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Test Bank For Nurse Practitioner Certification Exam Prep 6th Edition by Margaret A. Fitzgerald 9780803677128 Chapter 1-19 Complete Guide.$32.49
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Test Bank For Nurse Practitioner Certification Exam Prep
6th Edition by Margaret A. Fitzgerald 9780803677128
Chapter 1-19 Complete Guide.
ANS: A
Pacing activities throughout the day conserves energy, and nursing care should be
paced as well. Fatigue is a common side effect of cancer and treatment; and while
adequate sleep is important, an increase in the number of hours slept will not resolve
the fatigue. Restriction of visitors does not promote healthy coping and can result in
feelings of isolation. - 3. Which of the following is the most appropriate intervention for
the nurse to include when planning care for a patient experiencing fatigue due to
chemotherapy?
a. Prioritization and administration of nursing care throughout the day
b. Completing all nursing care in the morning so the patient can rest the remainder of
the day
c. Completing all nursing care in the evening when the patient is more rested
d. Limiting visitors, thus promoting the maximal amount of hours for sleep
ANS: D
The earliest sign of infection in an immunosuppressed patient can be a mild fever.
Mucositis, confusion, and depression are possible clinical manifestations but are
representative of less life-threatening complications. - 4. The nurse is caring for a
patient who received a recent bone marrow transplant. The nurse would monitor for
which of the following clinical manifestations that could indicate a potentially life-
threatening situation?
a. Mucositis
b. Confusion
c. Depression
d. Mild temperature elevation
ANS: B
Primary prevention of cancer involves avoidance to known causes of cancer, such as
sun exposure. Secondary screening involves physical and diagnostic examination. - 1.
Which of the following options should the nurse incorporate into the plan of care as a
primary prevention strategy for reduction of the risk for cancer?
,a. Yearly mammography for women aged 40 years and older
b. Using skin protection during sun exposure while at the beach
c. Colonoscopy at age 50 and every 10 years as follow-up
d. Yearly prostate-specific antigen (PSA) and digital rectal exam for men aged 50 and
over
ANS: A
Early colon cancer is often asymptomatic, with occult or frank blood in the stool being
an assessment finding in a patient diagnosed with colon cancer. If pain is present, it is
usually lower abdominal cramping. Constipation and diarrhea are more frequent
findings than nausea or ascites. - 2. While the nurse is collecting a health history on a
patient admitted for colon cancer, which of the following questions should the nurse ask
as a priority?
a. "Have you noticed any blood in your stool?"
b. "Have you been experiencing nausea?"
c. "Do you have back pain?"
d. "Have you noticed any swelling in your abdomen?"
ANS: D
Aging is a non-modifiable risk factor for the development of cancer with an associated
increase seen with aging. In terms of gender and age, lifetime risk is higher for males
than females. Family history of co-morbidities such as hypertension is not directly
correlated with cancer development. Cigarette smoking as a teenager for the patient is
a risk factor but may have mitigated impact at this point in time based on the patient's
stated age and length of time as a non-smoker. - 5. While the nurse is obtaining the
health history of a 75-year-old female patient, which of the following has the greatest
implication for the development of cancer?
a. Being a woman
b. Family history of hypertension
c. Cigarette smoking as a teenager
d. Advancing age
ANS: D
Common signs/symptoms of lung cancer include coughing, hemoptysis, and weight
loss, shortness of breath and chest pain. The nurse should expect to see weight loss
and altered breathing patterns. Clear sputum and orthostatic blood pressure changes
would not be seen. - 6. In caring for a patient admitted with lung cancer, which of the
following should the nurse expect to find on assessment?
a. No use of accessory muscles during respirations
b. Orthostatic hypotension upon change of positioning
c. Clear sputum
d. Weight loss compared to last admission
,ANS: A
A comprehensive health history is vital to treating and caring for the patient. Often
times, symptoms are vague. The nurse should conduct a symptom analysis to gather as
much information as possible. Questions should address the duration of the symptoms
and include
the location, characteristics, aggravating and relief factors, and any treatments taken
thus far. - 7. A female patient complains of a "scab that just won't heal" under her left
breast. During your conversation, she also mentions chronic fatigue, loss of appetite,
and slight cough, attributed to allergies. What is the nurse's best action?
a. Continue to conduct a symptom analysis to better understand the patient's symptoms
and concerns.
b. End the appointment and tell the patient to use skin protection during sun exposure.
c. Suggest further testing with a cancer specialist and provide the appropriate literature.
d. Tell her to put a bandage on the scab and set a follow-up appointment in 1 week.
ANS: B
A nurse should be aware of potential complications relative to hormonal therapy such as
the development of thrombus formation. Massaging a calf that is swollen and painful is
never correct, because this action might break a clot, causing formation of an embolus,
which could then travel to the lungs. - 8. A patient with prostate cancer is taking
hormonal therapy to control tumor growth. He reports that his left calf is swollen and
painful. Which of the following would be the nurse's best action?
a. Instruct the patient to keep the leg elevated.
b. Measure the calf circumference and compare the measurement with the right calf
circumference measurement.
c. Apply ice to the calf after a 10-minute massage of the area.
d. Document assessment findings as an expected response with estrogen therapy.
ANS: A
Individuals with a family history of breast cancer (especially 1st degree relatives) are at
increased risk for disease occurrence. The nurse should inform the patient of the
outcome measures of the screening plan. The nurse should not dissuade the patient
from the process based on stating there is no family history, as there is no evidence that
an adequate family history has been obtained. Similarly, to correlate the need for
genetic testing with insurance and no implied risk cannot be stated equivocally.
Although the decision is up to the patient in the final analysis, that response does not
address relevant information about the purpose of genetic screening. - 9. A patient
being evaluated for breast cancer is not certain whether she and her family should
participate in a genetic screening plan since no one can guarantee the results. What is
the nurse's best response?
a. "If you have a family history of breast cancer, the chances for you to have this type of
cancer increase."
b. "The decision is up to you in the final analysis."
, c. "If there is no family history, then there is no need to go through the process."
d. "If your insurance will pay for the screening, then there is no associated risk."
ANS: B
Examination findings relative to oncology patients and neoplastic growth manifest as
visible lesions, physical asymmetry, palpable masses, abnormal sounds or the
presence of blood on screening tests. A blood pressure of 130/88 is within normal range
as is a negative guaiac test. Observation of a previous goiter which is consistent with a
prior admission is not a concern. The detection of physical asymmetry as seen by a
difference in circumference should be reported to the physician. - 10. A nurse is
reviewing assessment findings for a female patient admitted to the oncology unit. Which
finding should alert the nurse to contact the physician?
a. Blood pressure 130/88
b. Noticeable difference in circumference of lower legs
c. Presence of goiter previously identified on prior admission
d. Negative guaiac test
ANS: B
A 10-pound weight loss in 1 month could indicate cancer or may be an indication of
further progression of memory loss. Depression is also another common cause of
weight loss. The use of a marked pillbox and planning by the family for 24-hour care are
appropriate for this patient. It is not unusual that an older patient would have friends
who have died. - 1. The home care nurse is reviewing an older patient diagnosed with
mild cognitive impairment (MCI) in the home setting. Which information is of concern?
a. The patient's son uses a marked pillbox to set up the patient's medications weekly.
b. The patient has lost 10 pounds (4.5 kg) during the last month.
c. The patient is cared for by a daughter during the day and stays with a son at night.
d. The patient tells the nurse that a close friend recently died.
ANS: D
This patient is at an increased risk for sarcopenia and should be instructed to increase
activity that includes strength training to prevent muscle loss. Diet is not indicated. A
BMI of 31 is considered obese; however, this patient does not qualify for surgical
intervention
until BMI reaches over 35. - 2. The nurse is assisting a 79-year-old patient with
information about diet and weight loss. The patient has a body mass index (BMI) of 31.
How should the nurse instruct this patient?
a. "Your weight is within normal limits. Continue maintaining with current lifestyle
choices."
b. "You are a little overweight. Cut down on calories and increase your activity, and you
should be fine."
c. "You are morbidly obese, and we would like to schedule you an appointment to speak
with a bariatric specialist about surgery."
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