a client with squamous cell carcinoma of the lung comes to the emergency department reportand respir
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A client with squamous cell carcinoma of the lung
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A client with squamous cell carcinoma of the lung comes to the emergency
department reportand respir
A client with squamous cell carcinoma of the lung comes to the emergency department reporting
shortness of breath and respiratory difficulty. On assessment, the nurse notes generalized cyanosis and
edema of the face and arms. Based on this assessment, the nurse suspects the client is probably
experiencing which of the following? *
1 point
a.Spinal cord syndrome (SCS)
b.Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
c.Superior Vena Cava Syndrome (SVCS)
d.Tumor Lysis Syndrome (TLS)
As part of chemotherapy education, the nurse teaches a female client about the risk for bleeding and
self-care during the period of greatest bone marrow suppression (the nadir). The nurse understands that
further teaching is needed if the client makes which statement? *
1 point
1. “I should avoid blowing my nose.”
2. “I may need a platelet transfusion if my platelet count is too low.”
3. “I’m going to take aspirin for my headache as soon as I get home.”
4. “I will count the number of pads and tampons I use when menstruating.”
Which nursing diagnosis should a nurse plan to document for the client with gastric cancer experiencing
hematemesis? *
1 point
a.Impaired oral mucous membrane
b.Decreased cardiac output
c.Impaired gas exchange
d.Fluid volume deficit
A patient's most recent diagnostic imaging has revealed that his lung cancer has metastasized to his
bones and liver. What is the most likely mechanism by which the patient's cancer cells spread? *
1 point
a.Hematologic spread
b.Lymphatic circulation
c.Invasion
d.Angiogenesis
,A client with squamous cell carcinoma of the lung comes to the emergency
department reportand respir
Priority Decision: The patient with advanced cancer is having difficulty controlling her pain. She says she
is afraid she will become addicted to the opioids. What is the first thing the nurse should do for this
patient? *
1 point
a. Administer a nonsteroidal antiinflammatory drug.
b. Assess the patient’s vital signs and behavior to determine the medication to use.
c. Have the patient keep a pain diary to better assess the patient’s potential addiction.
d. Obtain a detailed pain history including quality, location, intensity, duration, and type of pain
A client is brought to the surgical unit after a suprapubic prostatectomy. He has a three-way Foley
catheter. The nurse notices a very dark red output via the catheter. What is the appropriate nursing
intervention? *
1 point
a.Report the finding immediately to the physician.
b.Increase the irrigation flow rate.
c.Check the latest hemoglobin and hematocrit count.
d.Chart the observation in the medical record.
A nurse is reviewing the health record of a client who has suspected ovarian cancer. Which of the
following findings supports this diagnosis? (Select all that apply.) *
5 points
A. Previous treatment for endometriosis
B. Family history of colon cancer
C. First pregnancy at age 24
D. Report of scant menses
E. Use of oral contraceptives for 10 years
The nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which would
the nurse expect to note specifically in this disorder? *
1 point
1. Increased calcium level
2. Increased white blood cells
3. Decreased blood urea nitrogen level
4. Decreased number of plasma cells in the bone marrow
,A client with squamous cell carcinoma of the lung comes to the emergency
department reportand respir
The nurse explains to a patient undergoing brachytherapy of the cervix that she *
1 point
a. must undergo simulation to locate the treatment area.
b. requires the use of radioactive precautions during nursing care.
c. may experience desquamation of the skin on the abdomen and upper legs.
d. requires shielding of the ovaries during treatment to prevent ovarian damage.
An allogenic hematopoietic stem cell transplant is considered as treatment for a patient with acute
myelogenous leukemia. What information should the nurse include when teaching the patient about
this procedure? *
1 point
a. There is no risk for graft-versus-host disease because the donated marrow is treated to remove
cancer cells.
b. The patient’s bone marrow will be removed, treated, stored, and then reinfused after intensive
chemotherapy.
c. Peripheral stem cells are obtained from a donor who has a human leukocyte antigen (HLA) match with
the patient.
d. There is no need for posttransplant protective isolation because the stem cells are infused directly
into the blood.
A client says to a nurse, “I wish my family would let me die in peace. I get so angry that my family keeps
hovering over me as if I have given up. The doctor told me I have terminal lung cancer and there is no
cure!” Which is the best therapeutic response by the nurse? *
1 point
a. “Your family is hovering over you? I can ask them to leave if you wish.”
b. “You are angry because your family thinks that you have given up hope for a cure?”
c. “Have you talked to your family about your feelings?”
d. “You shouldn’t feel angry. Your family is just trying to show that they love and care for you.”
Computed tomography of a 72-year-old woman reveals lung cancer with metastasis to the liver. The
patient's son has been adamant that any “bad news” be withheld from his in order to protect her from
, A client with squamous cell carcinoma of the lung comes to the emergency
department reportand respir
stress, stating that this is a priority in his culture. How should the nurse and the other members of the
care team best respond? *
1 point
a.Explain to the son the team's ethical obligation to inform the patient.
b.Refer the family to social work.
c.Have a nurse or physician from the patient's culture make contact with her and her son.
d.Speak with the son to explore his rationale and attempt to reach a consensus.
The nurse is assessing a client who has a new ureterostomy. Which statement by the client indicates the
need for more education about urinary stoma care? *
1 point
1. “I change my pouch every week.”
2. “I change the appliance in the morning.”
3. “I empty the urinary collection bag when it is two-thirds full.”
4. “When I’m in the shower I direct the flow of water away from my stoma.”
During a health promotion seminar for senior citizens, a seminar participant asks a nurse to discuss
symptoms of gastric cancer. A nurse’s response should be based on the knowledge that: *
1 point
a.Cancers that do not penetrate the gastric muscular layer are asymptomatic in the majority of clients.
b.Pain from early gastric cancer lesions cannot be reduced by over-the-counter (OTC) histamine
receptor antagonists.
c.Unexplained weight gain and increased body mass index are early symptoms of gastric cancer.
d.Anemia is uncommon in gastric cancer, but if it occurs it is likely due to the effects of aging.
The nurse is instructing a client to perform a testicular self-examination (TSE). The nurse should provide
the client with which information about the procedure? *
1 point
1. To examine the testicles while lying down
2. That the best time for the examination is after a shower
3. To gently feel the testicle with 1 finger to feel for a growth
4. That TSEs should be done at least every 6 months
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