Test Bank - Nurse Practitioner Certification Exam Prep 5th Edition by Margaret A. Fitzgerald

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ANS: A mb



Pacing activities throughout the day conserves energy, and nursing care should be
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mbpaced as well. Fatigue is a common side effect of cancer and treatment; and
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mbwhile adequate sleep is important, an increase in the number of hours slept will
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mbnot resolve the fatigue. Restriction of visitors does not promote healthy coping and
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mbcan result in feelings of isolation. - 3. Which of the following is the most
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mbappropriate intervention for the nurse to include when planning care for a patient
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mbexperiencing fatigue due to chemotherapy? mb mb mb mb




a. Prioritization and administration of nursing care throughout the day
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b. Completing all nursing care in the morning so the patient can rest the
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remainder of the day
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c. Completing all nursing care in the evening when the patient is more rested
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d. Limiting visitors, thus promoting the maximal amount of hours for sleep
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ANS: D mb



The earliest sign of infection in an immunosuppressed patient can be a mild fever.
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Mucositis, confusion, and depression are possible clinical manifestations but are
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representative of less life-threatening complications. - 4. The nurse is caring for a
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patient who received a recent bone marrow transplant. The nurse would monitor
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for which of the following clinical manifestations that could indicate a potentially
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life- threatening situation?
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a. Mucositis
b. Confusion
c. Depression
d. Mild temperature elevation
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ANS: B mb



Primary prevention of cancer involves avoidance to known causes of cancer, such
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as sun exposure. Secondary screening involves physical and diagnostic
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examination. - 1. Which of the following options should the nurse incorporate into
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the plan of care as a primary prevention strategy for reduction of the risk for
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cancer?
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,a. Yearly mammography for women aged 40 years and older
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b. Using skin protection during sun exposure while at the beach
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c. Colonoscopy at age 50 and every 10 years as follow-up mb mb mb mb mb mb mb mb mb



d. Yearly prostate-specific antigen (PSA) and digital rectal exam for men aged 50
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and over
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ANS: A mb



Early colon cancer is often asymptomatic, with occult or frank blood in the stool
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being an assessment finding in a patient diagnosed with colon cancer. If pain is
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present, it is usually lower abdominal cramping. Constipation and diarrhea are
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more frequent findings than nausea or ascites. - 2. While the nurse is collecting a
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health history on a patient admitted for colon cancer, which of the following
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questions should the nurse ask as a priority?
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a. "Have you noticed any blood in your stool?"
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b. "Have you been experiencing nausea?"
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c. "Do you have back pain?"
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d. "Have you noticed any swelling in your abdomen?"
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ANS: D mb



Aging is a non-modifiable risk factor for the development of cancer with an
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associated increase seen with aging. In terms of gender and age, lifetime risk is
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higher for males than females. Family history of co-morbidities such as
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hypertension is not directly correlated with cancer development. Cigarette smoking
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as a teenager for the patient is a risk factor but may have mitigated impact at this
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point in time based on the patient's stated age and length of time as a non-
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smoker. - 5. While the nurse is obtaining the health history of a 75-year-old female
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patient, which of the following has the greatest implication for the development of
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cancer?
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a. Being a woman mb mb



b. Family history of hypertension
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c. Cigarette smoking as a teenager mb mb mb mb



d. Advancing age mb




ANS: D mb



Common signs/symptoms of lung cancer include coughing, hemoptysis, and weight
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loss, shortness of breath and chest pain. The nurse should expect to see weight
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loss and altered breathing patterns. Clear sputum and orthostatic blood pressure
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changes would not be seen. - 6. In caring for a patient admitted with lung cancer,
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which of the following should the nurse expect to find on assessment?
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a. No use of accessory muscles during respirations
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b. Orthostatic hypotension upon change of positioning mb mb mb mb mb



c. Clear sputum mb



d. Weight loss compared to last admission
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, ANS: A mb



A comprehensive health history is vital to treating and caring for the patient. Often
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times, symptoms are vague. The nurse should conduct a symptom analysis to
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gather as much information as possible. Questions should address the duration of
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the symptoms and include
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the location, characteristics, aggravating and relief factors, and any treatments
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taken thus far. - 7. A female patient complains of a "scab that just won't heal"
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under her left breast. During your conversation, she also mentions chronic
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fatigue, loss of appetite, and slight cough, attributed to allergies. What is the
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nurse's best action?
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a. Continue to conduct a symptom analysis to better understand the patient's
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symptoms and concerns.
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b. End the appointment and tell the patient to use skin protection during sun exposure.
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c. Suggest further testing with a cancer specialist and provide the appropriate literature.
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d. Tell her to put a bandage on the scab and set a follow-up appointment in 1 week.
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ANS: B mb



A nurse should be aware of potential complications relative to hormonal therapy
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such as the development of thrombus formation. Massaging a calf that is swollen
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and painful is never correct, because this action might break a clot, causing
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formation of an embolus, which could then travel to the lungs. - 8. A patient with
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prostate cancer is taking hormonal therapy to control tumor growth. He reports that
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his left calf is swollen and painful. Which of the following would be the nurse's best
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action?
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a. Instruct the patient to keep the leg elevated.
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b. Measure the calf circumference and compare the measurement with the right
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calf circumference measurement.
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c. Apply ice to the calf after a 10-minute massage of the area.
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d. Document assessment findings as an expected response with estrogen therapy.
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ANS: A mb



Individuals with a family history of breast cancer (especially 1st degree relatives)
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are at increased risk for disease occurrence. The nurse should inform the patient
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of the outcome measures of the screening plan. The nurse should not dissuade
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the patient from the process based on stating there is no family history, as there is
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no evidence that an adequate family history has been obtained. Similarly, to
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correlate the need for genetic testing with insurance and no implied risk cannot be
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stated equivocally.
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Although the decision is up to the patient in the final analysis, that response does
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not address relevant information about the purpose of genetic screening. - 9. A
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patient being evaluated for breast cancer is not certain whether she and her
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family should participate in a genetic screening plan since no one can guarantee
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the results. What is the nurse's best response?
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a. "If you have a family history of breast cancer, the chances for you to have this
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type of cancer increase."
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b. "The decision is up to you in the final analysis."
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