NRSG 3420 Final Big Review Questions with CORRECT
Answers (Grade A+)
Question 1:
A nurse is caring for a client newly diagnosed with cancer. Which therapies are used to treat cancer?
Select all that apply. A. electroconvulsive therapy B. hyperthermia C. surgery D. chemotherapy E.
radiation therapy
Answer:
B. hyperthermia C. surgery D. chemotherapy E. radiation therapy Explanation: Cancer is frequently
treated with a combination of therapies using standardized protocols. The basic methods used to treat
cancer are surgery, radiation therapy, hyperthermia, and chemotherapy. Electroconvulsive therapy is a
method of treatment for mental distress or illness. Reference: Hinkle, J.L., & Cheever, K.H., Brunner
& Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018,
Chapter 15: Management of Patients with Oncologic Disorders, p. 334.
Question 2:
During an annual examination, an older client tells the nurse, "I don't understand why I need to have so
many cancer screening tests now. I feel just fine!" Based on knowledge of neoplastic disease and the
aging immune system, what teaching should the nurse include in the client's plan of care? Select all that
apply.
Answer:
A. Nutritional intake to support a competent immune response plays an important role in reducing the
incidence of cancer. A healthy diet including protein, vitamins, minerals, and some fats can alter the
risk of cancer development. B. Tumor cells may possess special blocking factors that coat tumor cells
and prevent their destruction by killer T lymphocytes; therefore the body may not recognize the tumor
as foreign and fail to destroy the malignant cells. Routine screening increases the chance of finding and
treating cancer early. E. The increase in occurrence of autoimmune diseases with aging strongly
suggests a predisposition toward various types of cancer due to the body's inability to differentiate
between self and nonself. Routine screening increases the chance of finding and treating cancer early.
A. Nutritional intake to support a competent Explanation: immune response plays Large tumors can
release antigens into the blood, and these antigens an important role in recombine with circulating
antibodies and prevent them from attacking ducing the incidence of the tumor cells. Furthermore,
tumor cells may possess special blocking cancer. A healthy diet factors that coat tumor cells and
prevent their destruction by killer T including protein, vitlymphocytes. During the early development
of tumors, the body may amins, minerals, and fail to recognize the tumor antigens as foreign and
subsequently fail to some fats can alter the initiate destruction of the malignant cells. The incidence of
autoimmune risk of cancer developdiseases also increases with age, possibly from a decreased ability
ment. of antibodies to differentiate between self and nonself. Failure of the surveillance system to
,recognize mutant or abnormal cells also may be B. Tumor cells may responsible, in part, for the high
incidence of cancer associated with possess special blockincreasing age. Vitamin D deficiency has
been associated with increased ing factors that coat risk of common cancers. Evidence shows that
nutrition plays a role in tumor cells and prethe development of cancer and that diet and lifestyle can
alter the risk vent their destruction of the develo by killer T lymphocytes; therefore the body may not
recognize the tumor as foreign and fail to destroy the malignant cells. Routine screening increases the
chance of finding and treating cancer early. C. The immune system is integrated with other
psychophysiological proce
Question 3:
For a cancerous tumor, a client must undergo modified radical mastectomy, which includes axillary
node removal and immediate reconstruction. The nurse explains to the client that the axillary nodes
will be removed to: A. provide prognostic information. B. prevent metastasis. C. facilitate
postoperative recovery. D. facilitate breast reconstruction.
Answer:
A. provide prognostic information. Explanation: Lymph node dissection provides prognostic
information by helping to determine if chemotherapy is indicated. Although removal of lymph nodes
may assist in prevention of metastasis, lymph node dissection isn't a guarantee that metastasis won't
occur. This procedure doesn't affect breast reconstruction and may actually make postoperative
recovery more difficult. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of
Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 58: Assessment and
Management of Patients With Breast Disorders, Modified Radical Mastectomy, p. 1733.
Question 4:
The nurse is an occupational health nurse who is presenting a workshop on laryngeal cancer. What risk
factors would the nurse be sure to include in the workshop? Select all that apply. A. Region of country
Answer:
B. Tobacco C. Industrial pollutants D. Age E. Alcohol Explanation: lived in Carcinogens, such as
tobacco, alcohol, and industrial pollutants, are associated with laryngeal cancer. The age of the client is
also a factor, B. Tobacco with a higher incidence among those 65 years of age or older. Region of
country lived in is not associated with laryngeal cancer as a specific C. Industrial pollutants risk factor.
D. Age Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Med- E. Alcohol
ical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 22: Management of
Patients with Upper Respiratory Tract Disorders, Cancer of the Larynx, p. 572.
Question 5:
A nurse is working with a client who has recently received a diagnosis of human immunodeficiency
virus (HIV). When performing client education during discharge planning, what goal should the nurse
prioritize? A. Encourage the client to adhere to his therapeutic regimen. B. Encourage the client to
,exercise within his limitations. C. Encourage a disease-free state.
Answer:
A. Encourage the client to adhere to his therapeutic regimen. Explanation: One of the goals of client
education is to encourage people to adhere to their therapeutic regimen. This is a very important goal
because if clients do not adhere to their therapeutic regimen, they will not attain their optimal level of
wellness. In this client's circumstances, this is likely a priority over exercise or nutrition, though these
are important considerations. A disease-free state is not obtainable. Reference: Hinkle, J.L., & Cheever,
K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters
Kluwer, 2018, Chapter 4: Health Education and Health Promotion, Promoting Adherence to the
Therapeutic Regimen, p. 47. D. Appraise the client's level of nutritional awareness.
Question 6:
A nurse is teaching a client about the functions of the larynx. What should the nurse include in the
teaching? Select all that apply. A. Preventing infection B. Acting as a passage way for the respiratory
tract C. Facilitating coughing D. Protecting the lower airway from foreign objects E. Producing sound
Answer:
C. Facilitating coughing D. Protecting the lower airway from foreign objects E. Producing sound
Explanation: The larynx, or voice box, is a cartilaginous framework between the pharynx and trachea.
Its primary function is to produce sound. The larynx assists in protecting the lower airway. Facilitating
coughing is a function of the larynx. Preventing infection is the main function of the tonsils and
adenoids. The pharynx is a passageway for the respiratory tract. Reference: Hinkle, J.L., & Cheever,
K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters
Kluwer, 2018, Chapter 20: Assessment of Respiratory Function, pp. 481-482.
Question 7:
A client presents to the emergency department following a burn injury. The client has burns to the
abdomen and front of the left leg. Using the rule of nines, the
Answer:
A. 18%. Explanation: The rule-of-nines system is based on dividing anatomic regions, each
representing approximately 9% of the total body surface area (TBSA), quickly allowing clinicians to
obtain an estimate. If a portion of an nurse documents the anatomic area is burned, the TBSA is
calculated accordingly-for examtotal body surface area ple, if approximately half of the anterior leg is
burned, the TBSA burned percentage as would be 4.5%. More specifically, with an adult who has been
burned, the percent of the body involved can be calculated as follows: head = A. 18%. 9%, chest (front)
= 9%, abdomen (front) = 9%, upper/mid/low back and B. 36%. buttocks = 18%, each arm = 9% (front
= 4.5%, back = 4.5%), groin = 1%, C. 9%. and each leg = 18% total (front = 9%, back = 9%). In this
case the client's D. 27%. abdomen (9%) and front of the left leg (9%) add up to 18%. Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
Philadelphia, Wolters Kluwer, 2018, Chapter 62: Management of Patients with Burn Injury, p. 1848.
, Question 8:
A client with AIDS has developed cytomegalovirus (CMV) retinitis and is receiving treatment with
foscarnet. The nurse would monitor for which possible adverse drug effects? Select all that apply. A.
Hyperphosphatemia B. Hypercalcemia C. Seizures D. Hypomagnesemia E. Neutropenia
Answer:
A. Hyperphosphatemia C. Seizures D. Hypomagnesemia Explanation: Adverse reactions associated
with foscarnet include nephrotoxicity, including acute renal failure, and electrolyte imbalances such as
hypocalcemia, hyperphosphatemia, and hypomagnesemia, which can be life-threatening. Seizures also
may occur. Neutropenia is an adverse effect associated with ganciclovir. Reference: Hinkle, J.L., &
Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia,
Wolters Kluwer, 2018, Chapter 36: Management of Patients With Immune Deficiency Disorders,
Cytomegalovirus Retinitis, p. 1042.
Question 9:
A client is in the ED after being struck in the left eye with a baseball, leaving a large ecchymosis and
edema. In client education, the nurse explains to the client the functions of the various structures of the
eye. What are functions of the eyelids? Select all that apply. A. spread tears B. eliminate dust C. impact
ocular light D. produce tears
Answer:
A. spread tears C. impact ocular light Explanation: The eyelids adjust the amount of light that enters
the eye and spread tears over the surface of the eye. The eyelids do not produce tears. The eyelids
protect against foreign bodies but do not eliminate them. Reference: Hinkle, J.L., & Cheever, K.H.,
Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer,
2018, Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders, p. 1877.
Question 10:
A nurse is providing discharge teaching for a client with a burn wound on the leg. What instructions are
important to give the client? Select all that apply. A. Apply lubricating lotion to the wound bed. B.
Wash the wound with
Answer:
B. Wash the wound with soap and water. D. Continue physical therapy exercises. E. Report increased
redness and wound drainage to the healthcare provider. Explanation: The client being discharged with
burn wound care needs to demonstrate wound care technique; take prescribed pain medications if
needsoap and water. ed 30 minutes prior to wound care to achieve maximum effectiveness; use mild
soap, water, and a clean washcloth to clean wounds; apply C. Take pain medicaprescribed topical
medications( not lubricating lotions to the wound tions daily. bed) and dressings as instructed; inspect
wounds carefully with each dressing change for signs of infection, including increased redness, D.
Continue physical swelling, drainage, or foul odor; and state aspects of activities of daily therapy
exercises. living as per therapy. E. Report increased Reference: redness and wound Hinkle, J.L., &
Answers (Grade A+)
Question 1:
A nurse is caring for a client newly diagnosed with cancer. Which therapies are used to treat cancer?
Select all that apply. A. electroconvulsive therapy B. hyperthermia C. surgery D. chemotherapy E.
radiation therapy
Answer:
B. hyperthermia C. surgery D. chemotherapy E. radiation therapy Explanation: Cancer is frequently
treated with a combination of therapies using standardized protocols. The basic methods used to treat
cancer are surgery, radiation therapy, hyperthermia, and chemotherapy. Electroconvulsive therapy is a
method of treatment for mental distress or illness. Reference: Hinkle, J.L., & Cheever, K.H., Brunner
& Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018,
Chapter 15: Management of Patients with Oncologic Disorders, p. 334.
Question 2:
During an annual examination, an older client tells the nurse, "I don't understand why I need to have so
many cancer screening tests now. I feel just fine!" Based on knowledge of neoplastic disease and the
aging immune system, what teaching should the nurse include in the client's plan of care? Select all that
apply.
Answer:
A. Nutritional intake to support a competent immune response plays an important role in reducing the
incidence of cancer. A healthy diet including protein, vitamins, minerals, and some fats can alter the
risk of cancer development. B. Tumor cells may possess special blocking factors that coat tumor cells
and prevent their destruction by killer T lymphocytes; therefore the body may not recognize the tumor
as foreign and fail to destroy the malignant cells. Routine screening increases the chance of finding and
treating cancer early. E. The increase in occurrence of autoimmune diseases with aging strongly
suggests a predisposition toward various types of cancer due to the body's inability to differentiate
between self and nonself. Routine screening increases the chance of finding and treating cancer early.
A. Nutritional intake to support a competent Explanation: immune response plays Large tumors can
release antigens into the blood, and these antigens an important role in recombine with circulating
antibodies and prevent them from attacking ducing the incidence of the tumor cells. Furthermore,
tumor cells may possess special blocking cancer. A healthy diet factors that coat tumor cells and
prevent their destruction by killer T including protein, vitlymphocytes. During the early development
of tumors, the body may amins, minerals, and fail to recognize the tumor antigens as foreign and
subsequently fail to some fats can alter the initiate destruction of the malignant cells. The incidence of
autoimmune risk of cancer developdiseases also increases with age, possibly from a decreased ability
ment. of antibodies to differentiate between self and nonself. Failure of the surveillance system to
,recognize mutant or abnormal cells also may be B. Tumor cells may responsible, in part, for the high
incidence of cancer associated with possess special blockincreasing age. Vitamin D deficiency has
been associated with increased ing factors that coat risk of common cancers. Evidence shows that
nutrition plays a role in tumor cells and prethe development of cancer and that diet and lifestyle can
alter the risk vent their destruction of the develo by killer T lymphocytes; therefore the body may not
recognize the tumor as foreign and fail to destroy the malignant cells. Routine screening increases the
chance of finding and treating cancer early. C. The immune system is integrated with other
psychophysiological proce
Question 3:
For a cancerous tumor, a client must undergo modified radical mastectomy, which includes axillary
node removal and immediate reconstruction. The nurse explains to the client that the axillary nodes
will be removed to: A. provide prognostic information. B. prevent metastasis. C. facilitate
postoperative recovery. D. facilitate breast reconstruction.
Answer:
A. provide prognostic information. Explanation: Lymph node dissection provides prognostic
information by helping to determine if chemotherapy is indicated. Although removal of lymph nodes
may assist in prevention of metastasis, lymph node dissection isn't a guarantee that metastasis won't
occur. This procedure doesn't affect breast reconstruction and may actually make postoperative
recovery more difficult. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of
Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 58: Assessment and
Management of Patients With Breast Disorders, Modified Radical Mastectomy, p. 1733.
Question 4:
The nurse is an occupational health nurse who is presenting a workshop on laryngeal cancer. What risk
factors would the nurse be sure to include in the workshop? Select all that apply. A. Region of country
Answer:
B. Tobacco C. Industrial pollutants D. Age E. Alcohol Explanation: lived in Carcinogens, such as
tobacco, alcohol, and industrial pollutants, are associated with laryngeal cancer. The age of the client is
also a factor, B. Tobacco with a higher incidence among those 65 years of age or older. Region of
country lived in is not associated with laryngeal cancer as a specific C. Industrial pollutants risk factor.
D. Age Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Med- E. Alcohol
ical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 22: Management of
Patients with Upper Respiratory Tract Disorders, Cancer of the Larynx, p. 572.
Question 5:
A nurse is working with a client who has recently received a diagnosis of human immunodeficiency
virus (HIV). When performing client education during discharge planning, what goal should the nurse
prioritize? A. Encourage the client to adhere to his therapeutic regimen. B. Encourage the client to
,exercise within his limitations. C. Encourage a disease-free state.
Answer:
A. Encourage the client to adhere to his therapeutic regimen. Explanation: One of the goals of client
education is to encourage people to adhere to their therapeutic regimen. This is a very important goal
because if clients do not adhere to their therapeutic regimen, they will not attain their optimal level of
wellness. In this client's circumstances, this is likely a priority over exercise or nutrition, though these
are important considerations. A disease-free state is not obtainable. Reference: Hinkle, J.L., & Cheever,
K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters
Kluwer, 2018, Chapter 4: Health Education and Health Promotion, Promoting Adherence to the
Therapeutic Regimen, p. 47. D. Appraise the client's level of nutritional awareness.
Question 6:
A nurse is teaching a client about the functions of the larynx. What should the nurse include in the
teaching? Select all that apply. A. Preventing infection B. Acting as a passage way for the respiratory
tract C. Facilitating coughing D. Protecting the lower airway from foreign objects E. Producing sound
Answer:
C. Facilitating coughing D. Protecting the lower airway from foreign objects E. Producing sound
Explanation: The larynx, or voice box, is a cartilaginous framework between the pharynx and trachea.
Its primary function is to produce sound. The larynx assists in protecting the lower airway. Facilitating
coughing is a function of the larynx. Preventing infection is the main function of the tonsils and
adenoids. The pharynx is a passageway for the respiratory tract. Reference: Hinkle, J.L., & Cheever,
K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters
Kluwer, 2018, Chapter 20: Assessment of Respiratory Function, pp. 481-482.
Question 7:
A client presents to the emergency department following a burn injury. The client has burns to the
abdomen and front of the left leg. Using the rule of nines, the
Answer:
A. 18%. Explanation: The rule-of-nines system is based on dividing anatomic regions, each
representing approximately 9% of the total body surface area (TBSA), quickly allowing clinicians to
obtain an estimate. If a portion of an nurse documents the anatomic area is burned, the TBSA is
calculated accordingly-for examtotal body surface area ple, if approximately half of the anterior leg is
burned, the TBSA burned percentage as would be 4.5%. More specifically, with an adult who has been
burned, the percent of the body involved can be calculated as follows: head = A. 18%. 9%, chest (front)
= 9%, abdomen (front) = 9%, upper/mid/low back and B. 36%. buttocks = 18%, each arm = 9% (front
= 4.5%, back = 4.5%), groin = 1%, C. 9%. and each leg = 18% total (front = 9%, back = 9%). In this
case the client's D. 27%. abdomen (9%) and front of the left leg (9%) add up to 18%. Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
Philadelphia, Wolters Kluwer, 2018, Chapter 62: Management of Patients with Burn Injury, p. 1848.
, Question 8:
A client with AIDS has developed cytomegalovirus (CMV) retinitis and is receiving treatment with
foscarnet. The nurse would monitor for which possible adverse drug effects? Select all that apply. A.
Hyperphosphatemia B. Hypercalcemia C. Seizures D. Hypomagnesemia E. Neutropenia
Answer:
A. Hyperphosphatemia C. Seizures D. Hypomagnesemia Explanation: Adverse reactions associated
with foscarnet include nephrotoxicity, including acute renal failure, and electrolyte imbalances such as
hypocalcemia, hyperphosphatemia, and hypomagnesemia, which can be life-threatening. Seizures also
may occur. Neutropenia is an adverse effect associated with ganciclovir. Reference: Hinkle, J.L., &
Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia,
Wolters Kluwer, 2018, Chapter 36: Management of Patients With Immune Deficiency Disorders,
Cytomegalovirus Retinitis, p. 1042.
Question 9:
A client is in the ED after being struck in the left eye with a baseball, leaving a large ecchymosis and
edema. In client education, the nurse explains to the client the functions of the various structures of the
eye. What are functions of the eyelids? Select all that apply. A. spread tears B. eliminate dust C. impact
ocular light D. produce tears
Answer:
A. spread tears C. impact ocular light Explanation: The eyelids adjust the amount of light that enters
the eye and spread tears over the surface of the eye. The eyelids do not produce tears. The eyelids
protect against foreign bodies but do not eliminate them. Reference: Hinkle, J.L., & Cheever, K.H.,
Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer,
2018, Chapter 63: Assessment and Management of Patients With Eye and Vision Disorders, p. 1877.
Question 10:
A nurse is providing discharge teaching for a client with a burn wound on the leg. What instructions are
important to give the client? Select all that apply. A. Apply lubricating lotion to the wound bed. B.
Wash the wound with
Answer:
B. Wash the wound with soap and water. D. Continue physical therapy exercises. E. Report increased
redness and wound drainage to the healthcare provider. Explanation: The client being discharged with
burn wound care needs to demonstrate wound care technique; take prescribed pain medications if
needsoap and water. ed 30 minutes prior to wound care to achieve maximum effectiveness; use mild
soap, water, and a clean washcloth to clean wounds; apply C. Take pain medicaprescribed topical
medications( not lubricating lotions to the wound tions daily. bed) and dressings as instructed; inspect
wounds carefully with each dressing change for signs of infection, including increased redness, D.
Continue physical swelling, drainage, or foul odor; and state aspects of activities of daily therapy
exercises. living as per therapy. E. Report increased Reference: redness and wound Hinkle, J.L., &
