Treatment modalities for estrogen-receptor positive tumors include (select all that apply):
A. Estrogen-receptor downregulators (ERDs)
B. Selective
... [Show More] estrogen-receptor response modulators (SERMs)
C. Hormone therapy
D. Aromatase inhibitors - correct answer A, B, D
Stage IIIB describes invasive breast cancer in which:
A. The tumor measures up to 2 cm and has not spread outside the breast
B. No tumor is found in the breast
C. Cancer may have spread to up to 9 axillary lymph nodes causing swelling
D. The cancer has metastasized to other organs - correct answer C. Cancer may have spread to up to 9 axillary lymph nodes causing swelling
In stage IIIB carcinoma of the breast the cancer may have spread to up to 9 axillary lymph nodes. Ms. T has 8 of 12 lymph nodes affected. Answers A or B may occur in stage I, and answer choice D describes stage IV
3.Which of the following are important interventions when caring for a patient with Cushing syndrome? (Select all that apply)
A. Increase carbohydrate intake
B. Monitoring blood glucose levels
C. Observing for signs of hypotension
D. Protecting patient from exposure to infection - correct answer B, D
Hyperglycemia occurs with Cushing disease because of glucose intolerance (associated with cortisol-induced insulin resistance) and increased gluconeogenesis by the liver. High levels of corticosteroids increase susceptibility to infection and delay wound healing.
In a 29-year-old female client who is being successfully treated for Cushing's syndrome, nurse Lyzette would expect a decline in:
A. Menstrual flow
B. Bone mineralization
C. Hair loss
D. Serum glucose level - correct answer D. Serum glucose level
Serum glucose levels tend to be high in patients with Cushing's Syndrome due to excess corticosteroids in the body. When Cushing's syndrome is being treated successfully, a nurse should expect a decline in the patient's serum glucose level
Mr. A has been admitted to the hospital with a diagnosis of acute pancreatitis and the nurse is assessing his pain. What type of pain is associated with this diagnosis?
A. Burning and aching, located in the left lower quadrant and radiating to the leg
B. Severe and unrelenting, located in the epigastric area and radiating to the back
C. Burning and aching, located in the epigastric area and radiating to the umbilicus
D. Severe and unrelenting, located in the left lower quadrant and radiating to the hip - correct answer B. Severe and unrelenting, located in the epigastric area and radiating to the back
The pain associated with acute pancreatitis is often severe and unrelenting, is located in the epigastric region, and radiates to the back. It is also described as sudden onset, deep piercing, continuous or steady. The other options are incorrect.
The nurse is reviewing the prescription for Mr. A., a 55 year-old male admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions would the nurse expect to be prescribed for the client? Select all that apply.
A. Administer antacids as prescribed
B. Encourage coughing and deep breathing
C. When food is allowed follow a high-carbohydrate, low-fat, high-protein diet
D. Maintain the client in a supine and flat position.
E. Give Demerol or Dilaudid as prescribed for pain. - correct answer A, B, C, E
Because abdominal pain is a prominent symptom of pancreatitis, pain medication such as Demerol or Dilaudid should be administered as prescribed. The client is susceptible to respiratory infections because the retroperitoneal fluid raises the diaphragm, which causes the client to take shallow, guarded abdominal breaths. Therefore measures such as turning, coughing, and deep breathing should be instituted. Antacids may be prescribed to suppress gastrointestinal secretions. The diet is usually high in carbohydrates since it is less stimulating the exocrine portion of the pancreas.
A patient comes into the clinic with complaints of joint stiffness and pain. For which symptom might the nurse assess to distinguish rheumatoid arthritis from other connective tissue disorders?
A. The patient has unilateral joint involvement
B. Morning stiffness that lasts more than one hour
C. Inflammation of the great toe
D. Dry mouth and dry eyes - correct answer B. Morning stiffness that lasts more than one hour
You are providing education to a patient diagnosed with Rheumatoid Arthritis about how to manage her disease at home. Which statement by the patient would indicate understanding?
A. "I should place a pillow under my knees before I sleep."
B. "I will add weight lifting to my exercise routine."
C. "When I'm having painful inflammation, I should resume total bed rest."
D. "I may need 8-10 hours of sleep and daytime naps to help with fatigue." - correct answer D. "I may need 8-10 hours of sleep and daytime naps to help with fatigue."
Which of the following are symptoms of a ruptured AAA? Select all that apply:
A. Severe back pain
B. Ripping or tearing sensation
C. Polyuria
D. Clammy skin
E. Red rash on the abdomen - correct answer A, D
Usually, with a rupture back pain becomes severe. Ripping or tearing sensation is a sign of aortic dissection. Urine output should be decreased. The patient is going into shock from blood loss which contributes to his clammy skin. A red rash on the abdomen may be caused by many other conditions, but not a ruptured AAA. Grey Turner's sign is bruising in the flank area due to AAA rupture.
When teaching a patient about risk factors for AAA, which of the following, if stated by the patient indicates correct understanding?
A. Taking ACE inhibitors or ARBS
B. Being female
C. Smoking
D. Weightlifting - correct answer C. Smoking
Aortic Aneurysm can be caused by being male, smoking, family history, and hypertension. ACE inhibitors or ARBS might be useful in treating AAA. Weightlifting should be avoided post AAA repair
A patient reports during a routine check-up that he is experiencing chest pain and shortness of breath while performing activities. He states the pain goes away when he rests. This is known as:
A. Unstable angina
B. Variant angina
C. Stable angina
D. Prinzmetal angina - correct answer C. Stable Angina
Chronic Stable angina, is known to be relieved by resting or by administering nitroglycerin tablets. Stable angina can also be brought on by exercise
After teaching a patient with chronic stable angina about nitroglycerin, the nurse recognizes the need for further teaching when the patient makes which statement?
A. "I will replace my nitroglycerin supply every 6 months."
B. "I can take up to five tablets every 3 minutes for relief of my chest pain."
C. "I will take acetaminophen (Tylenol) to treat the headache caused by nitroglycerin."
D. "I will take the nitroglycerin 10 minutes before planned activity that usually causes chest pain." - correct answer B. "I can take up to five tablets every 3 minutes for relief of my chest pain."
This is not the new recommended dosing for nitroglycerin. The correct use of nitroglycerin is to take one pill sublingually, and wait for the pain to subside, if the pain does not subside or worsens after five minutes the patient then should contact emergency personal. If pain is steadily subsiding a patient can repeat another dose every five minutes but with a maximum of three doses only, if pain is not completely diminished, contact EMS.
The following are clinical manifestations of acute disseminated intravascular coagulation (DIC) EXCEPT:
A. Hypertension
B. Petechiae
C. Altered mental status
D. Mucosal/skin bleeding - correct answer A. Hypertension
A patient experiencing acute DIC will experience hypotension, not hypertension.
Which lab result would a nurse NOT expect to find in a client diagnosed with DIC?
A. Prolonged prothrombin time (PT)
B. Prolonged activated partial thromboplastin time (aPTT)
C. A decreased platelet count
D. A high fibrinogen level - correct answer A patient with DIC would have a low fibrinogen level. Fibrinogen predicts bleeding in DIC. As it decreases, the risk of bleeding increases. A prolonged PT, aPTT and decrease in platelet production are expected.
LB is a 40-year-old male with colon cancer presenting with lack of appetite, muscle wasting, and 10-lb weight loss since previous check-up two weeks ago. Which of the following is the best nursing diagnosis for LB?
A. Disturbed body image related to cachexia
B. Hopelessness related to terminal illness
C. Imbalanced nutrition: less than body requirements related to loss of appetite
D. Impaired oral mucous membrane related to chemotherapy - correct answer C. Imbalanced nutrition: less than body requirements related to loss of appetite
The question indicates that LB has lost 10 lbs within just 2 weeks and that he has a lack of appetite and muscle wasting. This tells you that LB has imbalanced nutrition: less than body requirements related to loss of appetite. The question does not indicate the other possible options and C is the best answer.
Which of the following assessment findings would likely be found in a patient with cancer cachexia? (Select all that apply)
A. Tardive dyskinesia
B. 10% weight loss in past 12 months
C. Hemoglobin 8 g/dL
D. Muscle wasting
E. Elevated energy levels
F. Serum albumin 2.5 g/dL - correct answer B, C, D, F
A person with cachexia is like to have 10% weight loss in past 12 months, a hemoglobin level of 8 g/dL, muscle wasting, and a serum albumin level of 2.5 g/dL. The other options are not indicated in a patient with cachexia.
A nurse is caring for a 57-year-old patient who has just been diagnosed with ER positive breast cancer. What additional teachings would you include as a nurse about treatment for this type of cancer?
A. The patient is likely to lose all of their hair
B. Drug therapy that lowers estrogen will likely be included in the treatment
C. Estrogen replacement drug therapy will likely be included in the treatment
D. Chemotherapy will not be necessary - correct answer B. Drug therapy that lowers estrogen will likely be included in the treatment
Answer choice A, telling the patient that she will lose all of her hair may be true, depending on the type of cancer treatment she is receiving but is not the best answer. Chemotherapy may be necessary for the patient's cancer therapy. Estrogen replacement is contraindicated for the treatment of ER positive breast cancer. The best answer is choice B, drug therapy that lowers estrogen will likely be included in the treatment
A nurse is caring for a 57-year-old patient who has just been diagnosed with ER positive breast cancer. Although a total mastectomy was recommended due to the size of the tumor, Ms. T decided to have a lumpectomy. She is currently 3 weeks post-operation and will begin chemotherapy and hormone therapy. Match the drug therapy to the intended effect:
A. Cytoxan- Alkylating agents
B. Adriamycin [doxorubicin]- Antitumor Antibiotics
C. Anastrozole- Aromatase Inhibitors
1. Causes breaks in the DNA double stranded helix
2. Binds directly to DNA, inhibiting synthesis and interfering with RNA transcription
3. Inhibits synthesis of an enzyme needed in estrogen synthesis - correct answer A - 1
B-2
C-3
Cytoxan works by breaking the DNA double stranded helix; Adriamycin works by binding directly to DNA, inhibiting synthesis and interfering with RNA transcription; Anastrozole works by inhibiting synthesis of an enzyme needed in estrogen synthesis
Which nursing intervention would you not implement with a patient who is diagnosed with Cushing's Syndrome?
A. Minimize stress in the environment
B. Monitor vital signs; observe for hypertension, edema
C. Tell patient to increase caloric intake to maintain body weight.
D. Protect client from exposure to infection - correct answer C. Tell patient to increase caloric intake to maintain body weight.
In patients with Cushing Syndrome, weight gain is a side effect, therefore monitoring caloric intake is an important aspect for the patient to monitor.
Nurse Ron is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse would expect to find:
A. Hypotension.
B. Thick, coarse skin.
C. Deposits of adipose tissue in the trunk and dorsocervical area.
D. Weight gain in arms and legs. - correct answer C. Deposits of adipose tissue in the trunk and dorsocervical area.
Because of changes in fat distribution, adipose tissue accumulates in the trunk, face (moonfaced), and dorso-cervical areas (buffalo hump). Hypertension is caused by fluid retention. Skin becomes thin and bruises easily because of a loss of collagen. Muscle wasting causes muscle atrophy and thin extremities.
Which assessment finding of a patient with acute pancreatitis is the nurse's priority and will require immediate intervention?
A. Acute LUQ pain radiating to the back
B. Rigid, board-like abdomen
C. Nausea and Vomiting
D. Fatigue - correct answer B. Rigid, board-like abdomen
Rigid, board-like abdomen is a sign of peritonitis which is a complication of acute pancreatitis that will require immediate intervention. All the other choices are common clinical manifestations of acute pancreatitis.
Which statement about acute pancreatitis made by the nursing student shows that further teaching is required?
A. The patient cannot remain on a high-fat diet.
B. Patient can request Gatorade if they feel weak.
C. Bluish discoloration around the umbilical area may occur in severe cases of acute pancreatitis
D. Patient cannot take antacids if they have a stomach ache flare up. - correct answer B. Patient can request Gatorade if they feel weak.
Patients with acute pancreatitis should be NPO to allow the pancreas to rest by suppressing pancreatic enzymes.
Ms. M, a 36-year-old female, who comes into the clinic complaining about increased pain and stiffness. He wants to know the best ways to help protect his joints. What is one way the nurse can teach Mr. M how he can protect his joints?
A. Wringing out water from a sponge
B. Stand while preparing and cooking meals
C. Push on the palms of your hands, not your fingers, when getting up from a chair
D. Modify your home so doorknobs and faucets are able to be turned, not pushed - correct answer C. Push on the palms of your hands, not your fingers, when getting up from a chair [Show Less]