Test Bank Focus on Adult Health Medical Surgical Nursing ,1st Edition by Linda Honan Pellico

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Test Bank Focus on Adult Health Medical
Surgical Nursing ,1st Edition by Linda Honan
Pellico
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chapter 6
1.
The school health nurse is presenting a health promotion class to a group of middleschool students. Which is the best intervention to address health promotion strategies
related to the leading cause of cancer deaths in North America?
A)
Monthly self-breast exams
B)
Smoking cessation
C)
Annual colonoscopies
D)
Monthly testicular exams
2.
3.
4.
While a patient is receiving IV doxorubicin hydrochloride, the nurse observes that there
is swelling and pain at the IV site. The nurse should:
A)
Stop the administration of the drug immediately.
B)
Notify the patient’s health care provider.
C)
Continue to administer but decrease the rate of infusion.
D)
Apply a warm compress to the site.
Your patient is receiving carmustine, a chemotherapy agent. A significant side effect of
this medication is thrombocytopenia. What symptom would the nurse assess for in a
patient at risk for thrombocytopenia?
A)
Interrupted sleep pattern
B)
Hot flashes
C)
Nose bleed
D)
Increased weight
You are a nurse working on a bone marrow transplant (BMT) unit. Your patient is
scheduled to receive a bone marrow transplant. What information will you provide to the
patient’s visitors?
A)
Bring plants to improve air quality.
B)
Take the patient to the cafeteria for meals.
C)
Wear hospital scrubs when entering the patient’s room.
D)
Do not visit if they’ve had a recent infection.
5.
6.
7.
You are caring for a patient who has just been given a 6-month prognosis. The patient
states that he would like to die at home. The patient’s care needs are unable to be met
in a home environment. In collaboration with the care team, what might you suggest as
an alternative?
A)
Discuss a referral for rehabilitation hospital.
B)
Panel the patient for a personal care home.
C)
Discuss a referral for acute care.
D)
Discuss a referral for hospice care.
The clinic nurse is caring for a 42-year-old male oncology patient. He complains of
extreme fatigue and weakness after his first week of radiation therapy. What response
by the nurse would best reassure this patient?
A)
“These symptoms usually result from radiation therapy; however, we will continue to
monitor your laboratory and X-ray studies.”
B)
“These symptoms are part of your disease and can’t be helped.”
C)
“Don’t be concerned about these symptoms. Everybody feels this way after having
radiation therapy.”
D)
“This is a good sign. It means that only the cancer cells are dying.”
A 16-year-old female patient experiences alopecia resulting from chemotherapy,
prompting the nursing diagnoses of disturbed body image and situational low selfesteem. What action by the patient would best indicate that she is meeting the goal of
improved body image and self-esteem?
A)
The patient requests that her family bring her makeup and wig.
B)
The patient begins to discuss the future with her family.
C)
The patient reports less disruption from pain and discomfort.
D)
The patient cries openly when discussing her disease.
8.
9.
10.
The nursing instructor is discussing the difference between normal cells and cancer cells
with the pre-nursing class in pathophysiology. What would the instructor cite as a
characteristic of a cancer cell?
A)
Malignant cells contain more fibronectin.
B)
The cell membrane of malignant cells contains proteins called tumor-specific
antigens.
C)
Chromosomes are commonly found to be strong.
D)
Nuclei of cancer cells are large and regularly shaped.
You are giving a report in your pathophysiology class. The subject of your report is
cancer cells. In differentiating between benign and malignant cells, what characteristics
would you cite? Select all that apply.
A)
Rate of growth
B)
Ability to cause death
C)
Size of cells
D)
Cell contents
E)
Ability to spread
You are the clinic nurse caring for a patient whose grandmother, mother, and sister all
had breast cancer. She has requested a screening test to determine her risk of
developing breast cancer and it has come back positive. The patient asks you what she
can do to help prevent breast cancer from occurring. What would be your best
response?
A)
“Research has shown that eating a healthy diet can reduce your chance of breast
cancer.”
B)
“Research has shown that taking tamoxifen can reduce your chance of breast
cancer.”
11.
12.
13.
C)
“Research has shown that exercising at least 30 minutes every day can reduce
your chance of breast cancer.”
D)
“Research has shown that reducing your intake of red meat can reduce your
chance of breast cancer.”
Mrs. Unger is a 53-year-old woman who was diagnosed with breast cancer following a
process that began with abnormal screen mammography results. Mrs. Unger, her
oncologist, and surgeon have agreed on a mastectomy as treatment and have
discussed the importance of rigorously assessing whether her cancer has metastasized.
What action will best detect possible metastasis of Mrs. Unger’s breast cancer?
A)
Serial bone marrow biopsies
B)
Biopsy of the axillary lymph nodes
C)
Careful grading of the tumor cells
D)
Gauging her response to radiation therapy
The results of a 22-year-old college student’s most recent Papanicolaou (Pap) test are
suggestive of cervical cancer. Since learning of this news, the patient has asked
numerous questions of all members of the health care team, including the nurses at the
campus medical clinic. What patient teaching should the nurse at the clinic prioritize in
this patient’s care?
A)
Environmental influences on the etiology of genitourinary cancers
B)
The relationship between viruses and cervical cancer
C)
Genetic and familial factors in the development of cervical cancer
D)
The role that the immune system normally plays in preventing cancer
You are a nurse who works in a public health setting. As such, you participate in many
health promotion activities that are ultimately aimed at reducing the high incidence and
prevalence of cancer in American society. Which of the following activities is an example
of secondary prevention?
14.
15.
A)
Teaching older adults why and how to perform fecal occult blood tests
B)
Educating middle school students about the health risks of smoking
C)
Conducting a campaign aimed at encouraging parents to apply sunscreen to their
young children
D)
Teaching workers at a factor about possible carcinogens in their workplace
A computed tomography (CT) scan has detected a “spot” on a patient’s liver, and a
subsequent liver biopsy has revealed cancer and been submitted for staging and
grading. The patient has asked you about the purpose of staging, stating that her
oncologist’s explanation left her somewhat confused. How could you best respond to this
patient’s question?
A)
“Staging allows the care team to determine how large and extensive your tumor is.”
B)
“The purpose of staging is to determine the site where your cancer most likely
originated.”
C)
“Staging is the process that helps your care team determine your prognosis for
recovery.”
D)
“Staging is the process of classifying a tumor according to the type of tissue it’s
made of.”
As a nurse who provides care on an oncology unit, you are aware that many of your
patients who undergo surgery during cancer treatment face a particularly high risk of
deep vein thrombosis (DVT) because of an increase in circulating procoagulants. In light
of this risk, you should prioritize assessments of:
A)
Active and passive range of motion
B)
Petechiae and hematomas on the lower extremities
C)
Nausea that fails to respond to antiemetics
D)
Limb symmetry and calf pain
16.
17.
18.
Your patient has recently completed her first round of chemotherapy in the treatment of
lung cancer. When reviewing this morning’s blood work, what findings would be
suggestive of myelosuppression?
A)
Decreased sodium levels and decreased potassium levels
B)
Increased creatinine and blood urea nitrogen (BUN)
C)
Decreased platelets and red blood cells
D)
Increased white blood cells and c-reactive protein (CRP)
You are an oncology nurse who has reconstituted a patient’s scheduled
chemotherapeutic drug. What action should you perform prior to administering this drug?
A)
Aspirate 5 to 10 mL of blood from the patient’s IV access device.
B)
Teach the patient about the pharmacodynamics of the drug.
C)
Administer a prophylactic antibiotic as ordered.
D)
Have a colleague confirm the chemotherapy dose.
You have begun the infusion of a patient’s first dose of docetaxel (Taxotere) that has
been ordered for the treatment of breast cancer. The patient’s vital signs and level of
consciousness were within normal limits prior to administration but shortly after
beginning the infusion, the patient has complained of sudden anxiety and shortness of
breath. As well, the patient’s face has become visibly flushed. What actions should you
perform next?
A)
Attempt to calm the patient and then document the event.
B)
Stop the infusion and protect the patient’s airway.
C)
Slow the infusion rate and reposition the patient in a supine position.
D)
Administer a dose of diphenhydramine and assess her orientation.
19.
20.
21.
You are an oncology nurse and have just begun infusion of a patient’s first dose of
doxorubicin (Adriamycin) for the treatment of the patient’s soft-tissue sarcoma. Shortly
after beginning the infusion, the patient complains of pain at the infusion site, which is
now swollen and reddened, and the IV pump has alarmed with a report of occlusion. As
a result, you suspect extravasation. What action should you prioritize?
A)
Stop the infusion and remove the patient’s IV cannula.
B)
Slow the infusion and take the patient’s vital signs.
C)
Discontinue the infusion and infuse a flush of normal saline.
D)
Stop the infusion and aspirate from the patient’s IV line.
Mr. Holmes is a 66-year-old man who is receiving radiation therapy and chemotherapy
for the treatment of small cell lung cancer. As Mr. Holmes’ nurse, you have assessed
him many times since he was admitted to the hospital. This morning, he admits that his
greatest challenge he is currently facing is his overwhelming fatigue. How should you
respond to this patient’s statement?
A)
“Your fatigue is actually a sign that your body is redirecting its energies toward
healing and away from more common functions like mobility.”
B)
“I’m sure you’ll agree that fatigue, even when it’s severe, is much preferable to pain.
It’s fortunate that your pain is now well-controlled.”
C)
“That must be incredibly difficult for you. How would you rate your fatigue if you had
to give it a number from 1 to 10?”
D)
“That’s entirely normal, given what your body is going through and how much
treatment you’re currently getting.”
As a nurse who provides care for many patients with cancer, you are aware that cancer
makes patients susceptible to many other health problems. Which of the following
assessments addresses the leading cause of death among patients who have cancer?
A)
Assessing patients’ lower legs for redness, swelling, or pain on dorsiflexion
22.
23.
B)
Arranging for serial electrocardiograms (ECGs) or cardiac telemetry whenever
possible
C)
Monitoring white blood cell (WBC) counts and assessing patients’ integumentary
systems
D)
Auscultating patients’ lungs thoroughly and monitoring oxygen saturation levels
Mr. Lao is a patient with cancer who developed neutropenia several days ago and has
consequently been placed in a single-bed room that has positive pressure. Mr. Lao’s
daughter has just come to visit her father after arriving from her home in another state
and has asked you for his room number. You notice that Mr. Lao’s daughter has
reddened eyes, sniffles, and a dry cough. What instruction should you provide to Mr.
Lao’s daughter?
A)
“Even though it might be difficult, it’s best for your father’s health if you get well
before visiting him in person, since he’s so vulnerable right now.”
B)
“Your father is extremely vulnerable to infections right now, so I’m going to ask you
to make sure you wear a gown when you go into his room.”
C)
“Your father is under neutropenic precautions right now so you’re not allowed to
visit him.”
D)
“It’s very important that you wash your hands thoroughly before you enter your
father’s room and as soon as you come out.”
A patient with a diagnosis of late-stage bladder cancer has experienced a steady decline
in his platelet counts, which are currently 18,000/mm3 (0.018 × 1012/L). Which of the
following nursing actions best accommodates the health risks associated with this
laboratory finding?
A)
Encouraging the patient to eat as many protein sources as possible and providing
multivitamins
B)
Organizing the patient’s activities to allow for frequent rest breaks and teaching him
about the correct use of assistive devices
C)
Encouraging the patient to increase his fluid intake and providing stool softeners
D)
24.
25.
Reminding the patient of the importance of diligent handwashing and the need to
avoid common areas
A patient with a diagnosis of prostate cancer is receiving radiation therapy, a treatment
that has resulted in stomatitis. To best manage this patient’s stomatitis, the nurse
should:
A)
Encourage the patient’s family to bring in mouthwash for the patient.
B)
Arrange for a low-residue diet for the patient and provide small, frequent meals.
C)
Provide a hypertonic solution for the patient to gargle.
D)
Encourage the patient to use an oral swab rather than a regular toothbrush.
A patient with a diagnosis of renal cell carcinoma is being treated with chemotherapy.
During a previous round of chemotherapy, the patient’s tumor responded well to
treatment but the chemotherapy caused intense nausea and vomiting. How should the
patient’s potential nausea and vomiting be addressed during this current round of
treatment?
A)
Prioritize nonpharmacological treatments over medications.
B)
Administer antiemetics in anticipation of the patient’s nausea.
C)
Provide the patient with antiemetics at his first complaint of nausea.
D)
Administer antiemetics if the patient vomits or believes he will soon vomit.
Answer Key
1.
B
2.
A
3.
C
4.
D
5.
D
6.
A
7.
A
8.
B
9.
A, B, E
10.
B
11.
B
12.
B
13.
A
14.
A
15.
D
16.
C
17.
D
18.
B
19.
D
20.
C
21.
C
22.
A
23.
C
24.
D
25.
B
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