Exam (elaborations) NURS 1102 PASSPOINT ONCOLOGIC

NURS 1102 PASSPOINT ONCOLOGIC Question 1 See full question A client with stage II ovarian cancer undergoes a total abdominal hysterectomy and bilateral salpingooophorectomy with tumor resection, omentectomy, appendectomy, and lymphadenectomy. During the second postoperative day, which assessment finding requires immediate intervention? You Selected:  Shallow breathing and increasing lethargy Correct response:  Shallow breathing and increasing lethargy Explanation: Remediation: Question 2 See full question A client has just begun treatment with busulfan, 4 mg by mouth daily, for chronic myelogenous leukemia. The client receives busulfan until his white blood cell (WBC) count falls to between 10,000/mm3 and 25,000/mm3. Then the drug is stopped. When should treatment resume? You Selected:  When the WBC count rises to 50,000/mm3 Correct response:  When the WBC count rises to 50,000/mm3 Explanation: Remediation: Question 3 See full question A client with metastatic brain cancer is admitted to the oncology floor. According to the Self- Determination Act of 1991 concerning the execution of an advance directive, the hospital is required to: You Selected:  inform the client or legal guardian of their rights to execute an advance directive. Correct response:  inform the client or legal guardian of their rights to execute an advance directive. Explanation: Remediation: Question 4 See full question Which nursing goal is appropriate for a client with multiple myeloma? NURS 1102 PASSPOINT ONCOLOGIC You Selected:  Decrease episodes of nausea and vomiting. Correct response:  Achieve effective management of bone pain. Explanation: Remediation: Question 5 See full question A 56-year-old woman is admitted for a modified radical mastectomy. The client appears anxious and asks many questions. The nurse's best course of action is to: You Selected:  explain to the client that she should discuss her questions with her health care provider (HCP). Correct response:  tell the client as much as she wants to know and is able to understand. Explanation: Remediation: Question 6 See full question A nurse is teaching an older adult who has had a left modified radical mastectomy with axillary node dissection about lymphedema. The nurse should tell the client that lymphedema occurs: You Selected:  at any time after surgery. Correct response:  at any time after surgery. Explanation: Remediation: Question 7 See full question A client is newly diagnosed with cancer and is beginning a treatment plan. Which action by the nurse will be most effective in helping the client cope? You Selected:  Identify available resources for the client and family. Correct response:  Identify available resources for the client and family. Explanation: Remediation: Question 8 See full question A client with cancer is uncertain about how to cope with all the issues that will arise. The nurse can best support the coping behaviors of a client with cancer by: You Selected:  relieving the client of decision making as much as possible. Correct response:  helping the client identify available resources. Explanation: Remediation: Question 9 See full question A terminally ill client’s husband tells the nurse, “I wish we had taken that trip to Europe last year. We just kept putting it off, and now I am furious that we did not go.” The nurse interprets the husband’s statement as indicating which stage of adaptation to dying? You Selected:  depression Correct response:  anger Explanation: Remediation: Question 10 See full question A 70-year-old client asks the nurse if she needs to have a mammogram. Which is the nurse's bestresponse? You Selected:  "We need to consider your family history of breast cancer first." Correct response:  "The incidence of breast cancer increases with age." Explanation: Remediation: Question 11 See full question The primary reason that a herpes simplex virus (HSV) infection is a serious concern to a client with human immunodeficiency virus (HIV) infection is that it: You Selected:  causes severe electrolyte imbalances. Correct response:  is an acquired immunodeficiency virus (AIDS)–defining illness. Explanation: Remediation: Question 12 See full question A woman tells the nurse, “There has been a lot of cancer in my family.” The nurse should instruct the client to report which possible sign of cervical cancer? You Selected:  leg edema Correct response:  light bleeding or watery vaginal discharge Explanation: Remediation: Question 13 See full question A right orchiectomy is performed on a client with a testicular malignancy. The client expresses concerns regarding his sexuality. The nurse should base the response on the knowledge that the client: You Selected:  should retain normal sexual drive and function. Correct response:  should retain normal sexual drive and function. Explanation: Remediation: Question 14 See full question After surgery for gastric cancer, a client is scheduled to undergo radiation therapy. The nurse should include which information in the teaching plan? You Selected:  management of alopecia Correct response:  nutritional intake Explanation: Remediation: Question 15 See full question A client states, "I do not want any more tests. Who cares what kind of leukemia I have? I just want to be treated now." Which is the nurse's best response? You Selected:  "I understand how you feel." Correct response:  "Your treatment can be more effective if it is based on more specific information about your disease." Explanation: Remediation: Question 16 See full question In assessing a client in the early stage of chronic lymphocytic leukemia (CLL), the nurse should determine if the client has: You Selected:  Headache. Correct response:  Unintentional weight loss. Explanation: Remediation: Question 17 See full question When the client who has had a modified radical mastectomy returns from the operating room to the recovery room, what should the nurse do first? You Selected:  Check the client’s dressings for drainage. Correct response:  Ensure that the client’s airway is free of obstruction. Explanation: Remediation: Question 18 See full question A client with testicular cancer is scheduled for a right orchiectomy. The day before surgery, the client tells the nurse that he is concerned about the effect that losing a testicle will have on his manhood. Which information about orchiectomy should form the basis for the nurse’s response? You Selected:  Sperm count increases in the remaining testicle. Correct response:  Sexual drive and libido are unchanged. Explanation: Remediation: Question 19 See full question The nurse notes that a placebo has been prescribed when a client requests pain medication. Which statement is most accurate about the use of placebos in the client’s plan of care? You Selected:  The use of placebos violates the client’s right to ethical care. Correct response:  The use of placebos violates the client’s right to ethical care. Explanation: Remediation: Question 20 See full question A client complains of sporadic epigastric pain, yellow skin, nausea, vomiting, weight loss, and fatigue. Suspecting gallbladder disease, the physician orders a diagnostic workup, which reveals gallbladder cancer. Which nursing diagnosis is appropriate for this client? You Selected:  Disturbed body image Correct response:  Anticipatory grieving Explanation: Question 21 See full question During a breast examination, which finding most strongly suggests that a client has breast cancer? You Selected:  Multiple firm, round, freely movable masses that change with the menstrual cycle Correct response:  A fixed nodular mass with dimpling of the overlying skin Explanation: Remediation: Question 22 See full question During chemotherapy, an oncology client has a nursing diagnosis of Impaired oral mucous membrane related to decreased nutrition and immunosuppression secondary to the cytotoxic effects of chemotherapy. Which nursing intervention is most likely to decrease the pain of stomatitis? You Selected:  Recommending that the client discontinue chemotherapy Correct response:  Providing a solution of viscous lidocaine for use as a mouth rinse Explanation: Remediation: Question 23 See full question A client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a chemotherapy-induced complication? You Selected:  Urine output of 400 ml in 8 hours Correct response:  Serum potassium level of [2.6 mEq/L (2.6 mmol/L)} Explanation: Remediation: Question 24 See full question A client receiving chemotherapy has a nursing diagnosis of Deficient diversional activity related to decreased energy. Which client statement indicates an accurate understanding of appropriate ways to deal with this deficit? You Selected:  "I'll bowl with my team after discharge." Correct response:  "I'll play card games with my friends." Explanation: Remediation: Question 25 See full question A nurse is speaking to a group of women about early detection of breast cancer. The average age of the women in the group is 47. Following the American Cancer Society (Canadian Cancer Society) guidelines, the nurse should recommend that the women: You Selected:  have a physician conduct a clinical examination every 2 years. Correct response:  have a mammogram annually. Explanation: Remediation: Question 26 See full question A nurse is caring for a client who has just had a modified radical mastectomy with immediate reconstruction. She's in her 30s and has two young children. Although she's worried about her future, she seems to be adjusting well to her diagnosis. What should the nurse do to support her coping? You Selected:  Refer the client to a community support program. Correct response:  Refer the client to a community support program. Explanation: Remediation: Question 27 See full question A client tells the nurse that she has found a painless lump in her right breast during her monthly selfexamination. Which assessment finding would strongly suggest that this client's lump is cancerous? You Selected:  Nonpalpable right axillary lymph nodes Correct response:  Nonmobile mass with irregular edges Explanation: Remediation: Question 28 See full question A nurse is interviewing a client about his past medical history. Which preexisting condition may lead the nurse to suspect that a client has colorectal cancer? You Selected:  Hemorrhoids Correct response:  Polyps Explanation: Remediation: Question 29 See full question What should a male client older than age 50 do to help ensure early identification of prostate cancer? You Selected:  Have a complete blood count (CBC) and blood urea nitrogen (BUN) and creatinine levels checked yearly. Correct response:  Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly. Explanation: Remediation: Question 30 See full question On discharge, a client who underwent left modified radical mastectomy expresses relief that "the cancer" has been treated. When discussing this issue with the client, the nurse should stress that she: You Selected:  should continue to perform breast self-examination on her right breast. Correct response:  should continue to perform breast self-examination on her right breast. Explanation: Remediation: Question 31 See full question A 30-year-old client whose mother died of breast cancer at age 44 and whose sister has ovarian cancer, is concerned about developing cancer. As a member of the oncology multidisciplinary team, the nurse should suggest that the client ask the physician about which topic? You Selected:  Genetic counseling Correct response:  Genetic counseling Explanation: Remediation: Question 32 See full question Which statement indicates that the client needs further teaching about taking medication to control cancer pain? You Selected:  "I should take my medication around-the-clock to control my pain.” Correct response:  "I should skip doses periodically so I do not get hooked on my drugs.” Explanation: Remediation: Question 33 See full question The nurse is conducting an initial nursing history of a client who is experiencing pain related to bone cancer. The most important information to gather in this initial assessment is the: You Selected:  amount of pain medication the client is taking. Correct response:  client’s self-reporting of the pain experience. Explanation: Remediation: Question 34 See full question A nurse is checking the laboratory results of an adult client with colon cancer admitted for further chemotherapy. The client has lost 30 lb (13.6 kg) since initiation of the treatment. Which laboratory result should be reported to the health care provider (HCP)? You Selected:  albumin level of 2.8 g/dL (28 g/L) Correct response:  albumin level of 2.8 g/dL (28 g/L) Explanation: Remediation: Question 35 See full question A client diagnosed with cancer is receiving chemotherapy. The nurses should assess which diagnostic value while the client is receiving chemotherapy? You Selected:  heart tissues Correct response:  bone marrow cells Explanation: Remediation: Question 36 See full question A client who is in the end-stages of cancer is increasingly upset about receiving chemotherapy. Which approach by the nurse would likely be most helpful in gaining the client's cooperation? You Selected:  Describe the probable effect that missing a treatment would have. Correct response:  Tell the client how the treatment can be expected to help. Explanation: Remediation: Question 37 See full question A 42-year-old female is interested in making dietary changes to reduce her risk of colon cancer. What dietary selections should the nurse suggest? You Selected:  granola, bagel with cream cheese, cauliflower salad Correct response:  bran muffin, skim milk, stir-fried broccoli Explanation: Remediation: Question 38 See full question The nurse is collaborating with the physician to develop a care plan to help control chronic pain in a client with cancer who is receiving hospice home care. Which of the following plans would be most appropriate for managing the client's pain? You Selected:  Keeping the client sedated with tranquilizers to prevent awareness of pain sensations. Correct response:  Administering analgesics on a regular basis, with administration of additional analgesics for break-through pain. Explanation: Remediation: Question 39 See full question A client has been receiving chemotherapy for cancer treatment. The client is competent and has been actively involved in decisions regarding care; however, the client has now decided to refuse treatment. What should the nurse do when the client refuses the next dose of chemotherapy? You Selected:  Ask the client’s spouse to encourage the client to take the chemotherapy. Correct response:  Document the client’s choice and offer to discuss feelings about the chemotherapy. Explanation: Remediation: Question 40 See full question A nurse is reviewing the medical record of an adult man with cancer. The health care provider (HCP) has prescribed filgrastim 400 mcg, subcutaneously once daily. The nurse reviews the laboratory report (shown) and determines treatment has been effective when: You Selected:  WBC count is 3,500/mm3 (3.5 X 109/L). Correct response:  WBC count is 3,500/mm3 (3.5 X 109/L). Explanation: Remediation: Question 41 See full question A nurse is teaching a community class about how to decrease the risk of cancer. What is the best food for the nurse to recommend? You Selected:  Baked beans Correct response:  Oranges Explanation: Remediation: Question 42 See full question A client diagnosed with terminal lung cancer tells the nurse that he would like to seek spiritual advice. Which intervention by the nurse best provides spiritual support for this client? You Selected:  The nurse could ask the client who his spiritual advisor is and make the contact. Correct response:  The nurse could ask the client who his spiritual advisor is and make the contact. Explanation: Remediation: Question 43 See full question Which action, displayed by a grieving partner over his dying wife, should cause the nurse to suggest counseling? You Selected:  He blames his wife's family for the client's current health problems. Correct response:  He blames his wife's family for the client's current health problems. Explanation: Remediation: Question 44 See full question A client with stage IV pancreatic cancer is admitted to hospice. The spouse breaks down crying, stating “I just don’t know what I will do if he dies!” Which is the best response by the nurse? You Selected:  “I see you are upset. I will come back in 10 minutes and we can talk.” Correct response:  “What has helped you cope with his illness so far?” Explanation: Remediation: Question 45 See full question A nurse is caring for a client who is receiving chemotherapy for lung cancer. During the hand-off report, the nurse from the previous shift states that the client has been placed on neutropenic precautions. Which laboratory value supports this nursing action? You Selected:  A retculocyte count of 1% Correct response:  A white blood cell count of 2200/mm3 Explanation: Remediation: Question 46 See full question A nurse is planning a program about cancer for a woman’s club. Which of the following should the nurse include in the discussion of risk factors for ovarian cancer? You Selected:  A 28-year-old woman who has been taking hormonal contraceptives for 10 years Correct response:  A 42-year-old woman who has never been pregnant Explanation: Remediation: Question 47 See full question A client is ordered a dose of epoetin alfa to treat anemia related to chemotherapy. The recommended dose is 150 units/kg. The client weighs 60 kg. The vial is labeled 10,000 units/ml. How many milliliters of epoetin alfa would the nurse administer? Record your answer using one decimal place. Your Response:  0.9 Correct response:  0.9 Explanation: Remediation: Question 48 See full question The nurse is working at the local family planning clinic completing family education. When devising a teaching plan, in which client group would the nurse stress the importance of an annual Papanicolaou test? You Selected:  Clients infected with the human papillomavirus (HPV) Correct response:  Clients infected with the human papillomavirus (HPV) Explanation: Remediation: Question 49 See full question The nurse is developing a care plan for a client with cancer receiving hospice home care. Which would be the most appropriate action for managing the client’s chronic pain? You Selected:  Administer analgesics regularly and additionally as needed for break-through pain. Correct response:  Administer analgesics regularly and additionally as needed for break-through pain. Explanation: Remediation: Question 50 See full question The nurse is teaching the family of a client diagnosed with leukemia about ways to prevent infection. Which instruction has the most impact? You Selected:  Maintaining an intact skin integrity Correct response:  Maintaining an intact skin integrity A few minutes after beginning a blood transfusion, a nurse notes that a client has chills, dyspnea, and urticaria. The nurse reports this to the physician immediately because the client probably is experiencing which problem? You Selected:  A hemolytic allergic reaction caused by an antigen reaction Correct response:  A hemolytic allergic reaction caused by an antigen reaction Question 1 See full question On the night before a 58-year-old wife and mother is to have a lobectomy for lung cancer, she remarks to the nurse, “I am so scared of this cancer. I should have quit smoking years ago. Now I have brought all this fear and sadness on myself and now my family.” The nurse should tell the client: You Selected:  "It is normal to be scared. I would be, too. We will help you through it." Correct response:  "It is okay to be scared. What is it about cancer that you are afraid of?" Explanation: Remediation: Question 2 See full question Which action is most important when the nurse is planning pain management for a client after a lobectomy for lung cancer? You Selected:  reassuring the client after administering pain medication Correct response:  reassessing the client after administering pain medication Explanation: Remediation: Question 3 See full question A client who is undergoing radiation therapy develops mucositis. Which action should be included in the client’s plan of care? You Selected:  providing the client with hot tea to drink Correct response:  promoting regular flossing of teeth Explanation: Remediation: Question 4 See full question After a lobectomy for lung cancer, the nurse instructs the client to perform deep-breathing exercises to: You Selected:  decrease blood flow to the lungs for rest and increased surface alveoli ventilation. Correct response:  expand the alveoli and increase lung surface available for ventilation. Explanation: Remediation: Question 5 See full question An woman with a history of a left radical mastectomy is being admitted for abdominal surgery. The woman has a swollen left arm. The nurse should: You Selected:  allow blood draws in the affected arm. Correct response:  take the blood pressure only in the unaffected arm. Explanation: Remediation: Question 6 See full question Lifestyle influences that are considered risk factors for colorectal cancer include: You Selected:  multiple sex partners. Correct response:  a high-fat, low-fiber diet. Explanation: Remediation: Question 7 See full question Doxorubicin is prescribed for a female client with breast cancer. The client is distressed about hair loss. What should the nurse do? You Selected:  Provide resources for a wig selection before hair loss begins. Correct response:  Provide resources for a wig selection before hair loss begins. Explanation: Remediation: Question 8 See full question When explaining the long-term toxic effects of cancer treatments on the immune system, what should the nurse tell the client? You Selected:  The helper T cells recover more rapidly than the suppressor T cells, which results in positive helper cell balance that can last 5 years. Correct response:  The use of radiation and combination chemotherapy can result in more frequent and more severe immune system impairment. Explanation: Remediation: Question 9 See full question A client with ovarian cancer asks the nurse, "What is the cause of this cancer?" Which is the mostaccurate response by the nurse? You Selected:  Women who have had at least two live births are protected from ovarian cancer. Correct response:  The risk of developing ovarian cancer is related to environmental, endocrine, and genetic factors. Explanation: Remediation: Question 10 See full question What is an instruction the nurse can give to help people prevent lung cancer? You Selected:  Encourage cigarette smokers to have yearly chest radiographs. Correct response:  Instruct people about techniques for smoking cessation. Explanation: Remediation: Question 11 See full question A client's bone marrow report reveals normal stem cells and precursors of platelets (megakaryocytes) in the presence of decreased circulating platelets. The nurse recognizes a knowledge deficit when the client says: You Selected:  "I need to stop flossing and throw away my hard toothbrush." Correct response:  "I am glad that my report turned out normal." Explanation: Remediation: Question 12 See full question The client with Hodgkin's disease undergoes an excisional cervical lymph node biopsy under local anesthesia. After the procedure, what does the nurse assess first? You Selected:  the airway Correct response:  the airway Explanation: Remediation: Question 13 See full question A nurse is caring for a terminally ill cancer client who is being transferred to hospice care. Which information regarding hospice care would the nurse include in the teaching plan? Select all that apply. You Selected:  Bereavement care is provided to the family.  Care is provided in the home, independent of physicians.  Hospice care is provided only in hospice centers. Correct response:  The focus of care is on controlling symptoms