Nursing 101: Actual Exam Questions with Correct Answers, Exams of Nursing

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A client with squamous cell carcinoma of the lung comes to the emergency department reporting shortness of breath and respiratory difficulty. On assessment, the nurse notes generalized cyanosis and edema of the face and arms. Based on this assessment, the nurse suspects the client is probably experiencing which of the following? * 1 point a. Spinal cord syndrome (SCS) b. Syndrome of Inappropriate Antidiuretic Hormone (SIADH) c. Superior Vena Cava Syndrome (SVCS) d. Tumor Lysis Syndrome (TLS) As part of chemotherapy education, the nurse teaches a female client about the risk for bleeding and self-care during the period of greatest bone marrow suppression (the nadir). The nurse understands that further teaching is needed if the client makes which statement? * 1 point

1. “I should avoid blowing my nose.”
2. “I may need a platelet transfusion if my platelet count is too low.”
3. “I’m going to take aspirin for my headache as soon as I get home.”
4. “I will count the number of pads and tampons I use when menstruating.” Which nursing diagnosis should a nurse plan to document for the client with gastric cancer experiencing hematemesis? * 1 point a. Impaired oral mucous membrane b. Decreased cardiac output c. Impaired gas exchange d. Fluid volume deficit A patient's most recent diagnostic imaging has revealed that his lung cancer has metastasized to his bones and liver. What is the most likely mechanism by which the patient's cancer cells spread? * 1 point a. Hematologic spread b. Lymphatic circulation c. Invasion d. Angiogenesis

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Priority Decision: The patient with advanced cancer is having difficulty controlling her pain. She says she is afraid she will become addicted to the opioids. What is the first thing the nurse should do for this patient? * 1 point a. Administer a nonsteroidal antiinflammatory drug. b. Assess the patient’s vital signs and behavior to determine the medication to use. c. Have the patient keep a pain diary to better assess the patient’s potential addiction. d. Obtain a detailed pain history including quality, location, intensity, duration, and type of pain A client is brought to the surgical unit after a suprapubic prostatectomy. He has a three-way Foley catheter. The nurse notices a very dark red output via the catheter. What is the appropriate nursing intervention? * 1 point a.Report the finding immediately to the physician. b.Increase the irrigation flow rate. c.Check the latest hemoglobin and hematocrit count. d.Chart the observation in the medical record. A nurse is reviewing the health record of a client who has suspected ovarian cancer. Which of the following findings supports this diagnosis? (Select all that apply.) * 5 points A. Previous treatment for endometriosis B. Family history of colon cancer C. First pregnancy at age 24 D. Report of scant menses E. Use of oral contraceptives for 10 years The nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which would the nurse expect to note specifically in this disorder? * 1 point

1. Increased calcium level
2. Increased white blood cells
3. Decreased blood urea nitrogen level
4. Decreased number of plasma cells in the bone marrow

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Computed tomography of a 72-year-old woman reveals lung cancer with metastasis to the liver. The patient's son has been adamant that any “bad news” be withheld from his in order to protect her from

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stress, stating that this is a priority in his culture. How should the nurse and the other members of the care team best respond? * 1 point a.Explain to the son the team's ethical obligation to inform the patient. b.Refer the family to social work. c.Have a nurse or physician from the patient's culture make contact with her and her son. d.Speak with the son to explore his rationale and attempt to reach a consensus. The nurse is assessing a client who has a new ureterostomy. Which statement by the client indicates the need for more education about urinary stoma care? * 1 point

1. “I change my pouch every week.”
2. “I change the appliance in the morning.”
3. “I empty the urinary collection bag when it is two-thirds full.”
4. “When I’m in the shower I direct the flow of water away from my stoma.” During a health promotion seminar for senior citizens, a seminar participant asks a nurse to discuss symptoms of gastric cancer. A nurse’s response should be based on the knowledge that: * 1 point a.Cancers that do not penetrate the gastric muscular layer are asymptomatic in the majority of clients. b.Pain from early gastric cancer lesions cannot be reduced by over-the-counter (OTC) histamine receptor antagonists. c.Unexplained weight gain and increased body mass index are early symptoms of gastric cancer. d.Anemia is uncommon in gastric cancer, but if it occurs it is likely due to the effects of aging. The nurse is instructing a client to perform a testicular self-examination (TSE). The nurse should provide the client with which information about the procedure? * 1 point
5. To examine the testicles while lying down
6. That the best time for the examination is after a shower
7. To gently feel the testicle with 1 finger to feel for a growth
8. That TSEs should be done at least every 6 months

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A client with carcinoma of the lung develops syndrome of inappropriate antidiuretic hormone(SIADH) as a complication of the cancer. The nurse anticipates that the health care provider will request which prescriptions? Select all that apply. * 5 points

1. Radiation
2. Chemotherapy
3. Increased fluid intake
4. Decreased oral sodium intake
5. Serum sodium level determination
6. Medication that is antagonistic to antidiuretic hormone A client with lung cancer is scheduled for a lobectomy. The nurse prepares the client to expect which of the following? * 1 point a.A sternal incision. b.Chest tubes. c.Moderate pain. d.Pulmonary function studies. A client who has been receiving radiation therapy for bladder cancer tells the nurse that it feels as if she is voiding through the vagina. The nurse interprets that the client may be experiencing which condition?

1 point

1. Rupture of the bladder
2. The development of a vesicovaginal fistula
3. Extreme stress caused by the diagnosis of cancer
4. Altered perineal sensation as a side effect of radiation therapy A client is diagnosed as having a bowel tumor. The nurse should monitor the client for which complications of this type of tumor? Select all that apply * 5 points
5. Flatulence

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2. Peritonitis
3. Hemorrhage
4. Fistula formation
5. Bowel perforation
6. Lactose intolerance 124.In planning the care of a bladder cancer patient experiencing fatigue related to chemotherapy, which of the following is the most appropriate nursing intervention? * 1 point a.Prioritize and administer nursing care throughout the day b.Accomplish all the nursing cares early in the day so the client can rest the remainder of the day c.Perform all nursing cares during the evening shift when the client is the most rested d.Limit the number of visitors, promoting a maximum opportunity for sleep A nurse is caring for a client who has chronic cancer pain and has a permanent epidural catheter for administration of a fentanyl/bupivacaine solution. The nurse should monitor the client for which of the following findings? (Select all that apply.) * 5 points A. Respiratory depression B. Hypotension C. Sedation D. Muscle spasticity E. Motor blockage The primary difference between benign and malignant neoplasms is the * 1 point a. rate of cell proliferation. b. site of malignant tumor. c. requirements for cell nutrients. d. characteristic of tissue invasiveness.

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a. increase urine output with hydration therapy. b. establish electrocardiographic (ECG) monitoring. c. administer a bisphosphonate such as pamidronate (Aredia). d. restrict fluids and administer hypertonic sodium chloride solution. The nurse is caring for a patient who has been recently diagnosed with late stage pancreatic cancer. The patient refuses to accept the diagnosis and refuses to adhere to treatment. What is the most likely psychosocial purpose of this patient's strategy? * 1 point a.The patient may be trying to protect loved ones from the emotional effects of the illness. b.The patient is being noncompliant in order to assert power over caregivers. c.The patient may be skeptical of the benefits of the Western biomedical model of health. d.The patient thinks that treatment does not provide him comfort. Other than by direct spread of prostatic cancer cells through the prostatic capsule, common sites of metastasis include which of the following? * 1 point a.Bladder, kidneys, and seminal vesicles. b.Bladder, kidneys, and testes. c.Bones, brain, and lymph nodes. d.Bones, liver, and lungs. A patient’s breast tumor originates from embryonal ectoderm. It has moderate dysplasia and moderately differentiated cells. It is a small tumor with minimal lymph node involvement and no metastases. What is the best description of this tumor? * 1 point a. Sarcoma, grade II, T3N4M b. Leukemia, grade I, T1N2M c. Carcinoma, grade II, T1N1M d. Lymphoma, grade III, T1N0M

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A 70-year-old male patient has multiple myeloma. His wife calls to report that he sleeps most of the day, is confused when awake, and complains of nausea and constipation. Which complication of cancer is this most likely caused by? * 1 point a. Hypercalcemia b. Tumor lysis syndrome c. Spinal cord compression d. Superior vena cava syndrome The presence of Reed-Sternberg cells is associated with: * 1 point A. prostate cancer. B. malignant melanoma. C. lung cancer. D. Hodgkin’s disease. The hospice nurse has just admitted a new patient to the program. What principle guides hospice care?

1 point a.Care addresses the needs of the patient as well as the needs of the family. b.Care is focused on the patient centrally and the family peripherally. c.The focus of all aspects of care is solely on the patient. d.The care team prioritizes the patient's physical needs and the family is responsible for the patient's emotional needs. When a patient is undergoing brachytherapy, what is it important for the nurse to be aware of when caring for this patient? * 1 point

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c. The goal of this treatment is only palliative and the patient should be aware of the expected outcome. d. Computerized dosimetry is used to determine the maximum dose of radiation to the tumor dose to normal tissue. within an acceptable A 73-year-old client has just undergone a colostomy for cancer of the colon. The client tells the nurse the pain is “8” on a scale of 10. Which of the following is the expected outcome of the nursing care for this client? * 1 point a.The client does not ask for pain medication b.The client self-medicates with an over-the-counter medication c.The client verbalizes satisfaction with the level of pain and pain control d.The client states the pain is “4” on a scale of 0 to 10 A nurse is caring for a young client scheduled for cystectomy with urinary diversion for treatment of bladder cancer. The client states to a nurse, “With all the smokers around, why couldn’t one of them get bladder cancer instead of me? I’ve never smoked in my life!” Which is the best response by the nurse? * 1 point a.“It seems unfair that you developed cancer?” b.“Smoking isn’t the only cause of bladder cancer.” c.“With your upcoming surgery, I can understand why you are afraid.” d.“You’re angry and I know you really don’t mean to wish this on someone else.” After examining a client’s laboratory results, a nurse suspects that a client’s colon cancer has metastasized to the liver. Which laboratory values should lead the nurse to make this conclusion? * 1 point a.Elevated aspartate aminotransferase (AST) and alkaline phosphatase (ALP) b.Elevated BUN (blood urea nitrogen) and Cr (creatinine)

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c.Decreased albumin and calcium d.Elevated WBCs (white blood cells) and neutrophils

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A group of nursing students are applying the concept of steady state to the nursing care plan of a patient who is undergoing chemotherapy and radiotherapy for the treatment of lung cancer. What would be the most complete statement by the students about the concept of steady state? * 1 point a.“The concept of steady state preserves life.” b.“The mechanisms of steady state work to maintain balance in the body.”

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c.“This concept compensates for biologic and environmental attacks on the body.” d.“Steady state is the same as adaptation.” A patient with a genetic mutation of BRCA1 and a family history of breast cancer is admitted to the surgical unit where she is scheduled that day for a bilateral simple mastectomy. What is the reason for this procedure? * 1 point a. Prevent breast cancer b. Diagnose breast cancer c. Cure or control breast cancer d. Provide palliative care for untreated breast cancer For a client with a newly created colostomy, a nurse creates this diagnosis: risk for sexual dysfunction related to body image change. To promote satisfying sexual functioning after ostomy surgery, which recommendation should the nurse make to the client? * 1 point a.Participate in sexual activity only in a darkened room b.Utilize self-gratification for the majority of sexual needs c.Empty and clean the ostomy pouch immediately before sexual activity d.Utilize only the female superior position for sexual activity Which nursing diagnosis should have the highest priority for a client experiencing superior vena cava syndrome secondary to lung cancer? * 1 point a.Ineffective breathing pattern b.Ineffective tissue perfusion c.Risk for infection d.Impaired skin integrity A client, who has been diagnosed with prostate cancer and received chemotherapy and radiation treatments, is admitted to a hospital for palliative care. A nurse understands that the client: * 1 point a.Will require minimal nursing care since a cure is no longer a treatment option.

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c.Is unable to make decisions independently regarding medical treatment. d.Will receive care that relieves symptoms without hastening or postponing the client’s death. The nurse is caring for a client who is postoperative following a pelvic exenteration and the health care provider changes the client’s diet from NPO (nothing by mouth) status to clear liquids. The nurse should check which priority item before administering the diet? * 1 point

1. Bowel sounds
2. Ability to ambulate
3. Incision appearance
4. Urine specific gravity JELAAA The occupational health nurse is conducting yearly health screenings. A 50-year-old man states, “My father had colon cancer, but I really don't understand why that means that I need a colonoscopy.” What could the nurse do to disseminate information about screening to more individuals? * 1 point a.Plan a health fair for the employees that provides information about screening for diseases that have an inheritance pattern. b.Refer each employee over the age of 50 to a gastroenterologist. c.Create a Web site on diet and exercise as it relates to the prevention of colon cancer in people over 50. d.Place brochures in the nurses' facility for the employees to access in answering their questions. A patient on chemotherapy and radiation for head and neck cancer has a WBC count of 1.9 × 103/μL, hemoglobin of 10.8 g/ dL, and a platelet count of 99 × 103/μL. Based on the CBC results, what is the most serious clinical finding? * 1 point a. Cough, rhinitis, and sore throat b. Fatigue, nausea, and skin redness at site of radiation c. Temperature of 101.9° F, fatigue, and shortness of breath d. Skin redness at site of radiation, headache, and constipation

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Which factors will assist a patient in coping positively with having cancer (select all that apply)? * 5 points a. Feeling of control b. Strong support system c. Internalization of feelings d. Possibility of cure or control e. A young person will adapt more easily f. Not having had to cope with previous stressful events A hospice nurse is caring for a 22-year-old with a terminal diagnosis of pancreatic cancer. When updating this patient's plan of nursing care, what should the nurse prioritize? * 1 point a.Interventions aimed at maximizing quantity of life b.Providing financial advice to pay for care c.Providing realistic emotional preparation for death d.Making suggestions to maximize family social interactions after the patient's death A nurse is planning care for a client who will undergo genetic testing for suspected cancer. Which of the following interventions should be included in the plan of care? * 1 point A. Obtain a signed informed consent form. B. Withhold all medications prior to the procedure. C. Verify the prescription for a tumor marker assay. D. Ensure the client is placed in a recovery position after testing What factor differentiates a malignant tumor from a benign tumor? * 1 point a. It causes death. b. It grows at a faster rate. c. It is often encapsulated. d. It invades and metastasizes.