196 Nursezone Med-surg Nursing Final Coaching (By Doc Tacs) Part 1 (36 To 60)

25 Questions | Total Attempts: 46

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196 Nursezone Med-surg Nursing Final Coaching (By Doc Tacs) Part 1 (36 To 60)

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Questions and Answers
  • 1. 
    SITUATION: Cancer in the genito-urinary tract is a growing concern. Adequate knowledge is expected from the nurse regarding these conditions   The most common initial nursing finding among clients with bladder cancer is:
    • A. 

      Painless hematuria

    • B. 

      Change in voiding pattern

    • C. 

      Abrupt weight gain

    • D. 

      Weakness

  • 2. 
    SITUATION: Cancer in the genito-urinary tract is a growing concern. Adequate knowledge is expected from the nurse regarding these conditions   A client with bladder cancer undergoes chemotherapy. The nurse understands that chemotherapy is needed to:
    • A. 

      Eliminate the need for surgery

    • B. 

      Augment the treatment regimen

    • C. 

      Reduce pain and anxiety before surgery

    • D. 

      Sterilize the bowel before surgery

  • 3. 
    SITUATION: Cancer in the genito-urinary tract is a growing concern. Adequate knowledge is expected from the nurse regarding these conditions   The nurse should include which of the following points in the preop teaching of a client with bladder cancer?
    • A. 

      The need to perform stoma self-care immediately after surgery

    • B. 

      The need to remain on bed rest for 3 days following surgery

    • C. 

      The procedure creates a stoma and he must wear a pouch afterward

    • D. 

      The patient will be able to control urine passage through the stoma

  • 4. 
    SITUATION: Cancer in the genito-urinary tract is a growing concern. Adequate knowledge is expected from the nurse regarding these conditions   Which nursing intervention best prevents urinary tract infections in a person who has an ileal conduit?
    • A. 

      Allowing the bag to fill completely

    • B. 

      Attaching a larger bag at night

    • C. 

      Restricting fluids to less than 1000 ml daily

    • D. 

      Changing the appliance every 8 hours

  • 5. 
    SITUATION: Cancer in the genito-urinary tract is a growing concern. Adequate knowledge is expected from the nurse regarding these conditions   A client with benign prostatic hypertrophy has been started on Proscar (finasteride). The nurse’s discharge teaching should include:
    • A. 

      Telling the client’s wife not to touch the tablets

    • B. 

      Explaining that the medication should be taken with meals

    • C. 

      Telling the client that symptoms will improve in 1 to 2 weeks

    • D. 

      Instructing the client to take the medication at bedtime, to prevent nocturia

  • 6. 
    SITUATION: Cancer in the genito-urinary tract is a growing concern. Adequate knowledge is expected from the nurse regarding these conditions   The nurse is caring for a client hospitalized with nephritic syndrome. Based on the client’s treatment, the nurse should:
    • A. 

      Limit the number of visitors

    • B. 

      Provide a low-protein diet

    • C. 

      Discuss the possibility of dialysis

    • D. 

      Offer the client additional fluids

  • 7. 
    SITUATION: Cancer in the genito-urinary tract is a growing concern. Adequate knowledge is expected from the nurse regarding these conditions   The nurse caring for a client in shock recognizes that the glomerular filtration rate of the kidneys will fall if the client’s mean arterial pressure falls bellow:
    • A. 

      140

    • B. 

      120

    • C. 

      100

    • D. 

      80

  • 8. 
    SITUATION: Cancer in the genito-urinary tract is a growing concern. Adequate knowledge is expected from the nurse regarding these conditions   During morning assessments, the nurse finds that a client’s nephrostomy tube has been clamped. The nurse’s first action should be to:
    • A. 

      Assess the drainage bag

    • B. 

      Check for bladder distention

    • C. 

      Unclamp the tubing

    • D. 

      Irrigate the tubing

  • 9. 
    SITUATION: Cancer in the genito-urinary tract is a growing concern. Adequate knowledge is expected from the nurse regarding these conditions   A patient hospitalized with acute glomerulonephritis has a positive ASO titer. The nurse understands that the client’s current illness is due to a:
    • A. 

      History of uncontrolled hypertension

    • B. 

      Prior bacterial infection

    • C. 

      Prolonged elevation in blood glucose

    • D. 

      Drug reaction that led to muscle breakdown

  • 10. 
    SITUATION: Cancer in the genito-urinary tract is a growing concern. Adequate knowledge is expected from the nurse regarding these conditions   A client is admitted to the hospital with benign prostatic hyperplasia, the nurse most relevant assessment would be:
    • A. 

      Flank pain radiating in the groin

    • B. 

      Distention of the lower abdomen

    • C. 

      Perineal edema

    • D. 

      Urethral discharge

  • 11. 
    SITUATION: Cancer in the genito-urinary tract is a growing concern. Adequate knowledge is expected from the nurse regarding these conditions   A client is admitted to the surgical unit following a transurethral prostatectomy (TURP). The nurse administers a B&O suppository to help prevent bladder spasms. The nurse would observe the client for:
    • A. 

      Insomnia and hyperactivity

    • B. 

      Physiological dependence on the drug

    • C. 

      Nausea and vomiting

    • D. 

      Diarrhea and abdominal cramping

  • 12. 
    SITUATION: Cancer in the genito-urinary tract is a growing concern. Adequate knowledge is expected from the nurse regarding these conditions   A 62 year old male patient had surgery for inguinal hernia repair 8 hours ago. He has not voided. What nursing intervention can help him void?
    • A. 

      Assist him to stand at the bedside

    • B. 

      Place his hands in warm water

    • C. 

      Pour cool water over his perineum

    • D. 

      Turn the water faucet on and let it run

  • 13. 
    SITUATION: Cancer in the genito-urinary tract is a growing concern. Adequate knowledge is expected from the nurse regarding these conditions   A client has undergone with penile implant. After 24 hours of surgery, the client’s scrotum was edematous and painful. The nurse should:
    • A. 

      Assist the client with sitz bath

    • B. 

      Apply war soaks in the scrotum

    • C. 

      Elevate the scrotum using a soft support

    • D. 

      Prepare for a possible incision and drainage

  • 14. 
    SITUATION: Cancer in the genito-urinary tract is a growing concern. Adequate knowledge is expected from the nurse regarding these conditions   The nurse assesses which signs and symptoms in a client diagnosed with uterine leiomyoma?
    • A. 

      Pelvic pain and dysmenorrhea

    • B. 

      Fatigue and mood swings

    • C. 

      Inguinal lymphadenopathy

    • D. 

      Lower abdominal pain and fever

  • 15. 
    SITUATION: Cancer in the genito-urinary tract is a growing concern. Adequate knowledge is expected from the nurse regarding these conditions   The nurse would suspect endometriosis in a client who manifests which of the following?
    • A. 

      Pre and postmenstrual dysmenorrheal and abnormal uterine bleeding

    • B. 

      Foul-smelling vaginal discharge with vulvar ulceration

    • C. 

      Yellow, frothy discharge with red excoriated vulva and vagina

    • D. 

      Abnormal pap smear findings and chronic erosions of the cervix

  • 16. 
    SITUATION: A patient is brought to the Oncology unit from the PACU after a Left MRM due to inflammatory breast cancer (IBC). There was a pressure dressing over the surgical site and two drains. Vital signs are stable and patient is fully awake and pain is under control   From the following data, which is not a risk factor for breast cancer?
    • A. 

      Age: 55

    • B. 

      Height: 5’2”, weight 160: lbs

    • C. 

      Menarche at age 13

    • D. 

      Mother died of colon cancer

  • 17. 
    SITUATION: A patient is brought to the Oncology unit from the PACU after a Left MRM due to inflammatory breast cancer (IBC). There was a pressure dressing over the surgical site and two drains. Vital signs are stable and patient is fully awake and pain is under control   The nurse read a literature that says by the time inflammatory breast cancer is diagnosed, 50% to 75% have palpable axillary nodes; as many as 30% have gross distant metastasis, and as few as 30% have underlying breast mass. Which of the following is the appropriate interpretation of this research finding?
    • A. 

      Axillary nodes were palpated on 20 out of 30 women positive for IBC

    • B. 

      Out of 20 women who were positive for IBC, only 5 has metastasis

    • C. 

      If there were 10 women diagnosed with IBC, 3 have positive lymph nodes

    • D. 

      Breast mass was identified on 8 out of 30 women positive for IBC

  • 18. 
    SITUATION: A patient is brought to the Oncology unit from the PACU after a Left MRM due to inflammatory breast cancer (IBC). There was a pressure dressing over the surgical site and two drains. Vital signs are stable and patient is fully awake and pain is under control   The nurse recognizes that adjuvant chemotherapy for breast cancer may involve any of the following, except:
    • A. 

      Monoclonal antibodies

    • B. 

      Antibiotics

    • C. 

      Proton inhibitors

    • D. 

      Antiestrogen

  • 19. 
    SITUATION: A patient is brought to the Oncology unit from the PACU after a Left MRM due to inflammatory breast cancer (IBC). There was a pressure dressing over the surgical site and two drains. Vital signs are stable and patient is fully awake and pain is under control   The nurse understands that when the antineoplastic agent leaks through the peripheral vascular access during a chemotherapy session which of the following is expected to be done first?
    • A. 

      Refer to the physician

    • B. 

      Stop the chemotherapy infusion

    • C. 

      Cleanse the site with saline solution

    • D. 

      Call another nurse to check the intravenous site

  • 20. 
    SITUATION: A patient is brought to the Oncology unit from the PACU after a Left MRM due to inflammatory breast cancer (IBC). There was a pressure dressing over the surgical site and two drains. Vital signs are stable and patient is fully awake and pain is under control   A clinical trial is currently being undertaken to test treatments for IBC. The research team leader wishes to include the patient as a participant in this study. As a patient advocate, which of the following will the nurse do first?
    • A. 

      Obtain informed consent from the patient

    • B. 

      Explain to the patient the scope of the clinical trial

    • C. 

      Inquire from the team leader benefits for the patient

    • D. 

      Read more related literatures

  • 21. 
    SITUATION: You are caring for Novie, 58 year old male, who is diagnosed with laryngeal cancer   Novie, who is scheduled for a total laryngectomy and radical neck dissection for cancer of the larynx asks you, “How will I talk after the surgery?” Which will be the best response?
    • A. 

      “You will breathe through a permanent opening in your neck, but you will not be able to communicate orally”

    • B. 

      “You won’t be able to talk right after surgery, but you will be able to speak again once the tracheostomy tube is removed”

    • C. 

      “You will have a permanent opening into your neck, and you will need to have rehabilitation for some type of voice restoration”

    • D. 

      “You won’t be able to speak as you used to, but there are artificial voice devices that will give you the ability to speak normally”

  • 22. 
    SITUATION: You are caring for Novie, 58 year old male, who is diagnosed with laryngeal cancer   Novie returns from surgery with a tracheostomy tube after a total laryngectomy and radical neck dissection. In caring for Novie during the first 24 hours after surgery, the priority nursing action is to:
    • A. 

      Avoid changing the tracheostomy ties

    • B. 

      Monitor for bleeding around the stoma

    • C. 

      Assess the airway patency and breath sounds

    • D. 

      Clean the inner cannula every 8 hours

  • 23. 
    SITUATION: You are caring for Novie, 58 year old male, who is diagnosed with laryngeal cancer   After doing assessment, one of the nursing diagnosis identified is “Body image disturbance related to loss of control of personal care.” To evaluate effectiveness of the interventions, the expected outcome for the problem that Novie should demonstrate is that he:
    • A. 

      Lets his wife provide hygiene and stoma care

    • B. 

      Wears clothing that minimizes the disfigurement caused by the surgery

    • C. 

      Asks that only family members be allowed to visit

    • D. 

      Learns to remove and clean the laryngectomy tube independently

  • 24. 
    SITUATION: You are caring for Novie, 58 year old male, who is diagnosed with laryngeal cancer   Novie is scheduled to start radiation therapy. You have just taught Novie all about radiation therapy. Which of the following statements by Novie would indicate that your teaching has been effective?
    • A. 

      “I can use lotions to moisturize the skin on my throat”

    • B. 

      “I will need to buy a water bottle to carry with me”

    • C. 

      “I need to use alcohol-based mouthwashes to help clean oral ulcers”

    • D. 

      “I may experience diarrhea, until the radiation is complete”

  • 25. 
    SITUATION: You are caring for Novie, 58 year old male, who is diagnosed with laryngeal cancer   After completing the discharge instructions for Novie, you determine that additional instruction is needed when he says:
    • A. 

      “I can participate in most of my prior fitness activities except swimming”

    • B. 

      “I should wear a medical alert bracelet that identifies me as a neck breather”

    • C. 

      “I must keep the stoma covered with a loose sterile dressing at all times”

    • D. 

      “I need to eat nutritious meals even though I can’t smell or taste very well”

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