
- FResectoscopic excision and cauterization of prostate tissue
3 Which therapies for BPH are done on an outpatient basis (select all that apply)?
- AIntraprostatic urethral stents
- BTransurethral needle ablation (TUNA)
- CTransurethral microwave therapy (TUMT)
- DTransurethral incision of prostate (TUIP)
- EVisual laser ablation of the prostate (VLAP)
4Before undergoing a TURP, what should the patient be taught?
- ASome degree of urinary incontinence is likely to occur.
- BThis surgery results in some degree of retrograde ejaculation.
- CErectile dysfunction is a common complication of this prostate surgery.
- DAn indwelling catheter will be used to maintain urinary output until healing is complete.
5Following a TURP, a patient has continuous bladder irrigation. Four hours after surgery, the catheter is draining thick, bright red clots and tissue. What should the nurse do?
- ARelease the traction on the catheter.
- BManually irrigate the catheter until the drainage is clear.
- CIncrease the rate of the irrigation and take the patient’s vital signs.
- DClamp the drainage tube and notify the patient’s health care provider.
6A patient with continuous bladder irrigation following a prostatectomy tells the nurse that he has bladder spasms and leaking of urine around the catheter. What should the nurse do first?
- ASlow the rate of the irrigation.
- BAssess the patency of the catheter.
- CEncourage the patient to try to urinate around the catheter.
- DAdminister a belladonna and opium (B&O) suppository as prescribed
7 The nurse provides discharge teaching to a patient following a TURP and determines that the patient understands the instructions when he makes which statement?
- A“I should use daily enemas to avoid straining until healing is complete.”
- B“I should avoid heavy lifting, climbing, and driving until my follow-up visit.”
- C“At least I don’t have to worry about developing cancer of the prostate now.”
- D“Every day I should drink 10 to 12 glasses of liquids such as coffee, tea, or soft drinks.”
8A 55-year-old man with a history of prostate cancer in his family asks the nurse what he can do to decrease the risk of prostate cancer. What should the nurse teach him about prostate cancer risks?
- ANothing can decrease the risk because prostate cancer is primarily a disease of aging
- BTreatment of any enlargement of the prostate gland will help to prevent prostate cancer.
- CSubstituting fresh fruits and vegetables for high-fat foods in the diet may lower the risk of prostate cancer.
- DUsing a natural herb, saw palmetto, has been found to be an effective protection against prostate cancer.
9When caring for a patient following a radical prostatectomy with a perineal approach, what is the priority nursing intervention the nurse should use to prevent complications?
- AUse chemotherapeutic agents to prevent metastasis.
- BAdminister sildenafil (Viagra) as needed for erectile dysfunction.
- CProvide wound care after each bowel movement to prevent infection.
- DInsert a smaller indwelling urinary catheter to prevent urinary retention.
10What accurately describes prostate cancer detection and/or treatment (select all that apply)?
- AThe symptoms of pelvic or perineal pain, fatigue, and malaise may be present.
- BPalpation of the prostate reveals hard and asymmetric enlargement with areas of induration or nodules.
- COrchiectomy is a treatment option for all patients with prostatic cancer except those with stage IV tumors.
- DThe preferred hormonal therapy for treatment of prostate cancer includes estrogen and androgen receptor blockers.
- EEarly detection of cancer of the prostate is increased with annual rectal examinations and serum prostatic acid phosphatase (PAP) measurements.
- FAn annual prostate examination is recommended starting at age 45 for African American men because of the increased mortality rate from prostatic cancer in this population.
11What is an explanation that the nurse should give to the patient who asks what his diagnosis of paraphimosis means?
- APainful, prolonged erection
- BInflammation of the epididymis
- CPainful downward curvature of an erect penis
- DRetracted tight foreskin preventing return over the glans
12The cremasteric reflex is absent in which problem of the scrotum and testes?
- AHydrocele
- BVaricocele
- CSpermatocele
- DTesticular torsion
13When teaching a patient testicular self-examination, the nurse instructs the patient to report which finding?
- AAn irregular-feeling epididymis
- BOne testis larger than the other
- CThe spermatic cord within the testicle
- DA firm, nontender nodule on the testis
14A patient is seeking medical intervention for erectile dysfunction. Why should he be thoroughly evaluated?
- ATreatment of erectile dysfunction is based on the cause of the problem.
- BPsychologic counseling can reverse the problem in 80% to 90% of the cases.
- CNew invasive and experimental techniques currently used have unknown risks.
- DMost treatments for erectile dysfunction are contraindicated in patients with systemic diseases
15A 66-year-old male patient is experiencing erectile dysfunction (ED). He and his wife have used tadalafil (Cialis) but because he experienced priapism, they have decided to change their treatment option to an intraurethral device. How should the nurse explain how this device works
- AThe device relaxes smooth muscle in the penis.
- BBlood is drawn into corporeal bodies and held with a ring.
- CThe device is implanted into corporeal bodies to firm the penis.
- DThe device directly applies drugs that increase blood flow in the penis.
16You are assessing a long-term-care client with a history of benign prostatic hyperplasia (BPH). Which information will require the most immediate action?
- AThe client states that he always has trouble starting his urinary stream.
- BThe chart shows an elevated level of prostate-specific antigen.
- CThe bladder is palpable above the symphysis pubis and the client is restless.
- DThe client says he has not voided since having a glass of juice 4 hours ago.
17While performing a breast examination on a 22-year-old client, you obtain the following data. Which finding is of most concern?
- ABoth breasts have many nodules in the upper outer quadrants.
- BAn irregularly shaped, nontender lump is palpable in the left breast.
- CThe breast on the right side is slightly larger than the left breast.
- DThe client reports bilateral breast tenderness with palpation.
18After undergoing a modified radical mastectomy, a client is transferred to the postanesthesia care unit (PACU). Which nursing action is best to delegate to an experienced LPN/LVN?
- AMonitoring the client’s dressing for any signs of bleeding
- BDocumenting the initial assessment on the client’s chart
- CCommunicating the client’s status report to the charge nurse on the surgical unit
- DTeaching the client about the importance of using pain medication as needed
19You are working with a UAP to care for a client who has had a right breast lumpectomy and axillary lymph node dissection. Which nursing action can you delegate to the UAP?
- ATeaching the client why blood pressure measurements are taken on the left arm
- BElevating the client’s arm on two pillows to promote lymphatic drainage
- CAssessing the client’s right arm for lymphedema
- DReinforcing the dressing if it becomes saturated
20You obtain the following assessment data about your client who has had a transurethral resection of the prostate (TURP) and has continuous bladder irrigation. Which finding indicates the most immediate need for nursing intervention?
- AThe client states that he feels a continuous urge to void.
- BThe catheter drainage is light pink with occasional clots.
- CThe catheter is taped to the client’s thigh.
- DThe client reports painful bladder spasms.
21A 67-year-old client with BPH has a new prescription for tamsulosin (Flomax). Which statement about tamsulosin is most important to include when teaching this client?
- A“This medication will improve your symptoms by shrinking the prostate.”
- B“The force of your urinary stream will probably increase.”
- C“Your blood pressure will decrease as a result of taking this medication.”
- D“You should avoid sitting up or standing up too quickly.”
22You are caring for a client who has just returned to the surgical unit after a TURP. Which assessment finding will require the most immediate action?
- ABlood pressure reading of 153/88 mm Hg
- BCatheter that is draining deep red blood
- CClient not wearing antiembolism hose
- DClient reports of abdominal cramping
23After a radical prostatectomy, a client is ready to be discharged. Which nursing action included in the discharge plan should be delegated to an experienced LPN/LVN?
- AReinforcing the client’s need to check his temperature daily
- BTeaching the client how to care for his retention catheter
- CDocumenting a discharge assessment in the client’s chart
- DInstructing the client about the prescribed narcotic analgesic
24The day after a radical prostatectomy, your client has blood clots in the urinary catheter and reports bladder spasms. The client says that his right calf is sore and that he feels short of breath. Which action will you take first?
- AIrrigate the catheter with 50 mL of sterile saline
- BAdminister oxybutynin (Ditropan) 5 mg orally.
- CApply warm packs to the client’s right calf.
- DMeasure oxygen saturation using pulse oximetry.
25After arriving for your shift in the emergency department (ED), you receive a change-of-shift report about all of these clients. Which one do you need to assess first?
- A19-year-old with scrotal swelling and severe pain that has not decreased with elevation of the scrotum
- B25-year-old who has a painless indurated lesion on the glans penis
- C44-year-old with an elevated temperature, chills, and back pain associated with recurrent prostatitis
- D77-year-old with abdominal pain and acute bladder distention
26A 68-year-old client who is ready for discharge from the ED has a new prescription for nitroglycerin (Nitrostat) 0.4 mg sublingual as needed for angina. Which client information has the most immediate implications for teaching?
- AThe client has BPH and some urinary hesitancy.
- BThe client’s father and two brothers all have had myocardial infarctions.
- CThe client uses sildenafil (Viagra) several times weekly for erectile dysfunction.
- DThe client is unable to remember when he first experienced chest pain.
27You are caring for a 21-year-old client who had a left orchiectomy for testicular cancer on the previous day. Which nursing activity will you delegate to an LPN/LVN?
- AEducating the client about post-orchiectomy chemotherapy and radiation
- BAdministering the prescribed “as needed” (PRN) oxycodone (Roxicodone) to the client
- CTeaching the client how to perform testicular self-examination on the remaining testicle
- DAssessing the client’s knowledge level about post-orchiectomy fertility
28You are the charge nurse on the oncology unit. Which client is best to assign to an RN who has floated from the ED?
- AClient who needs doxorubicin (Adriamycin) to treat metastatic breast cancer
- BClient who needs discharge teaching after surgery for stage II ovarian cancer
- CClient with metastatic prostate cancer who requires frequent assessment and treatment for breakthrough pain
- DClient with testicular cancer who requires preoperative teaching about orchiectomy and lymph node resection
29A client has had a needle biopsy of the prostate gland using the transrectal approach. Which statement is most important to include in the client teaching plan?
- A“The doctor will call you about the test results in a day or two.”
- B“Serious infections may occur as a complication of this test.”
- C“You will need to call the doctor if you develop a fever or chills.”
- D“It is normal to have a small amount of rectal bleeding after the test.”
30When you are developing the plan of care for a home health client who has been discharged after a radical prostatectomy, which activities will you delegate to the home health aide? (Select all that apply.)
- AMonitoring the client for symptoms of urinary tract infection
- BHelping the client to connect the catheter to the leg bag
- CChecking the client’s incision for appropriate wound healing
- DAssisting the client in ambulating for increasing distances
- EHelping the client shower at least every other day
31When assessing a client with cervical cancer who had a total abdominal hysterectomy yesterday, you obtain the following data. Which information has the most immediate implications for planning of the client’s care?
- AFine crackles are audible at the lung bases.
- BThe client’s right calf is swollen, and she reports calf tenderness.
- CThe client uses the patient-controlled analgesia device every 30 minutes.
- DUrine in the collection bag is amber and clear.
32You observe a student nurse who is caring for a client who has an intracavitary radioactive implant in place to treat cervical cancer. Which action by the student requires that you intervene immediately?
- AStanding next to the client for 5 minutes while assisting with her bath
- BAsking the client how she feels about losing her childbearing ability
- CAssisting the client to the bedside commode for a bowel movement
- DOffering to get the client whatever she would like to eat or drink
33A client who underwent an abdominal hysterectomy 3 days ago reports burning with urination. Her urine output during the previous shift was 210 mL, and her temperature is 101.3° F (38.5° C). Which of these actions prescribed by the health care provider will you implement first?
- AInsert a straight catheter PRN for output of less than 300 mL/8 hr.
- BAdminister acetaminophen (Tylenol) 650 mg orally.
- CSend a urine specimen to the laboratory for culture and sensitivity testing.
- DAdminister ceftizoxime (Cefizox) 1 g IV every 12 hours.
34You are working on a medical unit staffed with LPNs/LVNs and UAPs when a client with stage IV ovarian cancer and recurrent ascites is admitted for paracentesis. Which activity is best to delegate to an experienced LPN/LVN?
- AObtaining a paracentesis tray from the central supply area
- BCompleting the short-stay client admission form
- CMeasuring vital signs every 15 minutes after the procedure
- DProviding discharge instructions after the procedure
35While you are working in the clinic, a healthy 32-year-old woman whose sister is a carrier of the BRCA gene asks you which form of breast cancer screening is the most effective for her. Which response is best?
- A“An annual mammogram is usually sufficient screening for women your age.”
- B“Monthly self-breast examination is recommended because of your higher risk.”
- C“A yearly breast examination by a health care provider should be scheduled.”
- D“Magnetic resonance imaging is recommended in addition to annual mammography.”
36An 80-year-old female patient is receiving palliative care for heart failure. Primary purpose(s) of her receiving palliative care is (are) to (select all that apply)
- Aimprove her quality of life.
- Bassess her coping ability with disease.
- Chave time to teach pt and family about disease
- Dfocus on reducing the severity of disease symptoms.
- Eprovide care that the family is unwilling or unable to give
37The primary purpose of hospice is to
- Aall pts to die at home
- Bprovide better quality of care than the family can.
- Ccoordinate care for dying patients and their families.
- Dprovide comfort and support for dying pts and their family
38A 67-year-old woman was recently diagnosed with inoperable pancreatic cancer. Before the diagnosis she was very active in her neighborhood association. Her husband is concerned because his wife is staying at home and missing her usual community activities. Which common EOL psychologic manifestation is she most likely demonstrating?
- Apeacefullness
- Bdecreased socialization
- Cdecreased decision making
- Danxiety about unfinished business
39For the past 5 years Tom has repeatedly asked his mother to donate his deceased father's belongings to charity, but his mother has refused. She sits in the bedroom closet, crying and talking to her long-dead husband. What type of grief is Tom's mother experiencing?
- AAdaptive grief
- Bdisruptive grief
- CAnticipatory grief
- DProlonged grief disorder
40The home health nurse visits a 40-year-old patient with metastatic breast cancer who is receiving palliative care. The patient is experiencing pain at a level of 7 (on a 10-point scale). In prioritizing activities for the visit, the nurse would do which first?
- AAuscultate for breath sounds.
- BAdminister PRN pain medication.
- CCheck pressure points for skin breakdown.
- DAsk pt's family about food and fluid intake
41While caring for his dying wife, the husband states that his wife is a devout Roman Catholic but he is a Baptist. Who is considered the most reliable source for spiritual preferences concerning EOL care for the dying wife?
- Aa priest
- Bdying wife
- Chospice staff
- Dhusband of dying wife
42The family attorney informed a patient's adult children and wife that the patient did not have an advance directive after he suffered a serious stroke. Who is responsible for making the decision about EOL measures when the patient cannot communicate his or her specific wishes?
- ANotary and attorney
- BPhysician and family
- CWife and adult children
- DPhysician and nursing staff
43The children caregivers of an elderly patient whose death is imminent have not left the bedside for the past 36 hours. In the nurse's assessment of the family, what findings indicate the potential for an abnormal grief reaction to occur (select all that apply)?
- AFamily cannot express their feelings to one another
- BDying patient is becoming more restless and agitated.
- CA family member is going through a difficult divorce.
- DFamily talks with and reassures the patient at frequent intervals.
- ESiblings who were estranged from each other have now reunited.
44A nurse has been working full time with terminally ill patients for 3 years. He has been experiencing irritability and mixed emotions when expressing sadness since four of his patients died on the same day. To optimize the quality of his nursing care, he should examine his own
- Afull-time work schedule.
- Bpast feelings toward death.
- Cpatterns for dealing w/ grief
- Ddemands for involvement in patient care.
45 According to the World Health Organization, palliative care is an approach that improves quality of life for patients and their families who face problems associated with life-threatening illnesses. From the list below, identify the specific goals of palliative care (select all that apply).
- ARegard dying as a normal process.
- BMinimize the financial burden on the family.
- CProvide relief from symptoms, including pain.
- DAffirm life and neither hasten nor postpone death.
- EProlong the patient’s life with aggressive new therapies
- FSupport holistic patient care and enhance quality of life.
- GOffer support to patients to live as actively as possible until death.
- HAssist the patient and family to identify and access pastoral care services.
- IOffer support to the family during the patient’s illness and their own bereavement.
46The husband and daughter of a Hispanic woman dying from pancreatic cancer refuse to consider using hospice care. What is the first thing the nurse should do?
- AAssess their understanding of what hospice care services are.
- BAsk them how they will care for the patient without hospice care.
- CTalk directly to the patient and family to see if she can change their minds.
- DAccept their decision since they are Hispanic and prefer to care for their own.
47A terminally ill patient is unresponsive and has cold, clammy skin with mottling on the extremities. The patient’s husband and two grown children are arguing at the bedside about where the patient’s funeral should be held. What should the nurse do first?
- AAsk the family members to leave the room if they are going to argue.
- BTake the family members aside and explain that the patient may be able to hear them.
- CTell the family members that this decision is premature because the patient has not yet died.
- DRemind the family that this should be the patient’s decision and to ask her if she regains consciousness.
48A patient with end-stage liver failure tells the nurse, “If I can just live to see my first grandchild who is expected in 5 months, then I can die happy.” The nurse recognizes that the patient is demonstrating which of the following stages of grieving?
- AProlonged grief disorder
- BKübler-Ross’s stage of bargaining
- CKübler-Ross’s stage of depression
- DThe new normal stage of the Grief Wheel
49A terminally ill man tells the nurse, “I have never believed there is a God or an afterlife, but now it is too terrible to imagine that I will not exist. Why was I here in the first place?” What does this comment help the nurse recognize about the patient’s needs?
- AHe is experiencing spiritual distress.
- BThis man most likely will not have a peaceful death.
- CHe needs to be reassured that his feelings are normal.
- DThis patient should be referred to a clergyman for a discussion of his beliefs.
50 In most states, directives to physicians, durable power of attorney for health care, and medical power of attorney are included in which legal documents?
- ANatural death acts
- BAllow natural death
- CAdvance care planning
- DDo Not Resuscitate order
51A patient is receiving care to manage symptoms of a terminal illness when the disease no longer responds to treatment. What is this type of care known as?
- Aterminal care
- Bpalliative care
- Csupportive care
- Dmaintenance care
52 A patient in the last stages of life is experiencing shortness of breath and air hunger. Based on practice guidelines, what is the most appropriate action by the nurse?
- AAdminister O2
- BAdminister bronchodilators
- CAdminister antianxiety agents.
- DUse any methods that make the patient more comfortable.
53 End-of-life palliative nursing care involves
- Aconstant assessment for changes in physiologic functioning.
- Badministering large doses of analgesics to keep the patient sedated.
- Cproviding as little physical care as possible to prevent disturbing the patient
- Dencouraging the patient and family members to verbalize their feelings of sadness, loss, and forgiveness.
54The dying patient and family have many interrelated psychosocial and physical care needs. Which ones can the nurse begin to manage with the patient and family (select all that apply)?
- Aanxiety
- Bfear of pain
- CThe dying process
- Dcare being provided
- EAnger toward the nurse
- FFeeling powerless and hopeless
55 A deathly ill patient from a culture different than the nurse’s is admitted. Which question is appropriate to help the nurse provide culturally competent care?
- A“If you die, will you want an autopsy?”
- B“Are you interested in learning about palliative or hospice care?”
- C“Do you have any preferences for what happens if you are dying?”
- D“Tell me about your expectations of care during this hospitalization.”
56Trends in the incidence and death rates of cancer include the fact that
- Alung cancer is the most common type of cancer in men.
- Ba higher percentage of women than men have lung cancer
- Cbreast cancer is the leading cause of cancer deaths in women.
- DAfrican Americans have a higher death rate from cancer than whites.
57What features of cancer cells distinguish them from normal cells (select all that apply)?
- ACells lack contact inhibition.
- BCells return to a previous undifferentiated state.
- COncogenes maintain normal cell expression.
- DProliferation occurs when there is a need for more cells.
- ENew proteins characteristic of embryonic stage emerge on cell membrane.
58A characteristic of the stage of progression in the development of cancer is
- Aoncogenic viral transformation of target cells.
- Ba reversible steady growth facilitated by carcinogens.
- Ca period of latency before clinical detection of cancer.
- Dproliferation of cancer cells in spite of host control mechanisms.
59The primary protective role of the immune system r/t malignant cells is
- Asurveillance for cells with tumor-associated antigens.
- Bbinding with free antigen released by malignant cells.
- Cproduction of blocking factors that immobilize cancer cells.
- Dresponding to a new set of antigenic determinants on cancer cells.
60The primary difference b/w benign and malignant neoplasms is the
- Arate of cell proliferation
- Bsite of malignant tumor
- Creq's for cell nutrients
- Dcharacteristic of tissue invasiveness.
61The nurse is caring for a 59-year-old woman who had surgery 1 day ago for removal of a suspected malignant abdominal mass. The patient is awaiting the pathology report. She is tearful and says that she is scared to die. The most effective nursing intervention at this point is to use this opportunity to
- Amotivate change in an unhealthy lifestyle.
- Bteach her about the seven warning signs of cancer.
- Cinstruct her about healthy stress relief and coping practices.
- Dallow her to communicate about the meaning of this experience.
62The goals of cancer treatment are based on the principle that
- Asurgery is the single most effective treatment for cancer.
- Binitial treatment is always directed toward cure of the cancer.
- Ca combination of treatment modalities is effective for controlling many cancers.
- Daltho cancer cure is rare, quality of life can be increased with treatment modalities
63The most effective method of administering a chemotherapy agent that is a vesicant is to
- Agive it orally
- Bgive it intraarterially.
- Cuse an Ommaya reservoir.
- Duse a central venous access device.
64To prevent fever and shivering during an infusion of rituximab (Rituxan), the nurse should premedicate the patient with
- Aaspirin
- Bacetaminophen.
- Csodium bicarbonate
- Dmeperidine (Demerol).
65The nurse counsels the patient receiving radiation therapy or chemotherapy that
- Aeffective birth control methods should be used for the rest of the patient's life.
- Bif nausea and vomiting occur during treatment, the treatment plan will be modified.
- Cafter successful treatment, a return to the person's previous functional level can be expected.
- Dthe cycle of fatigue-depression-fatigue that may occur during treatment can be reduced by restricting activity
66A pt on chemo for 10 weeks started at a weight of 121 lb. She now weighs 118 lb and has no sense of taste. Which nursing intervention would be a priority?
- AAdvise the patient to eat foods that are fatty, fried, or high in calories.
- BDiscuss with the physician the need for parenteral or enteral feedings.
- CAdvise the patient to drink a nutritional supplement beverage at least three times a day.
- DAdvise the patient to experiment with spices and seasonings to enhance the flavor of food.
67A 70-year-old male patient has multiple myeloma. His wife calls to report that he sleeps most of the day, is confused when awake, and complains of nausea and constipation. Which complication of cancer is this most likely caused by?
- AHypercalcemia
- BTumor lysis syndrome
- CSpinal cord compression
- DSuperior vena cava syndrome
68A patient has recently been diagnosed with early stages of breast cancer. What is most appropriate for the nurse to focus on?
- AMaintaining the patient's hope
- BPreparing a will and advance directives
- CDiscussing replacement child care for the patient's children
- DDiscussing the pt's past experiences with her grandmother's cancer.
69 The nurse is presenting a community education program related to cancer prevention. Based on current cancer death rates, the nurse emphasizes what as the most important preventive action for both women and men?
- ASmoking cessation
- BRoutine colonoscopies
- CProtection from ultraviolet light
- DRegular examination of reproductive organs
70A patient is admitted with acute myelogenous leukemia and a history of Hodgkin’s lymphoma. What is the nurse likely to find in the patient’s history?
- AWork as a radiation chemist
- BEpstein-Barr virus diagnosed in vitro
- CIntense tanning throughout the lifetime
- DAlkylating agents for treating the Hodgkin’s lymphoma
71Which mutated tumor suppressor gene is most likely to contribute to many types of cancer, including bladder, breast, colorectal, and lung?
- Ap53
- BAPC
- CBRCA1
- DBRCA2
72Cancer cells go through stages of development. What accurately describes the stage of promotion (select all that apply)?
- AObesity is an example of a promoting factor.
- BThe stage is characterized by increased growth rate and metastasis.
- CWithdrawal of promoting factors will reduce the risk of cancer development.
- DTobacco smoke is a complete carcinogen that is capable of both initiation and promotion.
- EPromotion is the stage of cancer development in which there is an irreversible alteration in the cell’s DNA.
73 The patient was told she has carcinoma in situ, and the student nurse wonders what that is. How should the nurse explain this to the student nurse?
- AEvasion of the immune system by cancer cells
- BLesion with histologic features of cancer except invasion
- CCapable of causing cellular alterations associated with cancer
- DTumor cell surface antigens that stimulate an immune response
74Which word identifies a mutation of protooncogenes?
- AOncogenes
- BRetrogenes
- COncofetal antigens
- DTumor angiogenesis factor
75What is the name of a tumor from the embryonal mesoderm tissue of origin located in the anatomic site of the meninges that has malignant behavior?
- AMeningitis
- BMeningioma
- CMeningocele
- DMeningeal sarcoma
76 A patient’s breast tumor originates from embryonal ectoderm. It has moderate dysplasia and moderately differentiated cells. It is a small tumor with minimal lymph node involvement and no metastases. What is the best description of this tumor?
- ASarcoma, grade II, T3 N4 M0
- BLeukemia, grade I, T1 N2 M1
- CCarcinoma, grade II, T1 N1 M0
- DLymphoma, grade III, T1 N0 M
77 The nurse is counseling a group of individuals over the age of 50 with average risk for cancer about screening tests for cancer. Which screening recommendation should be performed to screen for colorectal cancer?
- ABarium enema every year
- BColonoscopy every 10 years
- CFecal occult blood every 5 years
- DAnnual prostate-specific antigen (PSA) and digital rectal exam
78 A small lesion is discovered in a patient’s lung when an x-ray is performed for cervical spine pain. What is the definitive method of determining if the lesion is malignant?
- Alung scan
- Btissue biopsy
- COncofetal antigens in the blood
- DCT or positron emission tomography (PET) scan
79 A patient with a genetic mutation of BRCA1 and a family history of breast cancer is admitted to the surgical unit where she is scheduled that day for a bilateral simple mastectomy. What is the reason for this procedure?
- APrevent breast cancer
- BDx breast cancer
- CCure or control breast cancer
- DProvide palliative care for untreated breast cancer
80Which patient would be most likely to be cured with chemotherapy as a treatment measure?
- ASmall cell lung cancer
- BNew neuroblastoma
- CSmall tumor of the bone
- DLarge hepatocellular carcinoma
81Which classification of chemotherapy drugs is cell cycle phase–nonspecific, breaks the DNA helix which interferes with DNA replication, and crosses the blood-brain barrier?
- ANitrosureas
- BAntimetabolites
- CMitotic inhibitors
- DAntitumor antibiotics
82The nurse uses many precautions during IV administration of vesicant chemotherapeutic agents, primarily to prevent
- Asepticemia.
- Bextravasation.
- Ccatheter occlusion
- Danaphylactic shock
83 For which type of malignancy should the nurse expect the use of the intravesical route of regional chemotherapy delivery?
- Abladder
- Bleukemia
- COsteogenic sarcoma
- DMetastasis to the brain
84 Which delivery system would be used to deliver regional chemotherapy for metastasis from a primary colorectal cancer?
- AIntrathecal
- BIntraarterial
- CIntravenous
- DIntraperitoneal
85When teaching the patient with cancer about chemotherapy, which approach should the nurse take?
- AAvoid telling the patient about possible side effects of the drugs to prevent anticipatory anxiety.
- BExplain that antiemetics, antidiarrheals, and analgesics will be provided as needed to control side effects.
- CAssure the patient that the side effects from chemotherapy are uncomfortable but never life threatening
- DInform the patient that chemotherapy-related alopecia is usually permanent but can be managed with lifelong use of wigs.
86Which normal tissues manifest early, acute responses to radiation therapy?
- Aspleen and liver
- BKidney and nervous tissue
- CBone marrow and gastrointestinal (GI) mucosa
- DHallow organs such as the stomach and bladder
87 The patient is learning about skin care related to the external radiation that he is receiving. Which instructions should the nurse include in this teaching?
- AMoisturize skin with lotion
- BKeep the area covered if it is sore
- CDry the skin thoroughly after cleansing it
- DAvoid extreme temperatures to the area
88When a patient is undergoing brachytherapy, what is it important for the nurse to be aware of when caring for this patient?
- AThe patient will undergo simulation to identify and mark the field of treatment.
- BThe patient is a source of radiation and personnel must wear film badges during care.
- CThe goal of this treatment is only palliative and the patient should be aware of the expected outcome.
- DComputerized dosimetry is used to determine the maximum dose of radiation to the tumor within an acceptable dose to normal tissue.
89To prevent the debilitating cycle of fatigue-depression-fatigue in patients receiving radiation therapy, what should the nurse encourage the patient to do?
- AImplement a walking program
- BIgnore the fatigue as much as possible
- CDo the most stressful activities when fatigue is tolerable
- DSchedule rest periods throughout the day whether fatigue is present or not
90 When the patient asks about the late effects of chemotherapy and high-dose radiation, what areas of teaching should the nurse plan to include when describing these effects?
- AThird space syndrome
- BSecondary malignancies
- CChronic nausea and vomiting
- DPersistent myelosuppression
91What describes a primary use of biologic therapy in cancer treatment?
- AProtect normal, rapidly reproducing cells of the gastrointestinal system from damage during chemotherapy
- BPrevent the fatigue associated with chemotherapy and high-dose radiation as seen with bone marrow depression
- CEnhance or supplement the effects of the host’s immune responses to tumor cells that produce flu-like symptoms
- DDepress the immune system and circulating lymphocytes as well as increase a sense of well-being by replacing central nervous system deficits
92While caring for a patient who is at the nadir of chemotherapy, the nurse establishes the highest priority for nursing actions related to
- Adiarrhea
- Bgreiving
- Crisk for infection
- Dinadequate nutritional intake
93The patient with advanced cancer is having difficulty controlling her pain. She says she is afraid she will become addicted to the opioids. What is the first thing the nurse should do for this patient?
- AAdminister a nonsteroidal antiinflammatory drug.
- BAssess the patient’s vital signs and behavior to determine the medication to use.
- CHave the patient keep a pain diary to better assess the patient’s potential addiction.
- DObtain a detailed pain history including quality, location, intensity, duration, and type of pain.
94Which factors will assist a patient in coping positively with having cancer (select all that apply)?
- Afeeling of control
- BStrong support system
- CInternalization of feelings
- Dpossibility of cure or control
- EA young person will adapt more easil
- FNot having had to cope with previous stressful events
95You are caring for a patient with esophageal cancer. Which task could be delegated to a UAP?
- AAssisting the patient with oral hygiene
- BObserving the patient’s response to feedings
- CFacilitating expression of grief or anxiety
- DInitiating daily weighings
96A 56-year-old patient comes to the walk-in clinic reporting scant rectal bleeding and intermittent diarrhea and constipation for the past several months. There is a history of polyps and a family history of colorectal cancer. While you are trying to teach about colonoscopy, the patient becomes angry and threatens to leave. What is the priority diagnosis?
- ADiarrhea/Constipation related to altered bowel patterns
- BDeficient Knowledge related to the disease process and diagnostic procedure
- CRisk for Deficient Fluid Volume related to rectal bleeding and diarrhea
- DAnxiety related to unknown outcomes and perceived threats to body integrity
97Which patient is at greatest risk for pancreatic cancer?
- AA young white obese woman with gallbladder disease
- BAn elderly African-American man who smokes
- CA young African-American man with type 1 diabetes
- DAn elderly white woman who has pancreatitis
98Patients receiving chemotherapy are at risk for thrombocytopenia related to chemotherapy or disease processes. Which actions are needed for patients who must be placed on bleeding precautions? (Select all that apply.)
- AProvide mouthwash with alcohol for oral rinsing.
- BUse paper tape on fragile skin.
- CProvide a soft toothbrush or oral sponge.
- DGently insert rectal suppositories.
- EAvoid aspirin or aspirin-containing products.
- FAvoid overinflation of blood pressure cuffs.
- GPad sharp corners of furniture
99When care assignments are being made for patients with alterations related to gastrointestinal (GI) cancer, which patient would be the most appropriate to assign to an LPN/LVN under the supervision of a team leader RN?
- AA patient with severe anemia secondary to GI bleeding
- BA patient who needs enemas and antibiotics to control GI bacteria
- CA patient who needs preoperative teaching for bowel resection surgery
- DA patient who needs central line insertion for chemotherapy
100The physician tells the patient with cancer that there will be an initial course of treatment with continued maintenance treatments and ongoing observation for signs and symptoms over a prolonged period of time. Which patient statement would concern you the most?
- A“My symptoms will eventually be cured; I’m so happy that I don’t have to worry any longer.”
- B“My doctor is trying to help me control the symptoms; I am grateful for the extension of time with my family.”
- C“My pain will be relieved, but I am going to die soon; I would like to have control over my own life and death.”
- D“Initially, I may have to take some time off of work for my treatments; I can probably work full time in the future.”
101For a patient who is experiencing side effects of radiation therapy, which task would be the most appropriate to delegate to the UAP?
- AHelping the patient to identify patterns of fatigue
- BRecommending participation in a walking program
- CReporting the amount and type of food consumed from the tray
- DChecking the skin for redness and irritation after the treatment
102A nurse is providing teaching to a pt who has TB and Rxs for rifampin and ehtambutol. The nurse should ID which of the following findings as an adverse effect of these meds that the pt should report to the provider?
- Ared-orange discoloration of urine
- Bunexpected weight gain
- Ctinnitus
- Ddecreased visual acuity
103The nurse is reviewing the pt's lab report. The pt's ABG levels are pH 7.5, PaCO2 32, and HCO3 24. The nurse should determine that the pt has while of the following acid-base imbalances?
- Arespiratory alkalosis
- Brespiratory acidosis
- Cmetabolic alkalosis
- Dmetabolic acidosis
104A nurse is planning care for a pt who is experiencing a sickle cell crisis. Which of the following interventions should the nurse include?
- AMaintain the pt's knees and hips in a flexed position
- BApply cold compresses to painful joints
- CW/hold opioids until the crisis is resolved.
- DEncourage increased fluid intake
105A nurse is providing teaching to a pt who has stomatitis d/t chemo and radiation therapy. Which of the following statements by the pt indicates the need for further teaching?
- AI will use a soft toothbrush or foam swab for oral care.
- BI will use lemon and glycerine swabs after eating
- CI will remove my dentures except when eating
- DI will rinse my mouth frequently w/ hydrogen peroxide solution
106A nurse in the ER is caring for a pt who reports developing severe right eye pain w/ a gritty sensation while sawing wood. Which of the following actions should the nurse take first?
- AInstill proparacaine hydrochloride eyedrops
- BPerforms ocular irrigation of the right eye
- CPlace the pt in a supine position w/ the head turned toward the affected side
- DAsk the pt about first aid performed at the scene
107A nurse is monitoring a pt following a thyroidectomy for the presence of hypoparathyroidism. Which of the following findings should the nurse expect?
- Aelevated BP
- Binvoluntary muscle spasm
- Ccold intolerance
- Dweight loss
108A nurse in an ER is assessing a pt who sustained a fall off of a roof. Which of the following findings should the nurse ID as an indication of a basilar skull fracture?
- AA depressed fracture of the forehead
- BClear fluid from the nares
- CBlack and blue discoloration around the eyes
- DBleeding from the top of the scalp
109A nurse is providing teaching to a pt who has cervical cancer and is scheduled to receive brachytherapy in an ambulatory care clinic. Which of the following statements by the pt indicates an understanding of the teaching?
- AI need to lie still in bed during my brachytherapy treatment
- BI will have an implant placed once a month during my brachytherapy treatment
- CI must stay at least 3 feet away from others b/w brachytherapy treatments
- DI should expect some blood in my urine after each brachytherapy treatment
110A nurse is providing teaching to a pt who is scheduled for a sigmoid colon resection w/ colostomy. Which of the following statements by the pt indicates a need for further teaching?
- AB/c most of my colon is still intact and functioning, my stool will be formed
- BMy stoma will appear large at first, but it will shrink over the next several weeks.
- CMy colostomy will begin to function 2-6 days after surgery
- DI will have to switch to a soft diet after surgery
111A nurse is planning to administer eye drops for a pt who has glaucoma. When giving the med, which of the following actions should the nurse take?
- AInstruct the pt to blink several times after giving the med
- BAsk the pt to look straight ahead while giving the med
- CApply pressure to the puncta after giving the med
- DPlace each drop of med directly into the pt's cornea
112A nurse is planning dietary teaching for a pt who has DM. Which of the following actions should the nurse plan to take first?
- AObtain sample menus from the dietitian to give to the pt
- BAsk the pt to ID the types of foods she prefers
- CID the recommended range for the pt's blood glucose level
- DDiscuss long-term complications that can result from noncompliance to the dietary plan
113A nurse is assessing a pt who has a fractured left femur and is in skeletal traction. Which of the following findings should the nurse report to the provider?
- Aecchymosis of the thigh
- Bserous drainage at the pin site
- Cchest petechiae
- Dmuscle spasms in the left leg
114A nurse is caring for a pt who has encephalitis d/t West Nile virus. Which of the following actions should the nurse take? (select all that apply)
- Aplace the pt on resp isolation
- Bmonitor vitals q2h
- Cassess neuro status q4h
- Dmaintain the pt in a modified Trendelenburg position
- EKeep the pt's room darkened
115A nurse is planning care for a pt who has acute myelogenous leukemia and a platelet count of 48,000. Which of the following interventions should the nurse include?
- Aavoid IM injections
- Bassess the pt for ecchymosis every shift
- Cdon't allow pt to have visitors
- Dencourage daily flossing b/w teeth
116A nurse is caring for a pt who has an upper GI bleed and a Hct level of 24. Prior to initiating a transfusion of packed RBC, which of the following actions should the nurse take?
- AAssess and document the pt's vitals
- BRestart the IV w/ a 22G needle
- CVerify w/ another nurse the blood type and Rh of the packed RBC
- DHang a bag of Lactated Ringer's IV solution
- EChange IV tubing to a set that has a filter
117A nurse is providing discharge teaching to an adult female pt who has infective endocarditis about how to prevent recurrence. Which of the following statements made by the pt indicates understanding of the teaching?
- AI will ask my provider to change my contraception to an IUD
- BI will notify my doctor before having dental procedures
- CI will avoid using antiseptic mouth wash during my oral care
- DI will wear a mask when I go out in public
118A nurse is providing teaching to a pt who has a hx of tonic-clonic seizures and is scheduled for a standard EEG. Which of the following instructions should the nurse include in the teaching?
- ARemain NPO 6-8 hours prior to EEG
- BTake a sedative the night before the EEG
- CThoroughly shampoo hair prior to EEG
- DSleep for at least 8 hours the night before the EEG
119A nurse is caring for a pt who has DM1 and a glucose of 48. Which of the following findings should the nurse expect?
- AKussmaul respirations
- Bdiaphoresis
- Cdecreased skin turgor
- Dketonuria
120A nurse is providing post-op care to a pt who has 2 chest tubes in place following a lobectomy. The pt asks why he has 2 chest tubes. The nurse should inform the pt that the lower chest tube is placed for what reason?
- Aremoving air from pleural space
- Bcreating access for irrigating the chest cavity
- Cevacuating secretions from the bronchioles and alveoli
- Ddraining blood and fluid from the pleural space
121A nurse is providing discharge teaching to a pt who has a new permanent pacemaker. Which of the following statements by the pt indicates an understanding of the teaching?
- AI should check my HR at the same time each day
- BI don't have to take my BP meds now that I have a pacemaker
- CI should keep a pressure dressing over the generator until the incision is healed
- DI can't stand in front of my new microwave when it is on
122A nurse is caring for a pt who is 72 hours post-op following an above-the-knee amputation. Which of the following actions should the nurse take?
- AElevate the residual limb on a soft pillow
- BAssist the pt to a prone position Q4h
- CReapply a bandage to the residual limb Q12h
- DApply dressing to the site in a proximal-to-distal direction
123A nurse is providing pre-op teaching for a pt who has colorectal cancer and is to undergo placement of a colostomy w/ a perineal wound. Which of the following statements by the pt indicates an understanding of the teaching?
- AIt will be a relief to not have any further rectal pain
- BI will need to sit on a rubber donut when I am out of bed in a chair
- CI can only have liquids 2 days before the surgery
- DThe colostomy will start working about 7 days after the surgery
124A nurse is collected a health hx from a pt. Which of the following factors is the highest risk factor for the pt developing bladder cancer?
- Apt is a hairdresser
- Bpt uses tobacco
- Cpt is over 60
- Dpt has frequent UTIs
125A nurse is collecting a health hx from a pt. Which of the following findings is the highest risk factor for the pt developing skin cancer?
- Aage over 60
- Bgenetic predisposition
- Clight-skinned race
- Doverexposure to sunlight
126A nurse is providing discharge teaching to a pt following a right breast mastectomy. The pt will be discharged with 2 drainage tube. Which of the following info should the nurse include in the teaching?
- AEmpty the drainage tubs QD
- BShowering is permitted before the drainage tubes are removed
- CThe drainage tubes often are removed at the same time as the stitches
- DDon't begin exercising the arm until the provider removes the drainage tubes
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- Description
- Med/Surg 2 Quiz on Exam 2 Part 4, created by Nicole Buda on 02/04/2017.
- Author
- Nicole Buda
- Language
- English
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- Created on 2 Apr 2017 · updated on 7 Apr 2018
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