PN CAPSTONE NCLEX QUESTIONS_4

1. Which intervention is appropriate for the nurse caring for a male client in severe pain receiving a continuous I.V. infusion of morphine? a. Assisting with a naloxone challenge test before therapy begins b. Discontinuing the drug immediately if signs of dependence appear c. Changing the administration route to P.O. if the client can tolerate fluids d. Obtaining baseline vital signs before administrating the first dose. 2. When caring for a client who has a colostomy created as part of a regimen to treat colon cancer, which activities would help to support the client in accepting changes in appearance or function? Select all that apply. a. Explain to the client that the colostomy is only temporary b. Encourage the client to participate in changing the ostomy c. Obtain a psychiatric consultation d. Offer to have a person who is coping with a colostomy visit e. Encourage the client and family members to express their feelings and concerns. 3. The nurse has received in report that the client receiving chemotherapy has severe neutropenia. Which of the following does the nurse plan to implement? Select all that apply. a. Assess for fever b. Observe for bleeding c. Administer Neulasta d. Do not permit fresh flowers or plants in the room e. Do not allow his 16 year old son to visit f. Teach the client to omit raw fruits and vegetables from his diet. 4. Which of the following findings would alarm the nurse when caring for a client receiving chemotherapy who has a platelet count of 17,000/mm3 a. Increasing shortness of breath b. Diminished bilateral breath sounds c. Change in mental status d. Weight gain of 4 pounds in 1 day 5. A 35 years old client with ovarian cancer is prescribed hydroxyurea (Hydrea), an antimetabolite drug. Anti-metabolites are a diverse group of antineoplastic agents that interfere with various metabolic actions of the cells. The mechanism of action of antimetabolites interferes with: a. Cell division or mitosis during the M phase of the cell cycle b. Normal cellular processes during the S phase of the cell cycle c. The chemical structure of deoxyribonucleic acid (DNA) and chemical binding between DNA molecules (Cell cycle-nonspecific). d. One or more stage of ribonucleic acid (RNA) synthesis, DNA synthesis, or both (cell cycle-nonspecific) 6. The ABCD method offers one way to assess skin lesions for possible skin cancer. What does the A stand for? a. Actinic b. Asymmetry c. Arcus d. Assessment 7. When caring for a male client diagnosed with a brain tumor of the parental lobe, the nurse expects to assess: a. Short-term memory impairment b. Tactile agnosia c. Seizures d. Contralateral homonymous hemianopia 8. A female client is undergoing tests for multiple myeloma. Diagnostic study findings in multiple myeloma include: a. A decreased serum creatinine level b. Hypocalcemia c. Bence Jones protein in the urine d. A low serum protein level 9. A 35 year old client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis (inflammation of the mouth)? a. White, cottage cheese-like patches on the tongue b. Yellow tooth discoloration c. Red, open sores on the oral mucosa d. Rust-colored sputum 10. During chemotherapy, an oncology client has a nursing diagnosis of impaired oral mucous membrane related to decreased nutrition and immunosuppression secondary to the cytotoxic effects of chemotherapy. Which nursing intervention is most likely to decrease the pain of stomatitis? a. Recommending that the client discontinue chemotherapy b. Proving a solution of hydrogen peroxide and water for use as a mouth rinse c. Monitoring the client’s platelet and leukocyte counts d. Checking regularly for signs and symptoms of stomatitis 11. What should a male client over age 52 do to help ensure early identification of prostate cancer? a. Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly. b. Have a transrectal ultrasound every 5 years c. Perform monthly testicular self-examinations, especially after age 50 d. Have a complete blood count (CBC) and blood urea nitrogen (BUN) and creatinine levels checked yearly 12. A male client complains of sporadic epigastric pain, yellow skin, nausea, vomiting, weight loss and fatigue. Suspecting gallbladder disease, the physician orders a diagnostic workup, which reveals gallbladder cancer. Which nursing diagnosis may be appropriate for this client? a. Anticipatory grieving b. Impaired swallowing c. Disturbed body image d. Chronic low self-esteem