1. A 20-year-old female client calls the nurse to report a lump she found in her
breast. Which response is the best for the nurse to provide?
A) Check it again in one month, and if it is still there schedule an appointment.
B) Most lumps are benign, but it is always best to come in for an examination.
C) Try not to worry too much about it, because usually, most lumps are benign.
D) If you are in your menstrual period it is not a good time to check for lumps.-
: B) Most lumps are benign, but it is always best to come in for an examination.
(B) provides the best response because it addresses the client's anxiety most
effectively and encourages prompt and immediate action for a potential problem.
(A) postpones treatment if the lump is malignant, and does not relieve the client's
anxiety. (C and D) provide false reassurance and do not help relieve anxiety.
2. The nurse should be correct in withholding a dose of digoxin in a client
with congestive heart failure without specific instruction from the healthcare
provider if the client's
A) serum digoxin level is 1.5.
B) blood pressure is 104/68.
C) serum potassium level is 3.
D) apical pulse is 68/min.: C) serum potassium level is 3.
Hypokalemia (C) can precipitate digitalis toxicity in persons receiving digoxin which
will increase the chance of dangerous dysrhythmias (normal potassium level is 3.5
to 5.5 mEq/L). The therapeutic range for digoxin is 0.8 to 2 ng/ml (toxic levels=
>2 ng/ml); (A) is within this range. (B) would not warrant the nurse withholding the
digoxin. The nurse should withhold the digoxin if the apical pulse is less than 60/min
(D).
3. In assessing a client diagnosed with primary hyperaldosteronism, the nurse
expects the laboratory test results to indicate a decreased serum level of
,which substance?
A) Sodium.
B) Antidiuretic hormone.
C) Potassium.
D) Glucose.: C) Potassium.
Clients with primary aldosteronism exhibit a profound decline in the serum levels
of potassium (C) (hypokalemia)--hypertension is the most prominent and universal
sign. (A) is normal or elevated, depending on the amount of water reabsorbed with
the sodium. (B) is decreased with diabetes insipidus. (D) is not affected by primary
aldosteronism.
, 4. Based on the analysis of the client's atrial fibrillation, the nurse should
prepare the client for which treatment protocol?
A) Diuretic therapy.
B) Pacemaker implantation.
C) Anticoagulation therapy.
D) Cardiac catheterization.: C) Anticoagulation therapy.
The client is experiencing atrial fibrillation, and the nurse should prepare the client
for anticoagulation therapy (C) which should be prescribed before rhythm control
therapies to prevent cardioembolic events which result from blood pooling in the
fibrillating atria. (A, B, and D) are not indicated.
5. Which information about mammograms is most important to provide a
post-menopausal female client?
A) Breast self-examinations are not needed if annual mammograms are ob-
tained.
B) Radiation exposure is minimized by shielding the abdomen with a
lead-lined apron.
C) Yearly mammograms should be done regardless of previous normal x-rays.
D) Women at high risk should have annual routine and ultrasound mammo-
grams.: C) Yearly mammograms should be done regardless of previous normal
x-rays.
The current breast screening recommendation is a yearly mammogram after age 40
(C). Breast self-exam (A) continues to be a priority recommendation for all women
because a small lump (or tumor) is often first felt by a woman before a mammogram
is obtained. The radiation exposure from a mammogram is low, so (B) is not
normally provided. The frequency of using routine and ultrasound mammograms (D)
in women with high-risk variables, such as a history of breast cancer, the presence
of BRC1 and BRC2 genes, or 2 first-degree relatives with breast cancer, should be
recommended and followed closely by the healthcare provider.
6. In assessing cancer risk, the nurse identifies which woman as being at
greatest risk of developing breast cancer?
A) A 35-year-old multipara who never breastfed.
B) A 50-year-old whose mother had unilateral breast cancer.
C) A 55-year-old whose mother-in-law had bilateral breast cancer.
D) A 20-year-old whose menarche occurred at age 9.: B) A 50-year-old whose
mother had unilateral breast cancer.
The most predictive risk factors for development of breast cancer are over 40 years
breast. Which response is the best for the nurse to provide?
A) Check it again in one month, and if it is still there schedule an appointment.
B) Most lumps are benign, but it is always best to come in for an examination.
C) Try not to worry too much about it, because usually, most lumps are benign.
D) If you are in your menstrual period it is not a good time to check for lumps.-
: B) Most lumps are benign, but it is always best to come in for an examination.
(B) provides the best response because it addresses the client's anxiety most
effectively and encourages prompt and immediate action for a potential problem.
(A) postpones treatment if the lump is malignant, and does not relieve the client's
anxiety. (C and D) provide false reassurance and do not help relieve anxiety.
2. The nurse should be correct in withholding a dose of digoxin in a client
with congestive heart failure without specific instruction from the healthcare
provider if the client's
A) serum digoxin level is 1.5.
B) blood pressure is 104/68.
C) serum potassium level is 3.
D) apical pulse is 68/min.: C) serum potassium level is 3.
Hypokalemia (C) can precipitate digitalis toxicity in persons receiving digoxin which
will increase the chance of dangerous dysrhythmias (normal potassium level is 3.5
to 5.5 mEq/L). The therapeutic range for digoxin is 0.8 to 2 ng/ml (toxic levels=
>2 ng/ml); (A) is within this range. (B) would not warrant the nurse withholding the
digoxin. The nurse should withhold the digoxin if the apical pulse is less than 60/min
(D).
3. In assessing a client diagnosed with primary hyperaldosteronism, the nurse
expects the laboratory test results to indicate a decreased serum level of
,which substance?
A) Sodium.
B) Antidiuretic hormone.
C) Potassium.
D) Glucose.: C) Potassium.
Clients with primary aldosteronism exhibit a profound decline in the serum levels
of potassium (C) (hypokalemia)--hypertension is the most prominent and universal
sign. (A) is normal or elevated, depending on the amount of water reabsorbed with
the sodium. (B) is decreased with diabetes insipidus. (D) is not affected by primary
aldosteronism.
, 4. Based on the analysis of the client's atrial fibrillation, the nurse should
prepare the client for which treatment protocol?
A) Diuretic therapy.
B) Pacemaker implantation.
C) Anticoagulation therapy.
D) Cardiac catheterization.: C) Anticoagulation therapy.
The client is experiencing atrial fibrillation, and the nurse should prepare the client
for anticoagulation therapy (C) which should be prescribed before rhythm control
therapies to prevent cardioembolic events which result from blood pooling in the
fibrillating atria. (A, B, and D) are not indicated.
5. Which information about mammograms is most important to provide a
post-menopausal female client?
A) Breast self-examinations are not needed if annual mammograms are ob-
tained.
B) Radiation exposure is minimized by shielding the abdomen with a
lead-lined apron.
C) Yearly mammograms should be done regardless of previous normal x-rays.
D) Women at high risk should have annual routine and ultrasound mammo-
grams.: C) Yearly mammograms should be done regardless of previous normal
x-rays.
The current breast screening recommendation is a yearly mammogram after age 40
(C). Breast self-exam (A) continues to be a priority recommendation for all women
because a small lump (or tumor) is often first felt by a woman before a mammogram
is obtained. The radiation exposure from a mammogram is low, so (B) is not
normally provided. The frequency of using routine and ultrasound mammograms (D)
in women with high-risk variables, such as a history of breast cancer, the presence
of BRC1 and BRC2 genes, or 2 first-degree relatives with breast cancer, should be
recommended and followed closely by the healthcare provider.
6. In assessing cancer risk, the nurse identifies which woman as being at
greatest risk of developing breast cancer?
A) A 35-year-old multipara who never breastfed.
B) A 50-year-old whose mother had unilateral breast cancer.
C) A 55-year-old whose mother-in-law had bilateral breast cancer.
D) A 20-year-old whose menarche occurred at age 9.: B) A 50-year-old whose
mother had unilateral breast cancer.
The most predictive risk factors for development of breast cancer are over 40 years
