NCLEX QUESTIONS (Medical Surgical Nursing) already passed and verified exam practice docs

NCLEX QUESTIONS (Medical Surgical Nursing) already passed and verified exam practice docs Oncology Which pathologic description of a client’s tumor does the nurse interpret as being the “most malignant” or “high grade” cancer? (pg. 365) A. Poorly differentiated; mitotic index = 20%, euploid B. Moderately differentiated; mitotic index = 50%, euploid C. Undifferentiated; mitotic index = 50%, aneuploidy D. Highly differentiated; mitotic index = 10%, aneuploidy A 65-year-old client tells the nurse she does not have mammograms because there is no history of breast cancer in her family. What is the nurse’s best response? (pg 369) A. “You are correct. Breast cancer is an inherited type of malignancy and your family history indicates a low risk for you.” B. “Performing breast self-examination monthly at home is sufficient screening for someone with your family history.” C. “Because your breasts are no longer as dense as they were when you were younger, your risk for breast cancer is now decreased.” D. “Breast cancer can be found more frequently in families; however, the risk for general, nonfamilial breast cancer increases with age.” The client receiving brachytherapy with implanted radioactive “seeds” for prostate cancer asks the nurse when these seeds will be removed. What is the nurse’s best response? (pg 377) A. “The half-life of radiation in these seeds is so short that it is not necessary to remove them.” B. “They will be removed only if their presence is painful or leads to an enlarged prostate gland.” C. “When we know for certain that all cancerous cells have been killed, the seeds will be removed.” D. “The seeds are small enough to be absorbed by your body and excreted in the urine or stool.” The client receiving high-dose chemotherapy who has neutropenia asks the nurse whether he and his wife can have sexual intercourse while he is receiving chemotherapy. What is the nurse’s best response? (pg 383) A. “No, this activity will increase the side effects of the chemotherapy.” B. “No, the danger of impregnating your wife is too great.” C. “Yes, as long as you feel like it and use a condom.” D. “Yes, if you do not have an infection.” Which precaution is most important for the nurse to teach the client who has chemotherapy-induced peripheral neuropathy? (pg 387) A. Avoid taking aspirin or any aspirin-containing products B. Use a bath thermometer to check bath water temperature C. Do not use mouthwashes that contain alcohol or glycerin D. Bathe daily using an antimicrobial soap or gel Which change in health status indicates to the nurse that the client’s supervisor vena cava syndrome is worsening? (pg 394) A. The client’s systolic blood pressure is rising, and the diastolic pressure is decreasing B. The client’s severe nausea and vomiting no longer respond to antiemetics C. The client has experienced for nosebleeds in the past 2 days D. Pedal edema is now present A client diagnosed with widespread lung cancer asks the nurse why he must be careful to avoid crowds and people who are ill. What is the nurse’s best response? (7th edition pg 410) A. “With lung cancer, you are more likely to develop pneumonia and could pass this on to other people who are already ill.” B. “When lung cancer is in the bones, it becomes a bone marrow malignancy, which stops producing immune system cells.” C. “The large amount of mucus produced by the cancer cells is a good breeding ground for bacteria and other microorganisms.” D. “When lung cancer is in the bones, it can prevent production of immune system cells, making you less resistant to infection.” Which precaution is most important for the nurse to teach a client receiving radiation therapy for head and neck cancer? (7th edition pg 414) A. Avoid eating red meat during treatment B. Pace your leisure activities to prevent fatigue C. See your dentist twice yearly for the rest of your life D. Avoid using headphones or headsets until your hair grows back A client receiving high-dose chemotherapy who has bone marrow suppression has been receiving daily injections of epoetin alfa (Procrit). Which assessment finding indicates to the nurse that today’s dose should be held and the health care provider notified? (7th edition pg 421) A. Hematocrit of 28% B. Total white blood cell count of 6200 cells/mm³ C. Blood pressure change from 130/90 mm Hg to 148/98 mm Hg D. Temperature change from 99° F (37.2° C) to 100° F (37.8° C) Which action is most important for the nurse to implement to prevent nausea and vomiting in a client who is prescribed to receive the first round of IV chemotherapy? (7th edition pg 422) A. Keep the client NPO during the time chemotherapy is infusing B. Administer antiemetic drugs before administering chemotherapy C. Ensure that the chemotherapy is infused over a 4 to 6 hr period D. Assess the client for manifestations of dehydration hourly during the infusion period A client being treated for advanced breast cancer with chemotherapy reports that she must be allergic to one of her drugs because her entire face is swollen. What assessment does the nurse perform? (7th edition pg 433) A. Asks whether the client has other known allergies B. Checks the capillary refill on fingernails bilaterally C. Examine the client’s neck and chest for edema and engorged veins D. Compares blood pressure measured in the right arm with that in the left arm