Solutions
37. The nurse is assessing a client with complaints of vague
upper abdominal pain worse at night but relieved by sitting up
and leaning forward. Which assessment question should the
nurse ask next?
1. "Have you noticed a yellow haze when you look at things?"
2. "Does the pain get worse when you eat a meal or snack?"
3. "Have you had your amylase and lipase checked recently?"
4. "How much weight have you gained since you saw an HCP?"
Correct Answers 2.
The abdominal pain is often made worse by eating and lying
supine in clients diagnosed with cancer of the pancreas
38. The nurse caring for a client diagnosed with cancer of the
pancreas writes the problem of "altered nutrition: less than body
requirements." Which collaborative intervention should the
nurse include in the plan of care?
1. Continuous feedings via (PEG) tube.
2. Have the family bring in foods from home.
3. Assess for food preferences.
4. Refer to the dietitian. Correct Answers 4.
A collaborative intervention is to refer to the nutrition expert,
the dietitian.
39. The nurse is planning a program for clients at a health fair
regarding the prevention and early detection of cancer of the
pancreas. Which self-care activity should the nurse discuss as an
example of a primary nursing intervention?
1. Monitor for elevated blood glucose at random intervals.
,2. Inspect the skin and sclera of the eyes for a yellow tint.
3. Limit meat in the diet and eat a diet low in fat.
4. Instruct the client with hyperglycemia about insulin
injections. Correct Answers 3.
Limiting the intake of meat and fats in the diet is an example of
primary interventions. Risk factors for the development of
cancer of the pancreas are cigarette smoking and eating a high-
fat diet. By changing these behaviors, the client could possibly
prevent the development of cancer of the pancreas. Other risk
factors include genetic predisposition and exposure to industrial
chemicals.
40. The nurse and an unlicensed assistive personnel (UAP) are
caring for clients on an oncology floor. Which intervention
should the nurse delegate to the UAP?
1. Assist the client with abdominal pain to turn to the side and
flex the knees.
2. Monitor the Jackson Pratt drainage tube to ensure it is
draining properly.
3. Check to see if the client is sleeping after pain medication is
administered.
4. Empty the bedside commode of the client who has been
having melena. Correct Answers 1.
The UAP can help a client to turn to the side and assume the
fetal position, which decreases some abdominal pain.
42. The client is being admitted to the outpatient department
prior to an endoscopic retrograde cholangiopancreatogram
(ERCP) to rule out cancer of the pancreas. Which preprocedure
instruction should the nurse teach?
, 1. Prepare to be admitted to the hospital after the procedure for
observation.
2. If something happens during the procedure, then emergency
surgery will be done.
3. Do not eat or drink anything after midnight the night before
the test.
4. If done correctly, this procedure will correct the blockage of
the stomach. Correct Answers 3.
The client should be NPO after midnight to make sure the
stomach is empty to reduce the risk of aspiration during the
procedure.
43. The client is diagnosed with cancer of the head of the
pancreas. Which signs and symptoms should the nurse expect to
assess?
1. Clay-colored stools and dark urine.
2. Night sweats and fever.
3. Left lower abdominal cramps and tenesmus.
4. Nausea and coffee-ground emesis. Correct Answers 1.
The client will have jaundice, clay-colored stools, and tea-
colored urine resulting from blockage of the bile drainage.
48. The nurse caring for a client diagnosed with cancer of the
pancreas writes the nursing diagnosis of "risk for altered skin
integrity related to pruritus." Which intervention should the
nurse implement?
1. Assess tissue turgor.
2. Apply antifungal creams.
3. Monitor bony prominences for breakdown.
4. Have the client keep the fingernails short. Correct Answers 4.