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Substance Abuse
Oncology
Immune Dysfunction
Reproductive
Breasts
100
The nurse is providing postoperative care for a 58-year-old woman who has had an open cholecystectomy. The patient’s daughter suggests that her mother may be alcohol dependent. The presence of which of these signs increase the likelihood that the patient may be experiencing early alcohol withdrawal symptoms?
Flat affect, palmar erythema, and rosacea Drowsiness, bradycardia, and hypotension Seizures, hallucinations, and gross tremors Increased reflexes, nausea, and diaphoresis
100
A 64-year-old male patient who is receiving radiation to the head and neck as treatment for an invasive malignant tumor complains of mouth sores and pain. Which intervention should the nurse add to this patient’s plan of care?
Weigh the patient every month to monitor for weight loss. Cleanse the mouth every 2 to 4 hours with hydrogen peroxide. Provide high-protein and high-calorie, soft foods every 2 hours. Apply palifermin (Kepivance) liberally to the affected oral mucosa.
100
Ten days after receiving a bone marrow transplant, a patient develops a skin rash on his palms and soles, jaundice, and diarrhea. What is the most likely etiology of these clinical manifestations?
The patient is experiencing a type I allergic reaction. An atopic reaction is causing the patient's symptoms. The patient is experiencing rejection of the bone marrow. Cells in the transplanted bone marrow are attacking the host tissue.
100
The nurse performs a breast examination on a 68-year-old female patient. Which clinical manifestation, if assessed by the nurse, indicates that further evaluation for breast cancer is needed?
Bilateral pendulous breasts Right breast is warm, painful to touch Irregular, nontender lump with induration Palpable lump that is tender and movable
100
The nurse teaches a 53-year-old patient about screening for early detection of breast cancer. Which statement by the patient requires an intervention by the nurse?
“I should plan to have a mammogram every year.” “I will see a health care provider every year for a breast examination.” “A breast examination should be done right after my menstrual period.” “Self-breast examination is a reliable way to detect breast cancer early.”
200
A 24-year-old woman is admitted to the emergency department for management of a cocaine overdose. What assessment findings will the nurse anticipate?
Fatigue, sleepiness, and depression Lethargy, pinpoint pupils, and nystagmus Palpitations, tachycardia, and hypertension Cold skin, decreased oxygen saturation, and bradypnea
200
A 33-year-old patient has recently been diagnosed with stage II cervical cancer. What should the nurse understand about the patient's cancer?
It is in situ. It has metastasized. It has spread locally. It has spread extensively.
200
A 21-year-old student had taken amoxicillin once as a child for an ear infection. She is given an injection of Penicillin V and develops a systemic anaphylactic reaction. What manifestations would be seen first?
Dyspnea Dilated pupils Itching and edema Wheal-and-flare reaction
200
What should teaching for patients with a sexually transmitted infection (STI) include (select all that apply)?
Treatment of sexual partners Douching may help to provide relief of itching. Cotton undergarments are preferred over synthetic materials. Sexual abstinence is indicated during the communicable phase of the disease. Condoms should be used during as well as after treatment during sexual activity.
200
A nurse is teaching a health promotion workshop to a group of women in their 40s and 50s. What information about nipple discharge should the nurse teach to participants?
Inappropriate lactation necessitates breast biopsy. Nipple discharge of any type is considered a precursor to cancer. Unexpected nipple discharge of any type warrants medical follow-up. Galactorrhea is a normal age-related change and a frequent perimenopausal symptom.
300
A 63-year-old woman is admitted via the emergency department with a fractured pelvis and femur after a motor vehicle crash. The patient reports severe pain which she rates as “10” on a scale of 0-10. Health records indicate that the patient has disclosed an opioid addiction. How will the nurse plan to manage this patient’s pain?
Administer opioids at a higher dose than for drug-naïve patients. Administer opioids sparingly if the patient agrees to substance abuse counseling. Non-narcotic pain medication should be administered to reduce drug-seeking behaviors. A mixed opioid agonist-antagonist such as butorphanol (Stadol) should be administered.
300
When caring for the patient with cancer, what does the nurse understand as the response of the immune system to antigens of the malignant cells?
Metastasis Tumor angiogenesis Immunologic escape Immunologic surveillance
300
The patient with an autoimmune disease will be treated with plasmapheresis. What should the nurse teach the patient about this treatment?
It will gather platelets for use later when needed. It will cause anemia because it removes whole blood and RBCs are damaged. It will remove the IgG autoantibodies and antigen complexes from the plasma. It will remove the peripheral stem cells in order to cure the autoimmune disease.
300
A 24-year-old patient is at the clinic with symptoms of purulent vaginal discharge, dysuria, and dyspareunia. She is sexually active and has multiple partners. What should the nurse explain to the patient as the rationale for screening her for Chlamydia?
Chlamydia is frequently co-morbid with HIV. Chlamydial infections may progress to sepsis. Untreated chlamydial infections can lead to infertility. Chlamydial infections are treatable only in the early stages of infection.
300
When caring for female patients, the nurse should be aware that most cancers occur where on the breast?
Nipple Inner, upper half Lower, inner half Outer, upper half
400
The patient is describing his use of an illicit drug as needing a larger dose to get the same effect. How should the nurse document this patient's usage?
Tolerance Addiction Substance abuse Substance dependence
400
A patient develops neutropenia after receiving chemotherapy. Which information about ways to prevent infection will the nurse include in the teaching plan (select all that apply)?
Cook food thoroughly before eating. Choose low fiber, low residue foods. Avoid public transportation such as buses. Use rectal suppositories if needed for constipation. Talk to the oncologist before having any dental work done.
400
A pregnant woman with a history of asymptomatic chronic human immunodeficiency virus (HIV) infection is seen at the clinic. The patient states, "I am very nervous about making my baby sick." Which information will the nurse include when teaching the patient?
The antiretroviral medications used to treat HIV infection are teratogenic. Most infants born to HIV-positive mothers are not infected with the virus. Because she is at an early stage of HIV infection, the infant will not contract HIV. It is likely that her newborn will become infected with HIV unless she uses antiretroviral therapy (ART).
400
A pregnant female is experiencing amenorrhea, morning sickness, and breast tenderness. In the ninth week after her last menstrual period, she is rushed to the hospital with severe left shoulder pain, blood pressure of 90/60 mm Hg, and heart rate of 112 beats/minute. What is the best diagnostic test to determine the cause of her problem?
Serum hemoglobin 12-lead electrocardiogram A transvaginal ultrasound Serial β-human chorionic gonadotropin levels
400
Which information should the nurse include in teaching a patient who is scheduled for external beam radiation to the breast?
The radiation therapy will take a week to complete. Careful skin care in the radiated area will be necessary. Visitors are restricted until the radiation therapy is completed. Wigs may be used until the hair regrows after radiation therapy.
500
The patient tells the nurse that he has used cannabis regularly for the last 20 years. What should the nurse expect to find in the history and physical assessment (select all that apply)?
Gastric ulcers Violent behavior Productive cough Memory impairment Crackles in the lungs Coronary artery disease
500
The patient and his family are upset that the patient is going through procedures to diagnose cancer. What nursing actions should the nurse use first to facilitate their coping with this situation (select all that apply)?
Maintain hope. Exhibit a caring attitude. Plan realistic long-term goals. Give them antianxiety medications. Be available to listen to fears and concerns. Teach them about all the types of cancer that could be diagnosed.
500
The nurse plans a presentation for community members about how to decrease the risk for antibiotic-resistant infections. Which information will the nurse include in the teaching plan (select all that apply)?
Continue taking antibiotics until all the medication is gone. Antibiotics may sometimes be prescribed to prevent infection. Unused antibiotics that are more than a year old should be discarded. Antibiotics are effective in treating influenza associated with high fevers. Hand washing is effective in preventing many viral and bacterial infections
500
After reviewing the electronic medical record for a patient who had transurethral resection of the prostate the previous day, which information requires the most rapid action by the nurse?
Elevated temperature Respiratory rate and lung sounds Bladder spasms and decreased urine output No prescription for antihypertensive drugs
500
The nurse is volunteering at a community center to teach women about breast cancer. What should the nurse include when discussing risk factors (select all that apply)?
Nulliparity Age 30 or over Early menarche Late menopause Personal history of colon cancer