NU 246 Final Exam Questions and
Correct Answers
Wellness ✅Being proactive and involved in self-care activities aimed towards physical,
psycho-social, and spiritual well being
Thyroid Cancer ✅•most common: papillary adenocarcinoma
•rare but increased risk of head/neck/chest radiation in infancy & childhood
Hemophilia A ✅deficiency of active clotting factor VIII (8)
Risk Factors for Breast Cancer ✅•female sex, age (50+)
•personal/family history
•BRCA 1 & BRCA 2 genetic mutations cause a 55%-85% lifetime risk
•radiation exposure as a teen/young adult
•hormonal factors (early menarche, late menopause, nullparity, first child >30 years old,
HRT)
Systemic Lupus Erythematosus (SLE) ✅•"Lupus"
•chronic, inflammatory, multi-system immune disorder
•develops antinuclear antibodies (ANA) that react against the body's own tissues
•*worry about infection all the time*
Conditions That Cause Immunosuppression ✅•cancer
•treatment of cancer
•treatment for organ transplant
•autoimmune disorders
Hemophilia B (Christmas Disease) ✅deficiency of clotting factor IX (9)
Discoid SLE ✅•erythematous butterfly rash over the nose and cheeks
•generally self-limiting
Clinical Manifestations of Breast Cancer ✅*early signs*
•lump usually in upper, outer quadrant
•non-tender
•fixed (immobile)
•hard w/ irregular border
*late signs*
•skin dimpling/peau d'orange
,•nipple retraction/changes
•ulcerating lesion/lesion on chest wall
Clinical Manifestations of Thyroid Cancer ✅•*lesion: single, hard & fixed on palpation,
involves cervical lymph nodes usually indicate malignancy*
•pain in neck
•dysphagia, wheezing
•hoarse voice, cough
•*diagnosed by biopsy*
Factors That Affect the Immune System ✅•skin
•age
•stress
•nutrition
•medications
•hormone levels
von Willebrand Disease (vWD) ✅•hereditary bleeding disorder characterized by a
deficiency, abnormality, or absence of the von Willebrand factor protein
•Normal platelet count but prolonged bleeding time and slightly prolonged aPTT
Common Sites for Breast Cancer Metastasis ✅•bone
•lung
•liver
•brain (later)
Management of Thyroid Cancer ✅•surgical removal: total or near-total thyroidectomy
•thyroid hormone therapy post-op
•radiation post-op (either oral or external)
•*early detection & treatment = good survival rates*
Systemic SLE ✅•affects the connective tissues of multiple organ systems and can lead
to major organ failure
Normal WBC Count ✅5,000-10,000
Manifestations of von Willebrand Disease ✅•bleeding tends to be mucosal -> recurrent
nosebleeds, easy bruising, heavy menses, prolonged bleeding from cuts, postop
bleeding, massive soft tissue or joint hemorrhages
Medication-Induced SLE ✅•procainamide, hydralazine, and isoniazid (INH) are
commonly associated with this
•finding resolve after medication is discontinued
,•does NOT cause renal or neurologic disease
Diagnostics for Breast Cancer ✅•BSE & clinical breast exam
•mammography (go to the same place)
•MRI: used for women already diagnosed & high risk women
•biopsy (fine needle, incisional, core, excisional)
•*80% of biopsies are negative for malignancy*
PreOp Nursing Care for Thyroid Cancer ✅•*diet high in calories, carbs, & protein*
•*avoid stimulants (caffeine)*
•explain procedure, decrease stress
Ductal Carcinoma In Situ (DCIS) ✅•noninvasive but can progress
•99% cure with total mastectomy
•may choose BCT (lumpectomy) w/ radiation & tamoxifen (Nolvadex) for 5 years after
PostOp Nursing Care for Thyroid Cancer ✅•*maintain airway*: r/t edema/hematoma
formation -> trach supplies at bed side, call HCP for resp. distress
•*bleeding*: assess dressings, vitals, *the sensation of pressure at the incision site*
•*hydration/nutrition*: IV fluids -> cold, oral fluids w/ puree diet
•*injury*: assess quality of voice
•*position* semi-fowlers, avoid head turning & talking
•*hypocalcemia* r/t removal of parathyroid gland (tetany)
•*home care & follow up*: discharged in 1-2 days, increased rest, hydration, humidity,
avoid stressing the incision
Clinical Manifestations of Lupus ✅•fatigue/malaise
•alopecia
•photosensitivity
•*butterfly erythematous rash*
•blurred vision
•pleuritic pain
•anorexia/weight loss
•joint pain & swelling
•depression
Symptoms of Hemophilia ✅•bleeding into the muscle
•prolonged bleeding after circumcision
•hemarthrosis -bleeding into a joint or muscle that causes pain & swelling
•abnormal bleeding after injury/surgery
•easy bruising
•frequent nosebleeds
•hematuria
•bleeding after dental work
, Leukopenia ✅<5,000 WBCs
Normal Neutrophil Count ✅3,000-7,000
Normal Prothrombin Time (PT) ✅11-13.5 seconds
H&C textbook says 9-12 seconds
Joint Symptoms of Lupus ✅•arthralgias
•arthritis (synovitis)
•joint swelling/tenderness
•morning stiffness/pain on movement
Lobular Carcinoma In Situ (LCIS) ✅•noninvasive (Stage 0) but increased r/f invasive
cancer
•treatment: close surveillance, bilateral mastectomy, chemoprevention w/ tamoxifen
Microvascular Complications of DM ✅*caused by capillary membrane thickening r/t
increased blood glucose leading to decreased perfusion & cell death*
•retinopathy
•nephropathy
•neuropathy
•peripheral neuropathy: starts distally & works up (feet first)
•autonomic neuropathy
Macrovascular Complications of DM ✅•MI
•TIA/CVA
•peripheral artery disease: increase in atherosclerotic growths (bad circulation)
Infiltrating Ductal Carcinoma ✅•75% of all breast cancers
•tumors are hard on palpation
•frequent mets to axillary lymph nodes
Cardiac Symptoms of Lupus ✅•pericarditis & myocarditis
•substernal chest pain
•HTN
•dysrhythmias
•valvular disorders
•athersclerosis
Normal Partial Thromboplastin Time (PTT) ✅60-70 seconds
Neutropenia ✅<1,000
•life threatening if <500
