Cancer
The nursing instructor is discussing the difference between normal cells and cancer cells with the prenursing class in pathophysiology. What would the instructor cite as a characteristic of a cancer cell?
1. Malignant cells contain more fibronectin
2. The cell membrane of malignant cells also contains proteins called Tumor specific antigens
3. Chromosomes are commonly found to be strong
4. Nuclei of cancer cells are large and regularly shaped
2. The cell membrane of malignant cells also contains proteins called Tumor specific antigens
The client with cirrhosis who has ascites receives 100 mL of 25% serum albumin IV. Which finding would best indicate that the albumin is having its desired effect?
1. Increased urine output
2. Increased serum albumin level
3. Decreased anorexia
4. Increased blood pressure
1. Increased urine output
The nurse monitors for which clinical manifestation of poor organ perfusion in the client with left ventricular failure secondary to a myocardial infarction.
1. Headache
2. Hypertension
3. Urine output of 50 mL in two hours
4. Heart rate of 55 to 60 beats per min
3. Urine output of 50 mL in two hours
•The nurse is suctioning a client who had a laryngectomy. What is the maximum amount of time the nurse should suction the client?
1. 5 seconds
2. 15 seconds
3. 25 seconds
4. 30 seconds
2. 15 seconds
A 25-yr-old patient has been admitted with a severe crushing injury after an industrial accident. Which laboratory result will be most important to report to the health care provider?
1. Serum creatinine level of 2.1 mg/dL
2. Serum potassium level of 6.5 mEq/L
3. White blood cell count of 11,500/µL
4. Blood urea nitrogen (BUN) of 56 mg/dL
2. Serum potassium level of 6.5 mEq/L
The nurse questions which activity for the client with thrombocytopenia?
1. Application of warm compresses to bruises
2. Cleaning teeth with a soft bristle brush
3. Taking acetaminophen (Tylenol) for pain
4. Using stool softeners daily for constipation
1. Application of warm compresses to bruises
Which finding indicates to the nurse that a patient’s transjugular intrahepatic portosystemic shunt (TIPS) placed 3 months ago has been effective?
1. Increased serum albumin level
2. Decreased indirect bilirubin level
3. Improved alertness and orientation
4. Fewer episodes of bleeding varices
4. Fewer episodes of bleeding varices
After pulmonary artery catheter insertion, the nurse assesses a pulmonary artery pressure of 45/25 mm Hg and a pulmonary artery occlusion pressure (PAOP) of 20 mm Hg. Which physician order is of the highest priority?
1. Apply 50% oxygen via venture mask
2. Insert an indwelling urinary catheter
3. Begin a dobutamine (Dobutrex) infusion
4. Obtain stat cardiac enzymes and troponin
3. Begin a dobutamine (Dobutrex) infusion
•The nurse assesses the client receiving radiation therapy for lung cancer. Which finding is most likely to be a direct result of his therapy?
1. Thinning scalp hair
2. Pain in the left shoulder
3. Difficulty swallowing solid food
4. Heart palpitations and night sweats
3. Difficulty swallowing solid food
A patient with diabetes who has bacterial pneumonia is being treated with IV gentamicin. What should the nurse monitor for adverse effects of the medication?
1. Blood glucose
2. Urine osmolality
3. Serum creatinine
4. Serum potassium
3. Serum creatinine
You are caring for a patient who is to begin receiving external radiation for a malignant tumor of the head and neck. While doing patient education, what side effects should the nurse discuss with the patient that should be assessed because of the radiation treatment?
1. Impaired nutritional status
2. Pink oral mucosa
3. Diarrhea
4. Alopecia
1. Impaired nutritional status
Which laboratory finding does the nurse recognize as a potential complication of liver disease?
1. Elevated AST and LDH levels
2. Elevated Pt and INR
3. Increased serum albumin levels
4. Decreased serum alkaline phosphatase and ALT levels
2. Elevated Pt and INR
The nurse obtains a rhythm strip on a patient who has had a myocardial infarction and makes the following analysis: no visible P waves, PR interval not measurable, ventricular rate of 162, R-R interval regular, QRS complex wide and distorted, and QRS duration of 0.18 second. How should the nurse interpret this cardiac rhythm?
1. Atrial flutter
2. Sinus tachycardia
3. Ventricular fibrillation
4. Ventricular tachycardia
4. Ventricular tachycardia
You patient is ordered a chest x-ray to confirm endotracheal tube placement. The tube should be how many cm above the carina?*
1. About 3 - 4 cm
2. About 4 -5 cm
3. About 1- 2 cm
4. About 2 - 3 cm
4. About 2 - 3 cm
A patient with acute kidney injury (AKI) presents to the emergency department with hyperkalemia (serum potassium level of 7.2 mEq/L). Patient is complaining of palpitation and EKG show's frequent PVC's. Which intervention is the priority for treating hyperkalemia in this patient?
1. Administration of Normal Saline 500 mL Bolus
2. Initiation of continuous renal replacement therapy (CRRT)
3. Administration of sodium polystyrene sulfonate (Kayexalate).
4. IV Insulin, 1/2 amp D50 IVP, and 1 gm calcium gluconate IVPB
4. IV Insulin, 1/2 amp D50 IVP, and 1 gm calcium gluconate IVPB
What assessment finding will interfere with scheduled chemotherapy administration?
1. Extensive total body hair loss
2. Anxiety of 8 on a 1-10 scale
3. Decreased neutrophil count
4. Increased platelet count
3. Decreased neutrophil count
Which finding indicates to the nurse that lactulose is effective for an older adult who has advanced cirrhosis?
1. The patient is alert and oriented.
2. The patient denies nausea or anorexia.
3. The patient’s bilirubin level decreases.
4. The patient has at least one stool daily.
1. The patient is alert and oriented.
The client diagnosed with an MI is 6 hours post right femoral PTCA. Which assessments would require immediate intervention by the nurse? Select All That Apply
1. The client refuses to keep the leg straight
2. The pressure dressing to the right femoral area is dry and intact
3. The client is complaining of numbness in the right foot
4. The client’s right pedal pulse is 3+ and bounding
5. The client’s BP is 110/70 and pulse is 90
1. The client refuses to keep the leg straight
3. The client is complaining of numbness in the right foot
A client has the following ABG values: pH 7.32, PaO2 82, PaCO2 31, HCO3 18. The nurse determines that which of the following is the most probably cause for these findings?
1. COPD
2. DKA with Kussmaul’s respirations
3. Pancreatitis
4. ARDS
2. DKA with Kussmaul's respirations
A client developed cardiogenic shock after a severe MI and has now developed acute kidney injury. The client’s family asks the nurse why the client has developed acute kidney injury. What is the nurse's best response?
1. A decrease in the blood flow through the kidneys
2. An obstruction of urine flow from the kidneys
3. A blood clot formed in the kidneys
4. Structural damage to the kidney resulting in ATN
1. A decrease in the blood flow through the kidneys
Which of the following conditions are considered oncologic emergencies? Select all that apply.
1. Tumor lysis syndrome
2. Superior vena cava syndrome
3. Spontaneous pneumothorax
4. Anemia
5. Hypercalcemia
1. Tumor lysis syndrome
2. Superior vena cava syndrome
5. Hypercalcemia
During change-of-shift report, the nurse learns about the following four patients. Which patient requires assessment first?
1. A 58-yr-old patient who has compensated cirrhosis and reports anorexia
2. A 40-yr-old patient with chronic pancreatitis who has gnawing abdominal pain
3 A 55-yr-old patient with cirrhosis and ascites who has an oral temperature of 102° F (38.8° C)
4. A 36-yr-old patient recovering from a laparoscopic cholecystectomy who has severe shoulder pain
3. A 55-yr-old patient with cirrhosis and ascites who has an oral temperature of 102° F (38.8° C)
The nurse is caring for a client diagnosed with an MI who is experiencing chest pain. Which interventions should the nurse implement? Select All That Apply
1. Administer morphine IM
2. Administer an aspirin orally
3. Apply O2 via nasal cannula
4. Place the client in a supine position
5. Administer nitroglycerin subcutaneously
2. Administer an aspirin orally
3. Apply O2 via nasal cannula
The nurse notes new onset confusion in an older patient who is normally alert and oriented. In which order should the nurse take the following actions?
1. Obtain the O2 saturation.
2. Check the patient’s pulse rate.
3. Document the change in status.
4. Notify the health care provider.
1, 2, 4, 3
The nurse is caring for client admitted with acute kidney injury due to dehydration and a potassium of 6 (mEq/L). What interventions does the nurse anticipate? Select All That Apply
1. Strict I's & O's
2. IV Fluids
3. Kayexalate
4. Furosemide
5. Temporary dialysis catheter insertion STAT
1. Strict I's & O's
2. IV Fluids
3. Kayexalate