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Nur356 > Exam IV > Flashcards

Exam IV Flashcards

1
Q

A nurse is caring for a client who has cancer and is scheduled for immediate chemotherapy. The client tells the nurse that she wants to try nontraditional treatments first. What response should the nurse make?
A. “Using nontraditional treatments is not a good idea. Id rather you avoid that route.”
B. “A lot of people think nontraditional treatments will work, and they find out too late that they made the wrong choice.”
C. “Your provider is ver knowledgeable. If he prescribes chemotherapy, its the best treatment for you.”
D. “Tell me more about your concerns about taking chemotherapy.”

A

D. Tell me more about your concerns about taking chemotherapy.

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2
Q

A nurse is caring for a client who has advanced lung cancer. The clients provide has recommended hospice services for the client. What statement by the client indicates a correct understanding of hospice care?
A. I will have to be admitted to a long-term care facility in order to receive hospice care.
B. I should expect the hospice team to help me manage my dyspnea.
C. Hospice care services are available to patients who are terminally ill regardless of their life expectancy.
D. My oncologist will continue to look for a cure for my cancer while I am receive hospice care.

A

B. “I should expect the hospice team to help me manage my dyspnea.”

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3
Q 
A nurse is reviewing the CBC findings for a female client who is receiving combination chemotherapy for breast cancer. What finding should the nurse report to the provider.
A. WBC 2300/mm3
B. RBC 5 million/mm3
C. Hemoglobin 12 g/dL
D. Platelets 155,000/mm3
A

A. WBC 2300/mm3

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4
Q 
A nurse is caring for a client who has cancer and a new prescription for ondansetron to treat chemotherapy-induced nausea. What adverse effects should the nurse monitor?
A. Headache
B. Dependent edema
C. Polyuria
D. Photosensitivity
A

A. Headache

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5
Q

A nurse is preparing a client who is to receive chemotherapy for treatment of ovarian cancer. What action should the nurse plan to take?
A. Tell the client to expect dark stools following chemotherapy.
B. Have the client floor 4x daily.
C. Have the client swish with commercial mouthwash before therapy.
D. Administer an antiemetic prior to the procedure.

A

D. Administer an antiemetic prior to the procedure.

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6
Q

A nurse is planning care for a client who is being treated with chemotherapy and radiation for metastatic breast cancer, and who has neutropenia. The nurse should include what restrictions in the client’s plan of care?
A. All visitors from entering the clients room
B. Fresh flowers and potted plants in the room
C. Oral fluid intake to between meals only
D. Activities that could result in bleeding

A

B. Fresh flowers and potted plants in the room (due to micro-organisms that are likely present on fresh flowers/plants, immunocompromised patients should not be around that)

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7
Q 
A nurse is caring for a client who is dying of metastatic breast cancer. She has a prescription for an opioid pain medication PRN. The nurse is concerned that administering a dose of pain medication might hasten the clients death. What ethical principles should the nurse use to support the decision not to administer the meds?
A. Utilitarianism
B. Nonmaleficence
C. Fidelity
D. Veracity
A

B. Nonmaleficence

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8
Q

A nurse is caring for a client who is to start chemotherapy for advanced breast cancer. She tells the nurse she is worried about the adverse effects of the treatment. What response should the nurse make?
A. I will have your provider discuss the adverse effects with you before the treatment begins.
B. Someone from the American Cancer Society will be here soon to answer your questions.
C. What is it about the adverse effects that concern you?
D. I agree. Sometimes the adverse effects can be worse than the disease.

A

C. What is it about the adverse effects that concern you?

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9
Q 
A client is receiving treatment for stage IV ovarian cancer and asks the nurse to discuss her prognosis. The client plans to have aggressive surgical, radiation, and chemotherapy treatments. What prognoses should the nurse discuss with the client?
A. Good
B. Guarded
C. Poor
D. Very good
A

C. Poor

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10
Q

A nurse is caring for a client who receives intermittent enteral feedings through an NG tube. Before administering a feeding, the nurse should measure the gastric residual for what purpose?
A. To confirm the placement of the NG tube
B. To remove gastric acid that might cause dyspepsia
C. To determine the clients electrolyte balance
D. To identify delayed gastric emptying

A

D. To identify deleted gastric emptying

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11
Q

How many calories are contained in a food item that has 15g of carbohydrates, 4g of protein, and 10g of fat?

A

166 cal (Carbs contain 4 cal per g 15x4=60, Proteins contain 4 cal per g 4x4=16, Fats contain 9 cal per g 10x9=90)

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12
Q 
A nurse is teaching a client who needs to increase their daily fluid intake. What food has the highest percentage of water by weight?
A. Yogurt
B. Milk
C. Lettuce
D. Honey
A

C. Lettuce

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13
Q

A charge nurse is observing a nurse auscultating a clients bowel sounds, What action requires intervention by the charge nurse?
A. Clamps the NG tube during auscultation
B. Performs auscultation between meals
C. Auscultates bowel sounds for 3-5 min
D. Palpates the abdomen prior to performing auscultation

A

D. Palpates the abdomen prior to performing auscultation

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14
Q 
A nurse is caring for a client who is receiving total parenteral nutrition (TPN). The pharmacy is delayed in supplying the clients next container of TPN. What fluid should the nurse infuse until the next container arrives?
A. Dextrose 5% in water
B. 0.9% sodium chloride
C. Dextrose 10% in water
D. Lactated Ringer's solution
A

C. Dextrose 10% in water

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15
Q

A nurse is completing a client assessment for admission to the medical unit. What abdominal assessment finding require further investigation by the nurse?
A. Symmetrical convex sphere shape
B. Concave umbilicus
C. Bilateral bowel sounds in lower quadrants
D. Ecchymosis

A

D. Ecchymosis

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16
Q 
A nurse is teaching a group of adults about nutrition. The nurse should include what amount as an appropriate daily intake of fiber for adult women?
A. 5-10 g
B. 10-15 g
C. 20-35 g
D. 40-50 g
A

C. 20-35 g

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17
Q 
A nurse is assessing a client who is receiving total parenteral nutrition (TPN). What finding should the nurse recognize as a complication of this therapy?
A. Hyperglycemia
B. Aspiration
C. Diarrhea
D. Stomatitis
A

A. Hyperglycemia

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18
Q 
A nurse is instructing a group of clients about nutrition. The nurse should include that what food is a good source of high-quality protein?
A. Soybeans
B. Grains
C. Legumes
D. Green vegetables
A

A. Soybeans

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19
Q 
A nurse is preparing a client for placement of a catheter for total parenteral nutrition. What access site should the nurse plan to prepare for catheter insertion?
A. Left antecubital vein
B. Right subclavian vein
C. Right femoral artery
D. Left arm radial artery
A

B. Right subclavian vein

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20
Q 
A nurse is caring for a client who has cancer and is receiving total parenteral nutrition (TPN). What lab value indicates the treatment is effective?
A. Hit 43%
B. WBC 8,000/uL
C. Albumin 4.2 g/dL
D. Calcium 9.4 mg/dL
A

C. Albumin 4.2 g/dL (indicates patient is receiving adequate amounts of protein)

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21
Q

A nurse is administering an IM injection to a client who has hepatitis C. Before placing the syringe and needle in a puncture-resistant container, what action should the nurse take?
A. Recap the needle.
B. Place the cap on the bedside table and slide the needle into the cap.
C. Wrap the needle with gauze.
D. Dispose of the needle uncapped.

A

D. Dispose of the needle uncapped.

22
Q 
A nurse is preparing to administer a dose of lactulose to a client who has cirrhosis. The client states, "I don't need this medication. I am not constipated." The nurse should explain that in clients who have cirrhosis, lactulose is used to decrease levels of what component in the bloodstream?
A. Glucose
B. Ammonia
C. Potassium
D. Bicarbonate
A

B. Ammonia

23
Q 
A nurse is assessing a client who has cirrhosis. What is an expected finding for this client?
A. Moist skin
B. Spider angiomas
C. Tarry stools
D. Blood in the urine
A

B. Spider angiomas (a lesion with a red center and numerous extensions that spread out like a spider web)

24
Q

A nurse is teaching self-management to a client who has hepatitis B. What instructions should the nurse include in the teaching?
A. You may donate blood 6 months after completing the medication regimen.
B. Consume a high-protein diet.
C. Rest frequently throughout the day.
D. Take acetaminophen every 4 hr, as needed, for discomfort.

A

C. Rest frequently throughout the day.

25
Q

A nurse is planning care for a client who has end-stage cirrhosis of the liver with encephalopathy. What interventions should the nurse plan to implement to decrease the clients ammonia level?
A. Administer diuretics.
B. Restrict the clients intake of fluids.
C. Reduce the clients intake of protein.
D. Administer vitamin K.

A

C. Reduce the clients intake of protein.

26
Q

A nurse is planning care for a client who has cirrhosis and ascites. What interventions should the nurse include in the plan of care?
A. Decrease the clients fluid intake.
B. Increase the clients saturated fat intake.
C. Increase the clients sodium intake.
D. Decrease the clients carbohydrate intake.

A

A. Decrease the clients fluid intake.

27
Q

A nurse is planning care for a client who has cirrhosis of the liver. What action should the nurse include in the plan? (SATA)
A. Administer furosemide.
B. Administer warfarin.
C. Implement a low-sodium diet.
D. Measure the clients abdominal girth.
E. Encourage weight lifting during physical therapy.

A

A, C, & D

28
Q 
A nurse is admitting a client who has hepatitis C. What precaution should the nurse implement?
A. Droplet
B. Contact
C. Airborne
D. Standard
A

D. Standard (blood-borne pathogen commonly spread by needle stick injury, sharing IV’s, or sexual contact.)

29
Q

A nurse is teaching a client who has hepatitis A about preventing transmission of the virus. What strategies should the nurse include in the teaching?
A. Avoid eating at fast food restaurants.
B. Avoid serving raw foods.
C. Practice effective hand hygiene.
D. Wear barrier protection during vaginal intercourse.

A

C. Practice effective hand hygiene.

30
Q 
A nurse is teaching a class about preventive care to clients who are at risk for acquiring viral hepatitis. What information should the nurse include in the presentation?
A. Avoid covering sores with bandages.
B. Avoid hand washing after eating.
C. Avoid foods prepared with tap water.
D. Avoid eating meat.
A

C. Avoid foods prepared with tap water.

31
Q

A nurse is teaching a client about self-administered peritoneal dialysis. What statement by the client indicates a need for further teaching?
A. “The fluid from my abdomen will be clear or slightly yellow.”
B. “The catheter can become infected even with sterile precautions.”
C. “The microwave in my kitchen can warm the solution before I use it.”
D. “The volume of the output solution should be greater than the input solution.”

A

C. The microwave in my kitchen can warm the solution before I use it.

32
Q

A nurse is providing teaching to a client about measures to prevent urinary tract infections (UTIs). What client statement indicates a need for further teaching?
A. “I will need to wipe my perineal area from back to front after urination.”
B. “I will need to empty my bladder regularly and completely.”
C. “I will need to drink apple cider vinegar each day.”
D. “I need to drink 8 cups of liquid each day.”

A

A. I will need to wipe my perineal area from back to front after urination.

33
Q

A nurse is assessing a client who has end-stage kidney disease and is receiving hemodialysis. What finding should the nurse identify as an indication the client is experiencing fluid overload?
A. The client has a 5lb weight gain since yesterday.
B. Flattened neck veins
C. Oxygen saturation 93%
D. Return of skin to previous position when the clients shin is palpated

A

A. The client has a 5lb weight gain since yesterday.

34
Q 
A nurse is discussing kidney transplant with a client who has end-stage renal disease (ESRD). What should the nurse identify as a contraindication for this treatment?
A. Breast cancer survivor for 8 yrs
B. Pacemaker
C. 65-years of age
D. Alcohol use disorder
A

D. Alcohol use disorder

35
Q 
A nurse is caring for a client who has end-stage renal disease (ESRD). What are expected findings? (SATA)
A. Slurred speech
B. Bone pain
C. Bradypnea
D. Pruritus
E. Hypotension
A

A, B, & D

36
Q

A nurse is caring for a client who has impaired renal function. What finding should the nurse notify the provider?
A. Urine output of 175 mL in the past 8 hr.
B. Urine output of 2,200 mL in the past 24 hr.
C. First-voided urine in the morning has a strong odor.
D. Urine is cloudy after sitting in the urinal for 6 hr.

A

A. Urine output of 175mL int hep ast 8 hr

37
Q

A nurse is teaching a client who has pre-dialysis end-stage kidney disease about diet. What instructions should the nurse include?
A. Increase intake of dietary phosphorous.
B. Eliminate foods high in protein from your diet.
C. Reduce intake of foods high in potassium.
D. Increase intake of sodium-containing food.

A

C. Reduce intake of foods high in potassium. (Potassium clearance is impaired in clients who have end-stage kidney disease)

38
Q

A nurse is teaching a client who has a UTI and is taking ciprofloxacin. What instructions should the nurse give to the client?
A. If the medicine causes an upset stomach, take an antacid at the same time.
B. Limit your daily fluid intake while taking this medication.
C. This medication can cause photophobia, so be sure to wear sunglasses outdoors.
D. You should report any tendon discomfort you experience while taking this medication.

A

D. You should report any tendon discomfort you experience while taking this medication.

39
Q 
A nurse is assessing a client who is experiencing prostatic hypertrophy. What finding associated with urinary retention should the nurse expect? (SATA)
A. Report of feeling pressure
B. Tenderness over symphysis pubis
C. Distended bladder
D. Voiding 30mL frequently
E. Dysuria
A

A, B, C, & D

40
Q 
A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. What lab results should the nurse review for an indication of a therapeutic effect of the medication?
A. The leukocyte count
B. The platelet count
C. The hematocrit (Hct)
D. The erythrocyte sedimentation rate
A

C. The hematocrit (Hct) (epoetin alfa is an antinomic med that is indicated in treatment of anemia due to reduced production of endogenous erythropoietin. this may occur in clients who have end-stage renal disease)

41
Q

A nurse is teaching a client who has acute kidney injury about the oliguric phase. What information should the nurse include in the teaching?
A. Renal function is reestablished.
B. BUN and creatinine levels decrease.
C. Urine output is less than 400 mL per 24 hr.
D. The glomerular filtration rate (GFR) recovers.

A

C. Urine output is less than 400 mL per 24 hr.

42
Q 
A nurse is caring for a client who has an indwelling urinary catheter and notes blood-tinged urine in the catheter bag. The nurse recognized this finding can be a manifestation of what urinary alteration?
A. Pernicious anemia
B. Dehydration
C. Prostate enlargement
D. Bladder infection
A

D. Bladder infection

43
Q 
A nurse is providing dietary teaching for a client who has just learned that she has type 2 diabetes mellitus. The nurse should explain that which of the following sweeteners will add calories to the clients carbohydrate count?
A. Sorbitol
B. Sucralose
C. Aspartame
D. Acesulfame potassium
A

A. Sorbitol (less elevation in blood glucose levels than sucrose does)

44
Q 
A nurse working for a home health agency is teaching is teaching a client who has diabetes mellitus about disease management. Which of the following glycosylated hemoglobin (HcA1c) values should the nurse include in the teaching as an indicator that the client is appropriately controlling his glucose levels?
A. 6.3%
B. 7.8%
C. 8.5%
D. 10%
A

A. 6.3% (6.5% or less)

45
Q 
A nurse is providing teaching to a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize the client understands the teaching when he identifies what manifestations of hypoglycemia? (SATA)
A. Polyuria
B. Blurred vision
C. Polydipsia
D. Tachycardia
E. Moist, clammy skin
A

B, D, & E

46
Q 
A nurse is caring for a client with type 1 diabetes mellitus who reports feeling shaky and having palpitations. When the nurse finds the clients blood glucose to be 48 mg/dL on the glucometer, he should give the client what?
A. Graham crackers
B. 1 tsp sugar
C. 4 oz diet soda
D. 4 oz skim milk
A

A. Graham crackers (nurse should give client 15 g of a rapid-caring, concentrated carb, i.e. 4oz of fruit juice, 8oz of skim milk, 3 tsp sugar or honey, 3 graham crackers or commercially prepared glucose tablets –> recheck glucose in 15 mins)

47
Q

A nurse is teaching a client who has type 1 diabetes mellitus about exercise. What instructions should the nurse include?
A. Perform vigorous exercise when blood glucose is less than 100 mg/dL.
B. Do not exercise if ketones are present in your urine.
C. Avoid eating for 2 hr before exercise.
D. Examine your feet weekly.

A

B. Do not exercise if ketones are present in your urine.

48
Q

A nurse is providing discharge teaching to the parents of a child who has a new diagnosis of diabetes mellitus. What statements by the parents indicates an understanding of the teaching?
A. “The onset of low blood glucose usually occurs slowly.”
B. “My son might complain of feeling shaky when he has a low blood glucose level.”
C. “Sweating can occur with hyperglycemia.”
D. “My son might have nausea and vomiting with hypoglycemia.”

A

D. “My son might have nausea and vomiting with hypoglycemia.”

49
Q 
A nurse is caring for a client who has type 1 diabetes mellitus. What recommendations should the nurse make to the client for a sweetener?
A. Corn syrup
B. Natural honey
C. Nonnutritive sugar substitute
D. Guava nectar
A

C. Nonnutritive sugar substitute (clients with type 1 diabetes should limit carb intake, this sugar allows clients to sweeten foods without increasing carb intake)

50
Q

A nurse is providing dietary teaching to a client who has nephropathy secondary to diabetes mellitus and plans to make dietary adjustments. What instructions should the nurse include?
A. Consume less than 45% of total calories from carbohydrates per day.
B. Eat no more than 300 mg of cholesterol per day.
C. Consume less than 0.8 g/kg of body weight of protein per day.
D. Eat at least 45 g of fiber per day.

A

C. Consume less than 0.8 g/kg of body weight of protein per day.

51
Q 
A nurse is reviewing the medication list for a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize what medication can cause glucose intolerance?
A. Ranitidine
B. Guaifenesin
C. Prednisone
D. Atorvastatin
A

C. Prednisone

52
Q

A nurse is caring for a client who has diabetes and plans to administer his regular insulin subcutaneously before he eats breakfast at 0800. After checking the clients morning glucose level, what action should the nurse take?
A. Give the insulin at 0700.
B. Give the insulin when the breakfast tray arrives.
C. Give the insulin 30 min after breakfast with the clients other routine medicines.
D. Give the insulin at 0730.

A

D. Give the insulin at 0730.

Nur356 (5 decks)

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