Test Bank For Understanding Medical Surgical Nursing 6th Edition, Linda S. Williams Paula D. Hopper | VERIFIED

A client is suspected of having a reaction. Which lab test would alert the nurse regarding the possibility of a hypersensitivity reaction? 1. Eosinophils of 2% of the total WBC 2. Indirect Coombs’ showing no agglutination 3. Patch test with a one-inch area of erythema 4. Rh antigen with negative results Answer: 3 Rationale: A patch test assesses a one-inch area impregnated with the allergen, which is applied for 48 hours. Absence of a response indicates a negative result. Positive responses are graded from mild (erythema in the exposed area) to severe (papules, vesicles, or ulcerations). Direct Coombs’ test detects antibodies in the client’s RBC that damage and Test Bank for Understanding Medical-Surgical Nursing 6th Edition Linda S. Williams Paula D. Hopper destroy the cells. This is used following a suspected transfusion reaction to detect antibodies coating the transfused RBCs. This is also part of the crossmatch of a blood type and crossmatch. Indirect Coombs’ test detects the presence of circulating antibodies against RBCs. The eosinophil count is 1–4%, which is within normal range. Cognitive Level: Comprehension Client Needs: Physiological Integrity Nursing Process: Assessment 6. A client has a diagnosis of AIDS. The nurse is teaching the client regarding a diet with increased kilocalories. Which of the following diets would indicate that the client has an understanding of the appropriate diet? 1. Spaghetti and meat sauce, raisin salad, whole grain roll with butter, vanilla milkshake (with Ensure), and a piece of pecan pie 2. Baked chicken (thigh), cabbage, small green salad, slice of white bread, dried prunes, and a soda 3. Red beans and rice, slaw, tomato, crackers, chocolate pudding, and iced tea 4. Vegetable soup, small piece of cornbread, banana pudding, and water Answer: 1 Rationale: Provide a diet high in protein and kilocalories. A high-protein, high-kilocalorie diet provides the necessary nutrients to meet metabolic and tissue healing needs. The diet with the most kilocalories is the spaghetti and meat sauce with the vanilla milkshake made with Ensure and pecan pie. Cognitive Level: Application Client Needs: Health Promotion and Maintenance Nursing Process: Implementation 7. Which of the following statements by the client who has HIV would require further teaching by the healthcare professional? 1. “I know I have to practice safe sex with my partner.” 2. “I will not share my toothbrush or razor with my partner.” 3. “I know I can’t donate blood anymore since I have HIV.” Test Bank for Understanding Medical-Surgical Nursing 6th Edition Linda S. Williams Paula D. Hopper 4. “I know to use an oil-based lubricant to prevent spread of the disease to my partner.” Answer: 4 Rationale: The nurse should educate the client regarding the prevention of the spread of HIV. The client will need further education when he states that he will use an oil-based lubricant. The client should be educated to use latex condoms for oral, vaginal, or anal intercourse; avoid natural or animal skin condoms, which allow passage of HIV. The client should use only water-based lubricants—not oil-based, such as petroleum jelly, which can result in condom damage. The client is correct in stating that it is not an acceptable practice to share toothbrushes or razors. The client is also correct in stating that blood donation is prohibited. Cognitive Level: Application Client Needs: Physiological Integrity Nursing Process: Implementation 8. The home health nurse is planning the day. Which of the following clients should the nurse see first? 1. A client with wasting syndrome who has end-stage AIDS who needs modifications and education regarding dietary changes 2. A client with a long history of AIDS who is receiving IV antibiotics daily for toxoplasmosis 3. A client with PCP (Pneumocystis carinii pneumonia) who called the office to report a new onset of fever, cough, and SOB this AM 4. A client with AIDS who is receiving Epivir (lamivudine) because of a diagnosis of a low CD4 cell count. Answer: 3 Rationale: The home health nurse should see the client with Pneumocystis carinii pneumonia because of the complaint of shortness of breath with the new onset of fever. All of the clients need to be seen by the nurse, but based on the ABCs (airway, breathing, and circulation), the nurse should visit this client first and obtain vital signs and perform a respiratory assessment initially. Cognitive Level: Application Client Needs: Safe, Effective Care Environment Nursing Process: Planning Test Bank for Understanding Medical-Surgical Nursing 6th Edition Linda S. Williams Paula D. Hopper 9. A nurse is performing an admission assessment on a client with AIDS. Which of the following questions would be inappropriate for the nurse to ask the client in the interview process? 1. “Have you ever experimented with recreational drugs?” 2. “How long have you had AIDS?” 3. “Does your partner have AIDS?” 4. “Have you had any fever, diarrhea, or chills over the last 48 hours?” Answer: 3 Rationale: During the interview process, the nurse should ask questions specific to the client’s history, including current medications, diet, and signs and symptoms that the client has experienced. The nurse cannot ask about the client’s partner. Cognitive Level: Application Client Needs: Psychosocial Integrity Nursing Process: Assessment 10. A client with HIV states “I don’t think I am going to live much longer. I feel so bad.” The nurse determines that which of the following would be the best response? 1. “You will be fine; you just need to let the medication have a chance to work.” 2. “It must be very difficult for you right now dealing with your diagnosis.” 3. “You need to be more positive about your diagnosis because it will improve your chances of surviving this disease.” 4. “Try not to be negative. You need to give yourself some time to feel better about your diagnosis.” Answer: 2 Rationale: The nurse should be realistic with the client. The nurse cannot give false reassurance or false hope about a terminal illness. It is important for the nurse to express empathy for the client. Cognitive Level: Application Client Needs: Psychosocial Integrity Nursing Process: Evaluation Test Bank for Understanding Medical-Surgical Nursing 6th Edition Linda S. Williams Paula D. Hopper 11. A nurse is monitoring a client who is receiving a unit of packed red blood cells. The client suddenly develops chest pains, hives, chills, and hypotension. Number the action that the nurse would take in order of priority. 1. Start normal saline at KVO (keep vein open). 2. Stop the transfusion. 3. Notify the physician and blood bank. 4. Remove the blood bag and the tubing with the blood in it. 5. Obtain a urine specimen and send to the lab. Answer: 2, 4, 1, 3, 5 Rationale: The client is experiencing an adverse reaction to the blood transfusion. The blood should be stopped immediately if a reaction occurs, no matter how mild. The nurse should remove the blood bag and the tubing with blood in it. Flush new intravenous tubing with normal saline, keeping the IV line open. Notify the physician and the blood bank. If a reaction is suspected, send the blood and administration set to the laboratory with a freshly drawn blood sample and urine specimen from the client. These will be used to identify the reaction as well as its effect on the client. Cognitive Level: Application Client Needs: Physiological Integrity Nursing Process: Implementation 12. The nurse has admitted a client who has a diagnosis of Crytosporidium. Which care activity would be appropriate to delegate to the UAP (unlicensed assistive personnel)? Select all that apply. 1. Obtain a detailed history regarding the client’s history. 2. Obtain the client’s admitting height and weight. 3. Review the client’s home medications, and complete the medication reconciliation sheet. 4. Obtain the client’s admitting vital signs. 5. Educate the client regarding the diet that the physician has ordered. Answer: 2; 4 Rationale: The nurse can never delegate assessment or education. The nurse can appropriately delegate to the UAP the task of obtaining weight, height, and vital signs. The nurse practice act assists the nurse with the tasks that can be delegated. Anytime the nurse delegates activities to other professionals, that nurse is accountable for the overall nursing care of the client. Test Bank for Understanding Medical-Surgical Nursing 6th Edition Linda S. Williams Paula D. Hopper Cognitive Level: Analysis Client Needs: Safe, Effective Care Nursing Process: Implementation 13. The nurse would report to the physician which of the following laboratory values for a client newly diagnosed with AIDS? Select all that apply. 1. CD4 cell count 344/mm3 2. T4 cell count 150 3. WBC 6,500 4. CD4 lymphocytes 12% 5. Viral load 11,500 copies/mL Answers: 1; 2; 4; 5 Rationale: The risk of opportunistic infection is the most common manifestation of AIDS. The risk of opportunistic infection is predictable by the T4 and CD4 cell count. The normal CD4 call count is greater than 1,000/mm3 . All of the labs are abnormal except for the WBC, which was within normal range (4,500–10,000). Cognitive Level: Analysis Client Needs: Physiological Integrity Nursing Process: Implementation Test Bank for Understanding Medical-Surgical Nursing 6th Edition Linda S. Williams Paula D. Hopper Chapter 14 1. A client is attending a health fair at work today. The client shows the nurse a new sore on the forearm that has been increasing in size and will not heal. The nurse caring for this client knows that which of the following signs could also point to a diagnosis of a malignant neoplasm? Hint: Types of Neoplasms Answer Choices: 1. Rapid growth, well-defined borders, and cohesiveness 2. Invasive, local, and does not stop at tissue border 3. Noncohesive, invasive, and invades and destroys surrounding tissues 4. Slow growth, well-defined borders, and encapsulated Answer: 3 Rationale: Benign neoplasms are local, cohesive, with well-defined borders. They push other tissues out of the way, are characterized by slow growth, are encapsulated, are easily removed, and do not recur. Malignant neoplasms are invasive, are noncohesive, do not stop at the tissue border, invade and destroy surrounding tissues, are characterized by rapid growth, metastasize to distant sites, are not always easy to remove, and can recur. Nursing Process: Diagnosis Client Need: Health Promotion and Maintenance Client Need Subcategory: Prevention and/or Early Detection of Health Problems Cognitive Level: Application Objective: Define cancer, and differentiate benign from malignant neoplasms. Strategy: Look at every sign provided in each answer choice. The correct answer has to have all correct components to be correct. If any component is incorrect, then the answer is incorrect. 2. A nursing student is learning about the theories of carcinogenesis. Which statement by the nursing student indicates the need for further teaching? Hint: Theories of Carcinogenesis Answer Choices: Test Bank for Understanding Medical-Surgical Nursing 6th Edition Linda S. Williams Paula D. Hopper 1. “Oncogenes are genes that promote cell proliferation and are capable of triggering cancerous characteristics.” 2. “Inherited cancers can become inactive by deletion or mutation.” 3. “The theory of cellular mutation suggests that carcinogens cause mutations in cellular RNA.” 4. “Known carcinogens include viruses, drugs, hormones, and chemical and physical agents.” Answer: 3 Rationale: Oncogenes are genes that promote cell proliferation and are capable of triggering cancerous characteristics. Inherited cancers can become inactive by deletion or mutation. The theory of cellular mutation suggests that carcinogens cause mutations in cellular DNA, not RNA. Known carcinogens include viruses, drugs, hormones, and chemical and physical agents. Nursing Process: Evaluation Client Need: Physiological Integrity Client Need Subcategory: Physiological Adaptation Cognitive Level: Analysis Objective: Describe the theories of carcinogenesis. Strategy: Read each statement. Choose the incorrect statement as the correct answer, since the stem of the questions asks for an indication that further teaching is needed. 3. A college student is studying for final examinations. The student falls ill and presents to the student health center. The student is diagnosed with Epstein-Barr virus. The student has a history of smoking and recreational cocaine use, and works for a floor refinishing company part-time. Which risk factors are present in this student for developing cancer? Select all that apply. Hint: Known Carcinogens Answer Choices: 1. Drug use 2. Occupation 3. Age 4. Smoking 5. Viral infection Answers: 1; 2; 4; 5 Test Bank for Understanding Medical-Surgical Nursing 6th Edition Linda S. Williams Paula D. Hopper Rationale: Several viruses have been associated with the development of cancer. Some of these viruses include herpes simplex viruses I and II, the human cytomegalovirus, Epstein-Barr virus, the human herpesvirus-6, the hepatitis B virus, the papillomavirus, and the human T-lymphotropic viruses. Viruses play a significant role in weakening immunologic defenses against neoplasms. Some recreational drugs are also implicated as carcinogens. Immunosuppressant promoters include heroin and cocaine. Examples of industrial and environmental carcinogens include polycyclic hydrocarbons, found in soot; benzopyrene, found in cigarette smoke; and arsenic, found in pesticides. Other industrial and environmental chemicals are considered promotional agents. These include wood and leather dust, polymer esters used in plastics and paints, carbon tetrachloride, asbestos, and phenol. Nursing Process: Assessment Client Need: Health Promotion and Maintenance Client Need Subcategory: Prevention and/or Early Detection of Health Problems Cognitive Level: Analysis Objective: Explain and discuss known carcinogens, and identify risk factors for cancer. Strategy: Consider each risk factor in the development of cancer in this client. Multiple answers will be correct. 4. A student nurse extern is working for the summer on an oncology unit. The extern’s preceptor has been explaining the characteristics of malignant cells. Which statement by the student nurse extern demonstrates a good understanding of the information? Hint: Characteristics of Malignant Cells Answer Choices: 1. “Malignant cells continue to perform cellular functions.” 2. “The transformation into a malignant cell is reversible if treated promptly.” 3. “Malignant cells rarely break away from the primary tissue site and travel to other locations.” 4. “The work of malignant cells is simpler than that of normal cells.” Answer: 4 Rationale: A characteristic of malignant cells is loss of specialization and differentiation. Malignant cells do not perform typical cellular functions. Another characteristic of malignant cells is irreversibility. The transformation into a malignant cell is irreversible. Rarely does a malignant neoplasm revert to a benign state. Transplantability is another characteristic of malignant cells. Malignant cells often break away from the primary Test Bank for Understanding Medical-Surgical Nursing 6th Edition Linda S. Williams Paula D. Hopper tissue site and travel to other locations in the body. Simplified metabolic activities are another characteristic of malignant cells. The work of malignant cells is simpler than that of normal cells. Nursing Process: Evaluation Client Need: Health Promotion and Maintenance Client Need Subcategory: Prevention and/or Early Detection of Health Problems Cognitive Level: Analysis Objective: Compare the mechanisms and characteristics of normal cells with those of malignant cells. Strategy: Read each statement. Eliminate incorrect statements. Choose as the answer the statement that is correct and therefore demonstrates a good understanding on the part of the student nurse extern. 5. A client newly diagnosed with cancer is speaking to the nurse in the physician’s office. The nurse knows that because of this new diagnosis, the client might experience different physiologic and psychologic symptoms. Which effects would the nurse consider possible physiologic or psychologic effects of cancer? Hint: Physiologic and Psychologic Effects of Cancer Answer Choices: 1. Hyperglycemia, nephrotic syndrome, and body image concerns 2. Altered taste and smell, deep vein thrombosis, and increased leukocytes 3. Hypoglycemia, grief, and anorexia–cachexia syndrome 4. Decreased intracranial pressure, isolation, and acute pain Answer: 1 Rationale: Box 14-5 lists the physiologic and psychosocial effects of cancer. Some effects include hyperglycemia, nephrotic syndrome, body image concerns, altered taste and smell, deep vein thrombosis, decreased leukocytes, grief, anorexia–cachexia syndrome, increased intracranial pressure, isolation, and acute or chronic pain. Nursing Process: Diagnosis Client Need: Physiological Integrity Client Need Integrity: Physiological Adaptation Test Bank for Understanding Medical-Surgical Nursing 6th Edition Linda S. Williams Paula D. Hopper Cognitive Level: Analysis Objective: Describe physical and psychologic effects of cancer. Strategy: Each answer has three components. Consider each component. Eliminate any answer choice with at least one incorrect component. 6. A client presents to her gynecologist’s office as follow-up to a tumor found in her left breast. Today the client will be undergoing a procedure to remove part of the large tumor by cutting through the skin. Which procedure will this client be having done today? Hint: Table 14-9 Surgical Diagnostic Procedures Answer Choices: 1. A fine-needle biopsy 2. A needle core biopsy 3. An incisional biopsy 4. An excisional biopsy Answer: 3 Rationale: A fine-needle biopsy uses a very thin needle to aspirate a small amount of tissue from the tumors. A needle core biopsy uses a slightly larger needle than that used for a fine-needle biopsy to extract a small amount of tissue from tumors that cannot be aspirated by fine-needle aspiration. An incisional biopsy is the removal of part of a larger tumor by cutting through the skin. An excisional biopsy is the removal of an entire tumor through operation. Nursing Process: Planning Client Need: Physiological Integrity Client Need Subcategory: Reduction of Risk Potential Cognitive Level: Application Objective: Describe and compare laboratory and diagnostic tests for cancer. Strategy: Consider each procedure. Choose the procedure that is best described in the stem of the question. 7. A nursing student is studying for a pharmacology examination on chemotherapeutic agents. Which statement by the nursing student indicates the need for further teaching? Hint: Classes of Chemotherapy Drugs Test Bank for Understanding Medical-Surgical Nursing 6th Edition Linda S. Williams Paula D. Hopper Answer Choices: 1. “The main hormones used in cancer therapy are the corticosteroids, which are phase-specific.” 2. “Mitotic inhibitors are drugs that act to prevent cell division during the M phase.” 3. “Antitumor antibiotics disrupt RNA replication and DNA transcription.” 4. “Alkylating agents basically act on preformed nucleic acids by creating defects in tumor DNA.” Answer: 3 Rationale: Hormones and hormone antagonists are one class of chemotherapeutic agents. The main hormones used in cancer therapy are the corticosteroids, which are phasespecific. Mitotic inhibitors are drugs that act to prevent cell division during the M phase. Antitumor antibiotics disrupt DNA replication and RNA transcription, not the other way around. Alkylating agents basically act on preformed nucleic acids by creating defects in tumor DNA. Nursing Process: Evaluation Client Need: Physiological Integrity Client Need Subcategory: Pharmacological and Parenteral Therapies Cognitive Level: Analysis Objective: Discuss the role of chemotherapy in cancer treatment, and classify chemotherapeutic agents. Strategy: Look for an incorrect statement that indicates the need for further teaching. 8. A nurse is caring for a client undergoing brachytherapy. Which precaution should the nurse take when caring for this client? Hint: Box 14-6 Safety Principles for Radiation Answer Choices: 1. Care for this client regardless of pregnancy status. 2. Maintain the least possible distance form the client. 3. Avoid indirect exposure with radioisotopes containers. 4. Wear a monitoring device to measure whole-body exposure. Answer: 4 Rationale: Many safety principles apply when caring for a client receiving radiation. Test Bank for Understanding Medical-Surgical Nursing 6th Edition Linda S. Williams Paula D. Hopper Refer to box 14-6 for a complete list. In brachytherapy, the radioactive material is placed directly into or adjacent to the tumor. If pregnant, avoid contact with radiation sources. Maintain the greatest possible distance from the source of radiation. Avoid direct, not indirect, exposure with radioisotopes containers; for example, do not touch the container. Wear a monitoring device to measure whole-body exposure. Nursing Process: Planning Client Need: Physiological Integrity Client Need Subcategory: Reduction of Risk Potential Cognitive Level: Application Objective: Discuss the role of surgery, radiation therapy, and biotherapy in the treatment of cancer. Strategy: Look for a correct action when caring for a client with internal radiation. 9. A client is admitted to the hospital with a history of squamous-cell lung cancer. Upon admission, the client exhibits signs of arm and periorbital edema. Within the hour, the client exhibits dyspnea, cyanosis, tachypnea, and an altered level of consciousness. Which action should the nurse take FIRST? Hint: Nursing Interventions for Oncologic Emergencies Answer Choices: 1. Call the physician. 2. Administer oxygen. 3. Monitor vital signs. 4. Initiate seizure precautions. Answer: 2 Rationale: The superior vena cava can be compressed by mediastinal tumors or adjacent thoracic tumors. The most common cause is small-cell or squamous-cell lung cancers. Signs and symptoms can develop slowly, and include facial, periorbital, and arm edema as early signs. As the problem progresses, respiratory distress, dyspnea, cyanosis, tachypnea, and altered consciousness and neurologic deficits can occur. Emergency measures include the following: Provide respiratory support with oxygen, and prepare for a tracheostomy; monitor vital signs; administer corticosteroids to reduce edema; if the disorder is due to a clot, administer antifibrinolytic or anticoagulant drugs; provide a safe environment, including seizure precautions. Nursing Process: Implementation Test Bank for Understanding Medical-Surgical Nursing 6th Edition Linda S. Williams Paula D. Hopper Client Need: Physiological Integrity Client Need Subcategory: Basic Care and Comfort Cognitive Level: Analysis Objective: Identify causes and discuss the nursing interventions for common oncologic emergencies. Strategy: Consider whether the client needs further assessment or an action implemented due to the severity of the situation. Prioritize actions based on airway, breathing, and circulation. 10. A client with renal cancer is preparing for discharge. The nurse is teaching both the client and the family about when to call for help after discharge. Which statement by the client indicates that teaching has been successful? Hint: Box 14-13 When to Call for Help Answer Choices: 1. “I should call my physician if I experience new bleeding from any site.” 2. “I should call my physician if I have an oral temperature higher than 100.5°F.” 3. “I should call my physician if I have an episode of diarrhea.” 4. “I should call my physician if I experience an occasional headache.” Answer: 1 Rationale: Instruct the client or family member to call the nurse or physician if any of the following signs or symptoms occur: oral temperature higher than 101.5°F; severe headache; significant increase in pain at usual site, especially if the pain is not relieved by the medication regimen, or severe pain at a new site; difficulty breathing; new bleeding from any site; confusion, irritability, or restlessness; verbalizations of deep sadness or a desire to end life; changes in eating patterns; changes in body functioning, such as severe diarrhea or constipation; withdrawal; frequent crying; greatly decreased activity level; and the appearance of edema in the extremities or significant increase in edema already present. Nursing Process: Evaluation Client Need: Physiological Integrity Client Need Subcategory: Reduction of Risk Potential Cognitive Level: Analysis Test Bank for Understanding Medical-Surgical Nursing 6th Edition Linda S. Williams Paula D. Hopper Objective: Design an appropriate care plan for clients with cancer and their families regarding cancer diagnosis, treatment, and coping strategies. Strategy: Look for a correct statement, indicating that client teaching has been successful. 11. A 34-year-old client, who is at her annual gynecologic examination, is being taught about early screening for breast cancer. The client has a sister and mother with a history of breast cancer. Which action by the client demonstrates good screening techniques for someone with her family history? Hint: Box 14-10 American Cancer Society Guidelines for Cancer Screening Answer Choices: 1. Routine breast exams to begin after age 35 2. Reporting of any changes in breast tissue to the health provider at the next routine visit 3. Annual screening mammography staring at age 40 4. Clinical breast examination every three years Answer: 4 Rationale: American Cancer Society guidelines for cancer screening include routine breast self-examination starting at age 20; prompt reporting of any change in breast tissue to healthcare provider; clinical breast examination every three years from ages 20 to 39, and yearly thereafter; annual screening mammography starting at age 40, except in women at increased risk, who may have more frequent mammography or other tests such as breast ultrasound exams. Nursing Process: Assessment Client Need: Health Promotion and Maintenance Client Need Subcategory: Prevention and/or Early Detection of Health Problems Cognitive Level: Analysis Objective: Design an appropriate care plan for clients with cancer and their families regarding cancer diagnosis, treatment, and coping strategies. Strategy: Consider screening techniques for a woman with a family history of breast cancer. 12. A student nurse is studying risk factors in developing cancer. Which client should this student nurse determine to have the highest risk of developing cancer? Test Bank for Understanding Medical-Surgical Nursing 6th Edition Linda S. Williams Paula D. Hopper Hint: Incidence and Mortality Answer Choices: 1. An African-American man 2. A Native American woman 3. A Hispanic man 4. A Hispanic woman Answer: 1 Rationale: African-Americans are more likely to develop cancer than is any other ethnic or racial group in the United States. Cancer incidence and mortality are lower in Native American men and women than in any other ethnic or racial group. The incidence and mortality rates for all types of cancer are 35–39 percent lower in Hispanics. Nursing Process: Assessment Client Need: Health Promotion and Maintenance Cognitive Level: Analysis Objective: Explain and discuss known carcinogens, and identify risk factors for cancer. Strategy: Weigh the risk factors for developing cancer based on the client’s sex and ethnic background. 13. A client with breast cancer is receiving 5-Fluorouracil (5-FU). Based on knowledge of this medication, and anticipated adverse effects or side effects, which nursing action should the nurse perform? Hint: Table 14-10 Classifications of Chemotherapeutic Drugs Answer Choices: 1. Monitor ECG. 2. Assess lung sounds. 3. Test stool for occult blood. 4. Encourage daily fluid intake of 2–3 liters. Answer: 3 Rationale: The possible adverse effects or side effects associated with 5-FU are stomatitis, alopecia, nausea and vomiting, gastritis, enteritis, diarrhea, anemia, leucopenia, and thrombocytopenia. Assessing for bleeding by checking stool for occult blood is recommended in this client. Monitoring the ECG is recommended in clients receiving antitumor antibiotics. Assessing lung sounds is recommended in clients receiving alkylating agents, due to the potential for developing pulmonary fibrosis. Encouraging a daily fluid intake of 2–3 liters is recommended also for clients receiving Test Bank for Understanding Medical-Surgical Nursing 6th Edition Linda S. Williams Paula D. Hopper alkylating agents because they could potentially develop renal failure. Nursing Process: Implementation Client Need: Physiological Integrity Client Need Subcategory: Pharmacological and Parenteral Therapies Cognitive Level: Analysis Objective: Discuss the role of chemotherapy in cancer treatment, and classify chemotherapeutic agents. Strategy: Consider each nursing action. Determine which action is needed based on potential complications of the chemotherapeutic agent 5–FU. Chapter 15 1. A nursing student is studying the functions of the skin. Which statement by the nursing student indicates the need for further teaching? Hint: Table 15-1 Functions of the Skin and Its Appendages Answer Choices: 1. “The epidermis protects tissues from physical, chemical, and biologic damage.” 2. “The dermis regulates body temperature by dilating and constricting capillaries.” 3. “The eccrine sweat glands regulate body heat by excretion of perspiration.” 4. “The apocrine sweat glands cushion the scalp and provide insulation in cold weather.” Answer: 4 Rationale: The epidermis protects tissues from physical, chemical, and biologic damage. The dermis regulates body temperature by dilating and constricting capillaries. The eccrine sweat glands regulate body heat by excretion of perspiration. The apocrine sweat glands are a remnant of the sexual scent gland. Hair cushions the scalp and provides insulation in cold weather. Nursing Process: Assessment Client Need: Physiological Integrity Client Needs Subcategory: Physiological Adaptation Cognitive Level: Analysis Test Bank for Understanding Medical-Surgical Nursing 6th Edition Linda S. Williams Paula D. Hopper Objective: Describe the an