Exam 4 Messer Multiple Choice Practice Questions

Question 1

A patient with Hodgkin’s lymphoma who is undergoing external radiation therapy tells the nurse, “I am so tired I can hardly get out of bed in the morning.” Which intervention should the nurse add to the plan of care?

A) Minimize activity until the treatment is completed.
If we tell them this, they may just not do any activity at all
B) Establish time to take a short walk almost every day.
C) Consult with a psychiatrist for treatment of depression.
D) Arrange for delivery of a hospital bed to the patient’s home.

Answer 1

B) Establish time to take a short walk almost every day.

Question 2

A patient receiving head and neck radiation for larynx cancer has ulcerations over the oral mucosa and tongue and thick, ropey saliva. Which instructions should the nurse give to this patient?

A) Remove food debris from the teeth and oral mucosa with a stiff toothbrush.
B) Use cotton-tipped applicators dipped in hydrogen peroxide to clean the teeth.
C) Gargle and rinse the mouth several times a day with an antiseptic mouthwash.
Too painful!
D) Rinse the mouth before and after each meal and at bedtime with a saline solution.

Answer 2

D) Rinse the mouth before and after each meal and at bedtime with a saline solution.

Question 3

A patient has been assigned the nursing diagnosis of imbalanced nutrition: less than body requirements related to painful oral ulcers. Which nursing action will bemosteffective in improving oral intake?

A) Offer the patient frequent small snacks between meals.
B) Assist the patient to choose favorite foods from the menu.
C) Provide teaching about the importance of nutritional intake.
D) Apply prescribed anesthetic gel to oral lesions before meals.

Answer 3

B) Assist the patient to choose favorite foods from the menu.

Question 4

A widowed mother of four school-age children is hospitalized with metastatic ovarian cancer. The patient is crying and tells the nurse that she does not know what will happen to her children when she dies. Which response by the nurse ismostappropriate?

A) “Don’t you have any friends that will raise the children for you?”
B) “Would you like to talk about options for the care of your children?”
C) “For now you need to concentrate on getting well and not worrying about your children.”
D) “Many patients with cancer live for a long time, so there is time to plan for your children.”

Answer 4

B) “Would you like to talk about options for the care of your children?”

Question 5

A hospitalized patient who has received chemotherapy for leukemia develops neutropenia. Which observation by the nurse would indicate a need for further teaching?

A) The patient ambulates around the room.
B) The patient’s visitors bring in fresh peaches.
C) The patient cleans with a warm washcloth after having a stool.
D) The patient uses soap and shampoo to shower every other day.

Answer 5

B) The patient’s visitors bring in fresh peaches.

Question 6

The nurse reviews the laboratory results of a patient who is receiving chemotherapy. Which laboratory result ismostimportant to report to the health care provider?

A) Hematocrit 30%
B) Platelets 95,000/µL
C) Hemoglobin 10 g/L
D) White blood cells (WBC) 2700/µL

Answer 6

D) White blood cells (WBC) 2700/µL

Question 7

When caring for a patient who has pancytopenia, which action by unlicensed assistive personnel (UAP) indicates a need for the nurse to intervene?

A) The UAP assists the patient to use dental floss after eating.
B)The UAP adds baking soda to the patient’s saline oral rinses.
C) The UAP puts fluoride toothpaste on the patient’s toothbrush.
D) The UAP has the patient rinse after meals with a saline solution.

Answer 7

A) The UAP assists the patient to use dental floss after eating.

Question 8

The nurse supervises the care of a patient with a temporary radioactive cervical implant. Which action by unlicensed assistive personnel (UAP), if observed by the nurse, would require an intervention?

A) The UAP flushes the toilet once after emptying the patient’s bedpan.
B) The UAP stands by the patient’s bed for 30 minutes talking with the patient.
C) The UAP places the patient’s bedding in the laundry container in the hallway.
D) The UAP gives the patient an alcohol-containing mouthwash to use for oral care.

Answer 8

B) The UAP stands by the patient’s bed for 30 minutes talking with the patient.

• The patient is radioactive!
• Radiation precautions: Time, Distance, Protection
• Stay 6 feet away
• Wear a lead apron that covers the chest and thyroid

C) The UAP places the patient’s bedding in the laundry container in the hallway.
- This is actually wrong too, bedding should stay in the room.

Question 9

Which action should the nurse take when caring for a patient who is receiving chemotherapy and complains of problems with concentration?

A) Teach the patient to rest the brain by avoiding new activities.
B) Teach that “chemo-brain” is a short-term effect of chemotherapy.
C) Report patient symptoms immediately to the health care provider.
D) Suggest use of a daily planner and encourage adequate rest and sleep.

Answer 9

D) Suggest use of a daily planner and encourage adequate rest and sleep.

Question 10

After the change-of-shift report on the oncology unit, which patient should the nurse assess first?

A) Patient who has a platelet count of 82,000/µL after chemotherapy
B) Patient who has xerostomia after receiving head and neck radiation
C) Patient who is neutropenic and has a temperature of 100.5° F (38.1° C)
D) Patient who is worried about getting the prescribed long-acting opioid on time

Answer 10

C) Patient who is neutropenic and has a temperature of 100.5° F (38.1° C)

Question 11

A patient develops neutropenia after receiving chemotherapy. Which information about ways to prevent infection will the nurse include in the teaching plan? Select all that apply.

A) Cook food thoroughly before eating.
B) Choose low fiber, low residue foods.
C) Avoid public transportation such as buses.
D) Use rectal suppositories if needed for constipation.
E) Talk to the oncologist before having any dental work.

Answer 11

A) Cook food thoroughly before eating.
→ YES
B) Choose low fiber, low residue foods.
→ NO
C) Avoid public transportation such as buses.
→ YES
D) Use rectal suppositories if needed for constipation.
→ NO
E) Talk to the oncologist before having any dental work.
→ YES

Question 12

During a well-woman physical examination, a 43-yr-old patient asks about her risk for breast cancer. Which question ismostpertinent for the nurse to ask?

A) “Do you currently smoke tobacco?”
B)“Have you ever had a breast injury?”
C) “At what age did you start having menstrual periods?”
D) “Is there a family history of fibrocystic breast changes?”

Answer 12

C) “At what age did you start having menstrual periods?”

Question 13

A 53-yr-old woman who is experiencing menopause is discussing the use of hormone replacement therapy (HRT) with the nurse. Which information about the risk of breast cancer will the nurse provide?

A) HRT is a safe therapy for menopausal symptoms if there is no family history ofBRCAgenes.
B) HRT does not appear to increase the risk for breast cancer unless there are other risk factors.
C) The patient and her health care provider must weigh the benefits of HRT against the risks of breast cancer.
D) Natural herbs are as effective as estrogen in relieving symptoms without increasing the risk of breast cancer.

Answer 13

C) The patient and her health care provider must weigh the benefits of HRT against the risks of breast cancer.

Question 14

A 58-yr-old woman tells the nurse, “I understand that I have stage II breast cancer and I need to decide on a surgery, but I feel overwhelmed about the options. What do you think I should do?” Which response by the nurse isbest?

A) “I would have a lumpectomy, but you need to decide what is best for you.”
B) “Tell me what you understand about the surgical options that are available.”
C) “It would not be appropriate for me to make a decision about your health.”
D) “There is no need to make a decision rapidly; you have time to think about this.”

Answer 14

B) “Tell me what you understand about the surgical options that are available.”

Question 15

Which nursing action should be included in the plan of care for a patient returning to the surgical unit after a left modified radical mastectomy with dissection of axillary lymph nodes?

A) Obtain a permanent breast prosthesis before the patient is discharged from the hospital.
B) Teach the patient to use the ordered patient-controlled analgesia (PCA) every 10 minutes.
C) Post a sign at the bedside warning against venipunctures or blood pressures in the left arm.
D) Insist that the patient examine the surgical incision when the initial dressings are removed.

Answer 15

C) Post a sign at the bedside warning against venipunctures or blood pressures in the left arm.

Question 16

A patient diagnosed with breast cancer asks the nurse what “triple-negative” means. An accurate response from the nurse about triple-negative breast cancer should include which of the following?

A) the tumor is not likely to be responsive to hormone therapy.
B) HER-2 receptor testing was repeated for a total of three samples.
C) treatment with chemotherapy is not likely to be recommended.
D) estrogen receptor testing identified the three hormones causing cancer.

Answer 16

A) the tumor is not likely to be responsive to hormone therapy.

Question 17

Which information should the nurse include in teaching a patient who is scheduled for external beam radiation to the breast?
A) The radiation therapy will take a week to complete.
B) Careful skincare in the radiated area will be necessary.
C) Visitors should have minimal exposure to patient until patient has completed all their radiation.
D) Wigs may be used until the hair regrows after radiation therapy.

Answer 17

B) Careful skincare in the radiated area will be necessary.

Question 18

When the nurse is working in the women’s health care clinic, which action is appropriate to take?

A) Teach a healthy 30-yr-old patient about the need for an annual mammogram.
B) Discuss scheduling an ultrasound with a 22-year-old patient who is at average risk of breast cancer.
C) Explain to a 60-yr-old patient that mammography frequency can be reduced to every 5 years.
D) Teach a 28-yr-old patient with aBRCA-1mutation about magnetic resonance imaging (MRI).

Answer 18

D) Teach a 28-yr-old patient with aBRCA-1mutation about magnetic resonance imaging (MRI).

Question 19

Which action will the nurse include in the plan of care for a patient with right arm lymphedema?

A) Avoid isometric exercise on the right arm.
B) Assist with the application of a compression sleeve.
C) Keep the right arm at or below the level of the heart.
D) Check blood pressure (BP) on both right and left arms.

Answer 19

B) Assist with the application of a compression sleeve.

Question 20

What is the best snack for an individual with GERD?

A) Orange juice and a granola bar.
B) Flavored seltzer water & some almonds.
D) Chocolate chip protein bar and water.
E) Almond butter w/ a banana & apple juice.
F) Pizza bites and milk.

Answer 20

E) Almond butter w/ a banana & apple juice.

no-bubbly can be irritating for GERD

Question 21

What is each a symptom of/associated with?
(Gastritis, GERD, or PUD)

A) Patient reports frequent belching, sometimes with an acid taste in the mouth.
B) Gnawing, burning sensation in the abdomen that is accompanied by nausea and relieved by food.
C) Patient reports excess saliva.
D) Patient diagnosed with pernicious anemia.

Answer 21

A) Patient reports frequent belching, sometimes with an acid taste in the mouth.
→ GERD
B) Gnawing, burning sensation in the abdomen that is accompanied by nausea and relieved by food.
→ Duodenal ulcer
C) Patient reports excess saliva.
→ GERD (Water Brash)
D) Patient diagnosed with pernicious anemia.
→ CHRONIC Gastritis

Question 22

Which of the following lab values would a nurse expect to be associated with diverticulitis?
A) Elevated Hemoglobin
B) Elevated BUN
C) Elevated CRP
D) Elevated WBCs
E) Low Platelets
F) Low BNP
G) Elevated Creatinine

Answer 22

C) Elevated CRP

D) Elevated WBCs

Question 23

A patient is experiencing diverticulitis and states he is continuing to eat a high fiber diet and “hopes this will pass soon.” Which of the following statements from the nurse is most helpful for this patient?
A) A high fiber diet is really helpful when you have diverticulosis.
B) You will want to avoid high fiber foods until your inflammation resolves, then you can slowly add back fiber.
C) High fiber diets during diverticulitis can cause bowel perforation and even death.
D) You should consider adding intermittent fasting to this diet.

Answer 23

B) You will want to avoid high fiber foods until your inflammation resolves, then you can slowly add back fiber.