NURS202 Exam #2 - Cancer, Problems in Pregnancy, Newborn

A nurse is assessing a client with a family history of cancer. Which finding requires immediate follow up? - The client reports a feeling of a lump in the throat. A client, age 42, visits the gynaecologist. After examining the client, the healthcare provider suspects cervical cancer. What will be most important for the nurse to include in assessing the clients health history? - History of human papilloma virus infection. A client who is receiving chemotherapy express his concern at the thought of losing hair on their head. The nurses best response is: - "Your hair loss will be temporary. Would you like to tell me about your concerns?" A client with a modified radical mastectomy has been discharged. The client has been very reluctant to discuss the surgery or her situation. The nurse making assignments should delegate the clients care to the: - Same nurse who has cared for her the past three days, for continuity of care. Which outcome is expected of a nursing referral to a cancer support group? The client can: - Cope with cancer. The family of an older adult with terminal cancer asks about having hospice services. What should the nurse tell the family? Hospice care: - Focuses on supportive care for the client and family. The nurse teaches the client with chronic cancer pain about optimal pain control. Which recommendation is most effective for pain control? - Take prescribed analgesics on an around-the-clock schedule to prevent recurrent pain. Which strategy would be most effective in improving trans cultural communications with oncology clients and their families? - Establish a rapport and listen to their concerns. The nurse is teaching a client who is receiving chemotherapy and the family how to manage possible nausea and vomiting at home. What information should the nurse include in the teaching plan? - Eating small frequent meals A client with chronic cancer pain has been receiving opiates for four months. She rated the pain as an eight on a 10 point scale before starting the opioid medication. Following a thorough examination, there is no new evidence of increased disease, yet the pain is close to eight again. What is the most likely explanation for the increasing pain? - Tolerance to the opioid A nurse is conducting a cancer risk screening program. Which client is at greatest risk for skin cancer? - 60 year old mountain biker The client with brown hair is concerned about losing hair as a result of chemotherapy. What should the nurse tell the client? - "The hair loss is temporary. " The nurse is witnessing the client signature on the inform the surgical consent for an abdominal hysterectomy. The nurse should be certain the client understands that what will be the outcome of the surgery? - Infertility The client with stage to ovarian cancer undergoes a total abdominal hysterectomy and bilateral salpingo-oophorectomy with tumor resection, omentectomt, appendectomy, and Lymphadenectomy. During the second postoperative day, which assessment finding requires immediate intervention? - Shallow breathing and increasing lethargy A client ask the nurse with PSA is. The nurse should reply that it stands for: - Prostate-specific antigen, which is used to screen for prostate cancer A client is undergoing a left modified radical mastectomy for breast cancer. Postoperatively, blood pressure should be a clean from the right arm, and the clients left arm and hand should be elevated as much as possible to prevent: - Lymphedema The nurse is speaking to a group of women about early detection of breast cancer. Which screening does the nurse recommends to women age 50 and older? - Annual mammogram The nurse is conducting a health history for a client at risk for cancer. Which lifestyle factors considered at risk for colorectal cancer? - A high-fat, low-fiber diet A nurse is the average age of 47 following American Cancer Society Guidelines, the nurse she recommends that the women: - Have a mammogram annually 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 stated the client has been placed on neutropenic precautions. Which laboratory value supports this nursing action? - A white blood cell count of 2200/mm3 The care of which client can be assigned to an unlicensed assistant personal (UAP)? - A client who is having radiation for cancer of the stomach is to have the radiation site beers with warm water, followed by an application of a moisturizer A client with suspected gastric cancer undergoes an endoscopy of the stomach. Which assessment made after the procedure would indicate the development of a potential complication? - The client experiences a sudden increase in temperature Which expected outcome about nutrition would be appropriate for a client who has had a total gastrectomy for gastric cancer? The client will: - Maintain adequate nutrition through oral or parenteral feedings A client with colon cancer is having a barium enema. The nurse should instruct the client to take which type of medication after the procedure is completed? - Laxative The nurses in being a client about the past medical history. Which pre-existing condition may need the nurse to suspect that the client has colorectal cancer? - Polyps A client is admitted to the hospital for diagnostic testing to rule out colon rectal cancer. Which intervention should the nurse include in the plan of care? - Test all stools for a cold blood Which client is at highest risk for colon rectal cancer? - The client who has been treated for Crohn's disease for 20 years A client is being discharged after abdominal surgery and colostomy formation to treat: cancer. Which nursing action is most likely to promote continuity of care? - Asking the physician to write an order for home skilled nursing assessments and interventions When caring for a client with nonresectable colon cancer, which nursing diagnosis requires the nurse to function collaboratively to wish you the best outcome related to client comfort? - Acute pain A surgeon is discussing surgery with a client diagnosed with colon cancer. The client is visibly shaken over the possibility of a colostomy. Based on the clients response, the surgeon should collaborate with which health team member? - Enterostomal nurse The nurse should teach clients about which potential risk factor for the development of colon cancer? - History of inflammatory bowel disease A client is receiving monthly doses of chemo therapy for treatment of stage III Colon cancer. Which laboratory results to the nurse reports be oncologist before the next dose of chemotherapy is administered. Select all that apply. - -Platelet count of 40,000/mm3 -White blood cell count of 2300/mm3 -temperature of 101.2°F Which statement indicates that the client understands the need for routine screening to detect colorectal cancer? - "I need to have a colonoscopy at age45 then every 10 years until age 75." Which action is most important when the nurses planning pain management for a client after a lobectomy for lung cancer? - Reassessing the client after administering pain medication A client had a right pneumonectomy Four lung cancer yesterday and now has dyspnea. What position in bed will be best for this client? - Head of bed elevated After a lobectomy for lung cancer, the nurse instructed the client to perform deep breathing exercises. What is the expected outcome of these exercises? - Expand the alveoli and increase long surfaces available for ventilation After lobectomy for lung cancer, a client receives a chest tube connected to a disposable chest drainage system. The nurse observes at the drainage system is functioning correctly when the nurse notes title movements or fluctuations in which compartment of the system as the client breathes? - Water-seal chamber A client with suspected lung cancer is scheduled for thoracentesis as part of the diagnostic work up. The nurse reviewed the clients history for conditions that might contraindicate this procedure. Which condition is a contraindication for thoracentesis? - Bleeding disorder An adult with a history of chronic obstructive pulmonary disease (COPD) and metastatic carcinoma of the long has not responded to radiation therapy and is being admitted to the hospice program. The nurse should conduct a focused assessment for which symptom? - Dyspnea The nurse on the previous night shift documented that the lungs have a client has lung cancer we are clear to auscultation in all fields. While doing the shift assessment, the dayshift nurse noticed decreased breath sounds, especially in the right lower lobe. Which action is the nurses best choice? - Notified the physician of the change in client status A client receiving external radiation to the left thorax to treat lung cancer has a nursing diagnosis of risk for impaired skin integrity. Which intervention should be part of this clients care plan? - Avoiding using deodorant soap on the irradiated areas What is a risk factor for women who have had human papillomavirus? - Cervical cancer The nurse provides care to a client with anogenital warts. The nurse teachers that anogenital increase in adolescent females risk of which condition? - Cervical cancer A client with human papilloma virus infection is being treated by a colposcopy. The client asked the nurse if this procedure is really necessary. The nurse can tell the client that if the HPV infection is not treated which health problem is likely to occur? - Cervical cancer Which nurse should be assigned to a client receiving brachytherapy for the treatment of cervical cancer? - Female nurse with three years experience working in oncology A 52-year-old client is scheduled for total abdominal hysterectomy Pacifico cancer. When discussing the potential impact of this procedure on a client sexuality, how should the nurse respond to the client? - "Most women have concerns about their sexuality after this type of surgery. Do you have any concerns or questions?" A client with cervical cancer and is undergoing internal radium implant therapy. A lead lined container in a pair of long forceps have been placed in the clients hospital room. What should the nurse tell the client about how these will be used? The forceps in the container will be used for: - Handling of the dislodged radiation source A 30-year-old client whose mother died of breast cancer at age 44 and his 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? - Genetic counseling A woman tells the nurse, "T has been a lot of cancer in my family." The nurse should instruct the client to report which possible sign of cervical cancer? - Light bleeding or watery vaginal discharge A client with suspected cervical cancer has a colposcopy with conversation. What information should the nurse give the client about her menstrual period after the surgery? - Her next two or three periods may be heavier and more prolonged than usual A client tells the nurse that her bra fits more snuggly at certain times of the month and she is concerned that she may have a side of breast cancer. The nurse should give the client which information about the situation? - It is normal for the breast to increase in size before menstruation begins I'm at Sexting is recommended for a 68-year-old client diagnosed with breast cancer week ago. When approached about giving consent for the mastectomy, the client says, "what's the use in trying to get rid of the cancer? It will just come back! I can't handle another thing - having diabetes is enough. Besides, I'm getting old. It would be different if I were younger and had more energy." What should the nurse to? - Explore with client her feelings about her health problems and proposed surgery A client is receiving chemo therapy to treat breast cancer. Which assessment findings indicate a chemo therapy-induced complication? - Serum potassium level of 2.6 After a mastectomy for breast cancer, the nurse teaches the client how to avoid the development of lymphedema. The nurse should teach the client to: - Elevate the affected arm on a pillow A client tell the nurse that she has found a painless lump in her right breast during her monthly self examination. Which assessment finding would strongly suggest that this clients lump is cancerous? - Non-mobile mass with irregular edges A client with ovarian cancer ask the nurse, "what is the cause of this cancer?" Which is the most accurate response by the nurse? - The risk of developing ovarian cancer is related to environmental, endocrine, and genetic factors After instructing a 20-year-old nulligravid About adverse effects of oral contraceptives, the nurse determines that further instructions needed when the client states which has an adverse effect? - Ovarian cancer Which client has the highest risk of ovarian cancer? - 45-year-old woman who has never been pregnant The nurse is assigned a client with end-stage ovarian cancer with recurrent ascites, and the client is to undergo paracentesis. Which activity is best to delegate to an experienced licensed professional nurse (LPN)? - Vital signs every 15 minutes after the paracentesis On a visit to the gynecologist, a client complains of urinary frequency, pelvic discomfort, and weight loss. After a complete physical examination, blood studies, and a pelvic examination with a Papanicolaou Test, the Physician diagnosis stage for ovarian cancer. The nurse expect to prepare the client for which initial treatment? - Surgical procedure The nurse is planning a presentation about ovarian cancer to a group of women. Which topic should receive priority attention in the lesson plan? - Ovarian cancer signs and symptoms are often vague until late in development A nurse obtained the antepartum history of a client who is six weeks pregnant. Which finding is a concern? - The clients consumption of 68 cans of beer on weekends When evaluating a pregnant clients knowledge of symptoms to report immediately, which statement indicates to the nurse at the client understands the information given to her? - If I have blurred or double vision, I should call the clinic immediately An 18-year-old pregnant client tells the nurse that she is concerned that she may not be able to take care of herself during her pregnancy. She states that she is not sure what prenatal care is available, or if she should access it. The nurse should recognize that the client: - Should be referred to community resources available for pregnant women The nurse is reviewing a clients prenatal history. Which of the following is a significant factor in anticipating complications in labor and birth? - History of postpartum hemorrhage A nurse is assisting in developing a teaching plan for a client who's about to enter the third trimester of pregnancy. The teaching plan should know that which symptom should be reported immediately? - Blurred vision A client in her first trimester of pregnancy comes to the prenatal clinic and states, "I feel nauseous and vomiting all the time. I can't even keep down water." This client should be evaluated for what condition? - Hyperemesis gravidarum A nurse is caring for a client receiving IV magnesium sulfate. Which drug is the antidote for magnesium toxicity? - Calcium gluconate