Case Study NCLEX Questions
Treatment modalities for estrogen-receptor positive tumors include (select all that apply):
A. Estrogen-receptor downregulators (ERDs)
B. Selective estrogen-receptor response modulators (SERMs)
C. Hormone therapy
D. Aromatase inhibitors - ANSA, B, D
Stage IIIB describes invasive breast cancer in which:
A. The tumor measures up to 2 cm and has not spread outside the breast
B. No tumor is found in the breast
C. Cancer may have spread to up to 9 axillary lymph nodes causing swelling
D. The cancer has metastasized to other organs - ANSC. Cancer may have spread to up to 9
axillary lymph nodes causing swelling
In stage IIIB carcinoma of the breast the cancer may have spread to up to 9 axillary lymph
nodes. Ms. T has 8 of 12 lymph nodes affected. Answers A or B may occur in stage I, and
answer choice D describes stage IV
3.Which of the following are important interventions when caring for a patient with Cushing
syndrome? (Select all that apply)
A. Increase carbohydrate intake
B. Monitoring blood glucose levels
C. Observing for signs of hypotension
D. Protecting patient from exposure to infection - ANSB, D
Hyperglycemia occurs with Cushing disease because of glucose intolerance (associated with
cortisol-induced insulin resistance) and increased gluconeogenesis by the liver. High levels of
corticosteroids increase susceptibility to infection and delay wound healing.
In a 29-year-old female client who is being successfully treated for Cushing's syndrome, nurse
Lyzette would expect a decline in:
A. Menstrual flow
B. Bone mineralization
C. Hair loss
D. Serum glucose level - ANSD. Serum glucose level
, Serum glucose levels tend to be high in patients with Cushing's Syndrome due to excess
corticosteroids in the body. When Cushing's syndrome is being treated successfully, a nurse
should expect a decline in the patient's serum glucose level
Mr. A has been admitted to the hospital with a diagnosis of acute pancreatitis and the nurse is
assessing his pain. What type of pain is associated with this diagnosis?
A. Burning and aching, located in the left lower quadrant and radiating to the leg
B. Severe and unrelenting, located in the epigastric area and radiating to the back
C. Burning and aching, located in the epigastric area and radiating to the umbilicus
D. Severe and unrelenting, located in the left lower quadrant and radiating to the hip - ANSB.
Severe and unrelenting, located in the epigastric area and radiating to the back
The pain associated with acute pancreatitis is often severe and unrelenting, is located in the
epigastric region, and radiates to the back. It is also described as sudden onset, deep piercing,
continuous or steady. The other options are incorrect.
The nurse is reviewing the prescription for Mr. A., a 55 year-old male admitted to the hospital
with a diagnosis of acute pancreatitis. Which interventions would the nurse expect to be
prescribed for the client? Select all that apply.
A. Administer antacids as prescribed
B. Encourage coughing and deep breathing
C. When food is allowed follow a high-carbohydrate, low-fat, high-protein diet
D. Maintain the client in a supine and flat position.
E. Give Demerol or Dilaudid as prescribed for pain. - ANSA, B, C, E
Because abdominal pain is a prominent symptom of pancreatitis, pain medication such as
Demerol or Dilaudid should be administered as prescribed. The client is susceptible to
respiratory infections because the retroperitoneal fluid raises the diaphragm, which causes the
client to take shallow, guarded abdominal breaths. Therefore measures such as turning,
coughing, and deep breathing should be instituted. Antacids may be prescribed to suppress
gastrointestinal secretions. The diet is usually high in carbohydrates since it is less stimulating
the exocrine portion of the pancreas.
A patient comes into the clinic with complaints of joint stiffness and pain. For which symptom
might the nurse assess to distinguish rheumatoid arthritis from other connective tissue
disorders?
A. The patient has unilateral joint involvement
B. Morning stiffness that lasts more than one hour
C. Inflammation of the great toe
D. Dry mouth and dry eyes - ANSB. Morning stiffness that lasts more than one hour
Treatment modalities for estrogen-receptor positive tumors include (select all that apply):
A. Estrogen-receptor downregulators (ERDs)
B. Selective estrogen-receptor response modulators (SERMs)
C. Hormone therapy
D. Aromatase inhibitors - ANSA, B, D
Stage IIIB describes invasive breast cancer in which:
A. The tumor measures up to 2 cm and has not spread outside the breast
B. No tumor is found in the breast
C. Cancer may have spread to up to 9 axillary lymph nodes causing swelling
D. The cancer has metastasized to other organs - ANSC. Cancer may have spread to up to 9
axillary lymph nodes causing swelling
In stage IIIB carcinoma of the breast the cancer may have spread to up to 9 axillary lymph
nodes. Ms. T has 8 of 12 lymph nodes affected. Answers A or B may occur in stage I, and
answer choice D describes stage IV
3.Which of the following are important interventions when caring for a patient with Cushing
syndrome? (Select all that apply)
A. Increase carbohydrate intake
B. Monitoring blood glucose levels
C. Observing for signs of hypotension
D. Protecting patient from exposure to infection - ANSB, D
Hyperglycemia occurs with Cushing disease because of glucose intolerance (associated with
cortisol-induced insulin resistance) and increased gluconeogenesis by the liver. High levels of
corticosteroids increase susceptibility to infection and delay wound healing.
In a 29-year-old female client who is being successfully treated for Cushing's syndrome, nurse
Lyzette would expect a decline in:
A. Menstrual flow
B. Bone mineralization
C. Hair loss
D. Serum glucose level - ANSD. Serum glucose level
, Serum glucose levels tend to be high in patients with Cushing's Syndrome due to excess
corticosteroids in the body. When Cushing's syndrome is being treated successfully, a nurse
should expect a decline in the patient's serum glucose level
Mr. A has been admitted to the hospital with a diagnosis of acute pancreatitis and the nurse is
assessing his pain. What type of pain is associated with this diagnosis?
A. Burning and aching, located in the left lower quadrant and radiating to the leg
B. Severe and unrelenting, located in the epigastric area and radiating to the back
C. Burning and aching, located in the epigastric area and radiating to the umbilicus
D. Severe and unrelenting, located in the left lower quadrant and radiating to the hip - ANSB.
Severe and unrelenting, located in the epigastric area and radiating to the back
The pain associated with acute pancreatitis is often severe and unrelenting, is located in the
epigastric region, and radiates to the back. It is also described as sudden onset, deep piercing,
continuous or steady. The other options are incorrect.
The nurse is reviewing the prescription for Mr. A., a 55 year-old male admitted to the hospital
with a diagnosis of acute pancreatitis. Which interventions would the nurse expect to be
prescribed for the client? Select all that apply.
A. Administer antacids as prescribed
B. Encourage coughing and deep breathing
C. When food is allowed follow a high-carbohydrate, low-fat, high-protein diet
D. Maintain the client in a supine and flat position.
E. Give Demerol or Dilaudid as prescribed for pain. - ANSA, B, C, E
Because abdominal pain is a prominent symptom of pancreatitis, pain medication such as
Demerol or Dilaudid should be administered as prescribed. The client is susceptible to
respiratory infections because the retroperitoneal fluid raises the diaphragm, which causes the
client to take shallow, guarded abdominal breaths. Therefore measures such as turning,
coughing, and deep breathing should be instituted. Antacids may be prescribed to suppress
gastrointestinal secretions. The diet is usually high in carbohydrates since it is less stimulating
the exocrine portion of the pancreas.
A patient comes into the clinic with complaints of joint stiffness and pain. For which symptom
might the nurse assess to distinguish rheumatoid arthritis from other connective tissue
disorders?
A. The patient has unilateral joint involvement
B. Morning stiffness that lasts more than one hour
C. Inflammation of the great toe
D. Dry mouth and dry eyes - ANSB. Morning stiffness that lasts more than one hour
