Nurse Competency Quiz 02/14/2014

1. 5. A nurse is discharging a client to home after the client received a round of chemotherapy. The client states "I am glad to be going home so that I can continue my herbal remedy for nausea." The best response by the nurse is:

Tell me what herbal remedies you are planning on taking. Then we can discuss their safety with your physician.

I think herbal therapies are an excellent way to control nausea related to chemotherapy.

Be sure to research the herbal therapies with the salesperson at the health food store before you start taking them.

Herbal therapies are safe and effective for everyone. I do not know why physicians do not use them more.

The nurse's best response is to ask the client about the specific herbal remedies they plan on taking and then discuss their safety with the physician. This response shows the nurse's concern for the client's well-being and acknowledges the client's interest in using herbal remedies. By involving the physician in the discussion, the nurse ensures that the client's safety is prioritized and that any potential interactions or side effects can be addressed.

Explanation

The nurse's best response is to ask the client about the specific herbal remedies they plan on taking and then discuss their safety with the physician. This response shows the nurse's concern for the client's well-being and acknowledges the client's interest in using herbal remedies. By involving the physician in the discussion, the nurse ensures that the client's safety is prioritized and that any potential interactions or side effects can be addressed.

2. A patient with small cell lung cancer has a four-pound weight gain, headache, and excessive thirst. These symptoms indicate:

A. Tumor lysis syndrome

B. Hemolytic uremic syndrome

C. Neoplastic cardiac tamponade

D. Syndrome of inappropriate antidiuretic hormone

Rationale:
Small cell lung cancer accounts for 80% of syndrome of inappropriate antidiuretic hormone syndrome (SIADH) cases. Signs and symptoms include thirst, weight gain, lethargy, headache, anorexia, muscle cramps, and weakness.

Explanation

Rationale:
Small cell lung cancer accounts for 80% of syndrome of inappropriate antidiuretic hormone syndrome (SIADH) cases. Signs and symptoms include thirst, weight gain, lethargy, headache, anorexia, muscle cramps, and weakness.

3. A patient newly diagnosed with cancer tells the nurse, "The doctor ordered all of these tests for clinical staging. What does that mean?" The nurse's best response is based on the knowledge that staging:

A. Predicts response to treatment

B. Compares treatment results across populations

C. Assesses the usual patterns of spread of specific cancers

D. Evaluates the extent of local and potential metastatic disease

Rationale:
The primary purpose for staging is to provide optimal treatment selection and planning for each individual patient. Staging systems include clinical, surgical, pathology and biochemical determinants to define the extent of disease and direct treatment of the individual. Staging does not directly predict response to treatment, assess patterns of spread, nor compare results across a population.

Explanation

Rationale:
The primary purpose for staging is to provide optimal treatment selection and planning for each individual patient. Staging systems include clinical, surgical, pathology and biochemical determinants to define the extent of disease and direct treatment of the individual. Staging does not directly predict response to treatment, assess patterns of spread, nor compare results across a population.

4. 8. A client receiving chemotherapy states that everything she tries to eat does not taste good. The nurse explains that this is a side effect of chemotherapy and the client can perform which of the following to decrease this symptom.

Eat spicy foods to camouflage the taste.

Frequently perform mouth care.

Drink sips of water between every mouth of food.

Use commercial mouth wash before each meal.

Chemotherapy can cause changes in taste buds, resulting in a metallic or bitter taste in the mouth. Frequent mouth care, such as brushing teeth and rinsing with mouthwash, can help to alleviate this symptom. It can help to remove any lingering taste and maintain oral hygiene, which may improve the client's ability to taste food. Eating spicy foods, drinking water between bites, or using mouthwash before meals may not directly address the issue of taste changes caused by chemotherapy.

Explanation

Chemotherapy can cause changes in taste buds, resulting in a metallic or bitter taste in the mouth. Frequent mouth care, such as brushing teeth and rinsing with mouthwash, can help to alleviate this symptom. It can help to remove any lingering taste and maintain oral hygiene, which may improve the client's ability to taste food. Eating spicy foods, drinking water between bites, or using mouthwash before meals may not directly address the issue of taste changes caused by chemotherapy.

5. In addition to decreasing inflammation, corticosteroids:

A. Improve muscle tone

B. Stimulate weight loss

C. Stimulate the appetite

D. Reduce anxiety

Rationale:
Corticosteroids, such as dexamethasone and prednisone can stimulate the appetite. Additionally, this class of medications can create a sense of well-being, and may cause weight gain.

Explanation

Rationale:
Corticosteroids, such as dexamethasone and prednisone can stimulate the appetite. Additionally, this class of medications can create a sense of well-being, and may cause weight gain.

6. 7. A client is to start chemotherapy next week for ovarian cancer. The nurse knows the client understands teaching concerning alopecia when the client states:

I can't wait to get a tan on the top of my head.

I know my hair will fall out but, it will grow back just as it is now after the chemotherapy.

I know my hair will not fall out, because I have been using a mild shampoo.

I have decided to have my hair cut short tomorrow. I already bought my wig.

The client's statement of having her hair cut short and already buying a wig indicates that she understands that chemotherapy will cause her hair to fall out. This demonstrates her acceptance and preparation for the side effect of alopecia, showing that she has grasped the teaching about the potential hair loss and has taken proactive measures to cope with it.

Explanation

The client's statement of having her hair cut short and already buying a wig indicates that she understands that chemotherapy will cause her hair to fall out. This demonstrates her acceptance and preparation for the side effect of alopecia, showing that she has grasped the teaching about the potential hair loss and has taken proactive measures to cope with it.

7. 4. The nurse is teaching a client proper skin care for external radiation treatments. The nurse knows the client understands when the client states:

I will wash the area daily with betadine solution.

I will keep the area covered with an occlusive dressing.

I will wear clothing that does not place pressure on the area.

I will apply my usual dry skin lotion to the area.

The client's statement of wearing clothing that does not place pressure on the area demonstrates understanding of proper skin care for external radiation treatments. This is because radiation therapy can cause skin sensitivity and irritation, and wearing loose-fitting clothing helps to minimize friction and pressure on the treated area, reducing the risk of further skin damage.

Explanation

The client's statement of wearing clothing that does not place pressure on the area demonstrates understanding of proper skin care for external radiation treatments. This is because radiation therapy can cause skin sensitivity and irritation, and wearing loose-fitting clothing helps to minimize friction and pressure on the treated area, reducing the risk of further skin damage.

8. Which of the following is prescribed for a patient diagnosed with surgically unresectable renal cell carcinoma that has metastasized to the liver?

A. Fluorouracil (5-FU)

B. Temsirolimus (Torisel)

C. Nilotinib (Tasigna)

D. Cetuximab (Erbitux)

Rationale:
About 30% of individuals with renal cell cancer present with metastasis at the time of diagnosis. Chemotherapy has not demonstrated a response in renal cell carcinoma, but various biological therapies have, including temsiroliums.

Explanation

Rationale:
About 30% of individuals with renal cell cancer present with metastasis at the time of diagnosis. Chemotherapy has not demonstrated a response in renal cell carcinoma, but various biological therapies have, including temsiroliums.

9. 11. The goal of each chemotherapy treatment is to:

Eradicate all of the cancer cells

Eradicate all the actively proliferating cells in the body

Eradicate the wall of the cancerous tumor

Eradicate a percentage of the cancer cells

The goal of each chemotherapy treatment is to eradicate a percentage of the cancer cells. Chemotherapy works by using drugs to kill or slow down the growth of cancer cells. It is not always possible to completely eradicate all the cancer cells with chemotherapy, especially in advanced stages of cancer. The treatment aims to reduce the tumor size, control the spread of cancer, and improve the patient's quality of life.

Explanation

The goal of each chemotherapy treatment is to eradicate a percentage of the cancer cells. Chemotherapy works by using drugs to kill or slow down the growth of cancer cells. It is not always possible to completely eradicate all the cancer cells with chemotherapy, especially in advanced stages of cancer. The treatment aims to reduce the tumor size, control the spread of cancer, and improve the patient's quality of life.

10. What blood pressure classification would 120/80 be catagorized in?

Normal

Pre-hypertensive

Hypertensive 3

None of the above

A blood pressure of 120/80 mmHg is classified as normal. The top number (systolic) is the pressure when your heart beats, while the bottom (diastolic) is the pressure when your heart rests. This reading indicates healthy blood flow and a lower risk of heart problems. However, individual ranges vary, so it's crucial to monitor your blood pressure and consult your doctor for personalized advice. Sources and related content

Explanation

A blood pressure of 120/80 mmHg is classified as normal. The top number (systolic) is the pressure when your heart beats, while the bottom (diastolic) is the pressure when your heart rests. This reading indicates healthy blood flow and a lower risk of heart problems. However, individual ranges vary, so it's crucial to monitor your blood pressure and consult your doctor for personalized advice. Sources and related content

11. 15. A nurse is caring for a client wth thrombocytopenia. Which of the followng should be included in the client's plan of care? Check all that apply.

Monitor platelet counts

Assess the patient for melena

Monitor WBC counts

Monitor the patient for hematemesis

Thrombocytopenia is a condition characterized by low platelet counts, which can lead to an increased risk of bleeding. Monitoring platelet counts is important to assess the severity of thrombocytopenia and guide treatment. Melena is a symptom of gastrointestinal bleeding and can indicate bleeding in the upper gastrointestinal tract, which can be a complication of thrombocytopenia. Hematemesis is another symptom of gastrointestinal bleeding and should be monitored in patients with thrombocytopenia. Monitoring WBC counts is not directly related to thrombocytopenia and is not necessary in the client's plan of care.

Explanation

Thrombocytopenia is a condition characterized by low platelet counts, which can lead to an increased risk of bleeding. Monitoring platelet counts is important to assess the severity of thrombocytopenia and guide treatment. Melena is a symptom of gastrointestinal bleeding and can indicate bleeding in the upper gastrointestinal tract, which can be a complication of thrombocytopenia. Hematemesis is another symptom of gastrointestinal bleeding and should be monitored in patients with thrombocytopenia. Monitoring WBC counts is not directly related to thrombocytopenia and is not necessary in the client's plan of care.

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12. A fellow nurse has asked you to activate a code 99. You go to the hospital telephone in the mixing room next to JP's computer and dial what number?

Dialing *86 on the hospital telephone in the mixing room next to JP's computer will activate a code 99 as requested by the fellow nurse.

Explanation

Dialing *86 on the hospital telephone in the mixing room next to JP's computer will activate a code 99 as requested by the fellow nurse.

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