ONCOLOGY 1 EXAM BEST RATED QUESTIONS WITH ANSWERS TESTED AND VERIFIED SOLUTIONS WITH 2023/, Exams of Nursing

Download ONCOLOGY 1 EXAM BEST RATED QUESTIONS WITH ANSWERS TESTED AND VERIFIED SOLUTIONS WITH 2023/ and more Exams Nursing in PDF only on Docsity! ONCOLOGY 1 EXAM BEST RATED QUESTIONS WITH ANSWERS TESTED AND VERIFIED SOLUTIONS WITH 2023/2024 UPDATES Nurse April is reinforcing teaching about the diagnosis of cancer to a client who has a lump in her breast. The nurse instructs the client that a diagnosis of breast cancer is confirmed by doing a procedure that can detect whether the cancer is benign or malignant. This procedure is known as what: 1.66/1.66 Points  Mammography.  Biopsy.  Chest X-ray  Monthly Breast self-examination. 2) Nurse Lucia is providing breast cancer education at a community facility. She should inform the group that the American Cancer Society recommends that women get mammograms: 0/1.66 Points  After the first menstrual period and annually thereafter.  Every 3 years between ages 20 and 40 and annually thereafter.  Yearly after age 40.  After the birth of the first child and every 2 years thereafter. 3) The CAUTION is a mnemonic method of early detection of cancer. What does the C stand for? 1.66/1.66 Points  Curative  Change in bowel or bladder habbits  Carcinogen  Cancer 4) A 35-year-old client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis (mucositis)? 1.66/1.66 Points  Rust-colored sputum  Inflammation of the stoma site  Red, open sores inside the mouth  Red, open sore inside the stomach 5) When considering the impact of dietary intake on the development of cancer, which of the following statements is correct? 1.66/1.66 Points  Diets high in fat and low in fiber have been linked to cancer.  Low-protein diets are associated with the development of colon cancers.  Nearly 70% of cancer-related deaths can be attributed to high-fat and high-fiber diets.  High-protein diets are linked to breast cancer. Gently touch the testicle with one finger to feel for a growth. 11) Nurse Joy is caring for a client undergoing external radiation. When caring for the client, the nurse knows that? 0/1.66 Points  the patient is radioactive  patient's excretions are radioactive  pregnant woman should not care care for that patient due to radiation risk  patient does not emit radiation and does not pose a hazard to anyone 12) Using the TNM staging classification system, a tumor staged as T4N3M3 would mean what? 1.66/1.66 Points  Medium-sized tumor, no lymph node involvement, and distant metastasis.  Large tumor, three lymph node involvement, and three distant metastasis.  Carcinoma in situ, regional lymph node involvement, and metastasis to one site.  No evidence of primary tumor, no lymph node involvement, and no distant metastasis. 13) Which of the following characteristic is common with benign tumors? 1.66/1.66 Points  They divide and multiply in the same manner as normal cells  They progress and destroy surrounding tissues while spreading to distant parts of the body  They are benign, proliferate and cancerous  They remain localized and cannot metastasize 14) A patient, age 39, has been receiving chemotherapy for treatment of cancer of the breast. She has a WBC count of 2,000 and at risk for infection. The patient needs to be placed on what type of precaution? 1.66/1.66 Points  Contact precaution  Neutropenic precaution  Fall precaution  Bleeding precaution 15) A patient is admitted to the unit for an autologous bone marrow transplant. When reinforcing teaching, the nurse would tell the patient that the bone marrow for transplant will come from who? 1.66/1.66 Points  Her own marrow  Her identical twin.  A friend  An anonymous donor 16) Using the staging classification system, a tumor with Stage 0 or “is” would means what? 0/1.66 Points  High evidence of primary tumor, lymph node involvement, and distant metastasis.  Medium-sized tumor, no lymph node involvement, and distant metastasis.  Large tumor, lymph node involvement, and distant metastasis.  Carcinoma in situ, preinvasive cancer. 17) A patient, age 53, postmenopausal want to know the best time to do her monthly breast self-exam. Which response by the nurse is appropriate? 1.66/1.66 Points  It is best to do at least 1 month within a year.  Apply warm, moist compresses on the breast at least three times before doing the breast self-exam.  It is best to pick a date in the month and use that date to do the monthly breast exam  A prompt clinical breast examination by her physician is needed. 18) A patient is admitted to the unit for a syngeneic bone marrow transplant. During teaching, the nurse would tell the patient that the bone marrow for transplant will come from who? 1.66/1.66 Points  Increase in platelets level  Neutropenia (Low neutrofills)  Thrombocytopenia (Low platelets)  Anemia (Low RBC) 24) In which type of internal radiation, brachytherapy that the radioactive waste is not seen in body fluids but rather in the patient and requires Time, Distance and Shielding from the patient? 1.66/1.66 Points  Unsealed  Teletherapy  Open  Sealed 25) Pain associated with cancer is due to the following except? 1.66/1.66 Points  Benign  Bone destruction  Psychological fear  Organ obstruction  Compression of peripheral nerves 26) The step in the bone marrow transplantation that is the most critical moment to monitor the patient for extremely low levels of all the blood cells is call what? 1.66/1.66 Points  Engraftment  Harvest  Transplantation  Conditioning 27) The most preferred site to harvest the donor's bone marrow cells is called what? 1.66/1.66 Points  Ischium  Iliac crest  Pubis  Femur 28) The step in the bone marrow transplantation that involves the administration of immunosuppresant drugs is call what? 0/1.66 Points  Transplantation  Engraftment  Harvest  Conditioning 29) A hospitalized patient who has received chemotherapy for leukemia develops neutropenia and is placed on neutropenic precaution Which observation by the nurse would indicate a need for further teaching? 1.66/1.66 Points  The patient’s visitors bring in some fresh fruits and flowers from home.  The nurses upon entering the room wear PPE’s.  The patient cleans and washes his hands after using the bathroom.  The patient wears mask when going downstairs for procedures. 30) A post op patient is receiving heparin to prevent DVT (deep vein thrombosis). He develops nose bleeds and had passed some blood in his urine. The nurse knows which lab test is likely to be ordered is what? 1.66/1.66 Points  liver enzymes  kidney enzymes normal post-operative course  bowel obstruction  constipation  paralytic ileus 36) During the preoperative interview the nurse asks the client if she or anyone in her family ever experienced complications from anesthesia. The rationale for this question is to determine the risk of which of the following genetically-related complication of anesthesia? 1.66/1.66 Points  Malignant hypotension.  Malignant hypothermia  Malignant hypertension.  Malignant hyperthermia. 37) Which client is at the greater risk for deep vein thrombosis and should have the nursing interventions on their care plan to prevent this complication? 1.66/1.66 Points  45-year-old female traffic control police officer  56-year-old that smokes 4 packs a day and works as a cashier  30-year-old male construction worker  17-year-old male football player 38) When preparing to complete a surgical consent for a patient scheduled to undergo appendectomy surgery, which of the following individuals would require a guardian? 0/1.66 Points  A pregnant 15 year old female  A 25 year old with a mental illness (anxiety)  An alert and oriented 22 year old male  A married 16 year old pregnant female 39) The physician has ordered sequential compression devices (SCDs) for a client going to surgery. The best rationale for use of SCDs is to: 1.66/1.66 Points  Maintain balanced fluid volume.  Move the joints and to prevent contracture.  Promote venous stasis  Promote venous return 40) The nurse has just finished explaining the necessity of doing coughing and deep breathing exercises following surgery to a perioperative client that is on strict bedrest. Which of the following responses by the client would indicate his understanding and acceptance of what he has been taught? 1.66/1.66 Points  "I guess I'll try to remember to take a couple of deep breaths once in a while’  "When I do coughing and deep breathing exercises, I reduce my chances of getting pneumonia."  "It really hurts too much to do that. Deep breathing and coughing are impossible."  "I thought that incentive spirometry was supposed to do the job." 41) A patient who has been diagnosed with DVT should do what? 1.66/1.66 Points  Ambulate the entire unit  Massage lower extremities  Maintain strict bedrest as ordered to prevent pulmonary embolism  Apply heating pad to calf area 42) The postoperative client complains of hearing a “popping sound” and feeling “something popping out inside her abdominal operative site” when ambulating in the room. Which intervention should the nurse implement first? 1.66/1.66 Points  Put patient back in bed and assess the operative site for evisceration, then cover the site with a moistened sterile dressing  Contact the surgery department to prepare for emergency surgery Preoperative phase.  Perioperative phase.  Postoperative phase. 48) Which of the following patients would be at greatest risk for complication during surgery? 1.66/1.66 Points  70-year-old taking oral anticoagulant agents  20-year-old taking antibiotic agents  65-year-old taking occasional mild analgesic agent  23-year-old taking multivitamins 49) After administering a preoperative narcotic, the nurse can best meet the safety needs of the patient by: 1.66/1.66 Points  Obtaining the signed surgical consent  Putting the side rails up on the bed  Reinforcing cough and deep-breathing exercises  Giving the patient good oral hygiene 50) The nurse is assisting with the sponge and instrument count in the operating room. The operative phase in which the nurse is assisting with the counting of surgical supplies and equipment is called what? 1.66/1.66 Points  Perioperative phase.  Intraoperative phase  Preoperative phase.  Postoperative phase 51) The nurse is caring for a surgical patient, and one of the family member ask what perioperative nursing care is. How should the nurse respond? 1.66/1.66 Points  Perioperative nursing care includes activities and nursing care before, during, and after surgery.  Perioperative nursing care includes activities and nursing care only during the surgical procedure.  Perioperative nursing care occurs in preadmission testing.  Perioperative nursing care is activities and nursing care after surgery. 52) An alert 75 year-old patient is to undergo elective surgery. Who must sign the consent form? 1.66/1.66 Points  Both the patient and the spouse together  The patient  Both the patient and the surgeon  The patient's spouse 53) On admission of a patient to the PACU from surgery, on what should the nurse place the highest priority for assessment? 0/1.66 Points  The condition of the surgical site  The fluid and electrolyte balance  The patient's level of consciousness  Patent airway and breathing 54) The nurse is caring for a client who is scheduled for surgery. The client states concern about the surgical procedure. How should the nurse initially address the client's concerns? 1.66/1.66 Points  Provide explanations about the procedures involved in the planned surgery  Ask the client to tell you information they know about the planned surgery  Tell the client that preoperative fear is normal and everything will be fine  Explain all nursing care and possible discomfort that may result A postoperative eye surgery patient  A postoperative appendectomy patient  A postoperative spinal surgery patient  A postoperative brain surgery patient  A postoperative abdominal surgery patient 60) Which of the following are factors that do not contribute to cancer development? Select all that apply. 2.06/2.06 Points  "High fat diet."  "Low fiber diet"  "Low fat diet."  Low residue/fiber  "High fiber diet." Respiratory History Test Score 82.62% (B-) Start Time Oct 5, 2020 4:20pm End Time Oct 5, 2020 5:48pm 1) A patient is admitted to the hospital and is to undergo brain surgery. The client is very anxious and scared of upcoming surgery. He begins to hyperventilate and becomes dizzy. The patient looses consciousness and ABGs are drawn. The following is arterial blood gas result: pH 7.61, PaCO2 22, HCO3 25, PaO2 85. What acid base imbalance this is? 1.53/1.53 Points  metabolic acidosis  respiratory acidosis  metabolic alkalosis  respiratory alkalosis 2) An adult has a chest tube drainage system. Several hours after the chest tube was inserted, the nurse observes that there is continuous bubbling in the water seal chamber. What is the most likely reason for the continuous bubbling? 0/1.53 Points  Air is leaking into the drainage apparatus.  There is an obstruction in the tubing coming from the client  There is a mechanical problem in the pump.  The client is bleeding 3) A nurse is gathering data on a client with a diagnosis of tuberculosis (TB). The nurse reviews the results of which diagnosis test that will confirm this diagnosis? 1.53/1.53 Points  Chest X-ray.  Tuberculin skin test (PPD)  Sputum Culture (Acid-fast Bacillus)  Throat culture. 4) A client has been started on long-term therapy with Isoniazid (INH) for latent tuberculosis (TB). The nurse teaches the client that the medication: 1.53/1.53 Points  Is hepatotoxic, therefore he will have his liver function monitored routinely  Should always be taken with antacids  May be discontinued if symptoms are gone in 3 months  Causes orange discoloration of sweat, tears, urine and feces 5) A nurse has an order to give a client Albuterol a bronchodilator (two puffs), and Beclomethasone a steroid inhaler (two puffs) by metered-dose haler. The nurse administers the medication by giving the: 1.53/1.53 Points  Beclomethasone first and then the Albuterol  Beclomethasone, wait 5 minutes then Albuterol  Albuterol inhaler, wait 5 minutes then beclomethasone inhaler  Shortness of breath on exertion  Barrel chest  Jaundice 12) Which type of medication is used as rescue inhaler in an acute asthma attack? 1.53/1.53 Points  Salmeterol(Serevent)  Terbutaline (Brethine) PO  Ipratropium bromide (Atrovent)  Albuterol (Proventil, Ventolin) 13) A client with chronic bronchitis is prescribed Mucomyst (acetylcysteine) and is encouraged to increase fluids. In evaluating the effectiveness of interventions the nurse will anticipate which expected outcome? 1.53/1.53 Points  Cough suppression  Increased viscosity of respiratory secretions  Bronchial dilation  Thinning of respiratory secretions 14) A nurse is caring for a client who is two days postoperative right pneumonectomy. The nurse should place the client in which position to promote lung expansion? 0/1.53 Points  Fowler's  Prone  Right side  Left side 15) A 52-year-old patient has had a laryngectomy (removal of larynx) in treatment of cancer. A nursing diagnosis for the patient with a laryngectomy would be social isolation related to impaired verbal communication related to removal of the larynx. The correct nursing intervention to foster communication would be what? 1.53/1.53 Points  Provide an alphabet board or pencil and paper.  Cluster care.  Avoid asking questions.  Offer books or jigsaw puzzles for entertainment. 16) Which instruction by the nurse is NOT a proper technique for collection a sputum specimen? 1.53/1.53 Points  Collect specimens after meals.  Avoid brushing teeth before specimen collection.  Take deep breath and cough from lungs.  Collect sputum first thing in the morning. 17) A patient, age 22, is admitted with severe respiratory distress. The quickest way to assess whether the patient is having an asthma attack is to do what? 1.53/1.53 Points  Do a pulmonary function test.  Use a pulse oximetry and check the oxygen saturation.  Get arterial blood gases.  Do a pulse pressure assessment 18) To prevent unnecessary hypoxia during suctioning through a tracheostomy, a nurse should use which action? 1.53/1.53 Points  Maintain sterile technique  Lubricate three to four inches of the catheter tip  Withdraw catheter in a circular motion  Apply suction for no more than ten to fifteen seconds 19) A client with tuberculosis (TB) is started on Rifampin (Rifadin). Which statement by a nurse is most appropriate to include when reinforcing information? 1.53/1.53 Points  "You may notice an orange-red color to your urine."  "You may have occasional problems sleeping."  "You may experience an increase in appetite."  "You can wear contact lenses."  metabolic alkalosis  metabolic acidosis 26) The patient has been admitted for possible carcinoma of the larynx. The first sign or symptom that may be present in carcinoma of the larynx is what? 1.53/1.53 Points  persistent hoarseness in the voice  pain in the larynx.  hemoptysis.  dysphagia. 27) Which intervention is NOT appropriate for the health promotions and prevention of pneumonia? 1.53/1.53 Points  Allow a G-Tube patient to lie flat in bed during G-Tube feeding.  Position patient on high fowlers to prevent aspiration.  Encourage elder patients to receive influenza and pneumococcal vaccines.  Encourage use of incentive spirometer to promote lung expansion. 28) The laboratory has just called with the arterial blood gas (ABG) results on four patients. Which result shows respiratory acidosis? 1.53/1.53 Points  pH 7.84, PaCO2 30, HCO3 40, PaO2 85  pH 7.31, PaCO2 50, HCO3 24, PaO2 85  pH 7.45, PaCO2 25, HCO3 29, PaO2 85  pH 7.46, PaCO2 32, HCO3 40, PaO2 85 29) The nurse teaches a patient about discharge instructions after a rhinoplasty. Which statement, if made by the patient, indicates that the teaching was successful? 1.53/1.53 Points  “I will not engage in any coughing activity.”  “I will safely re“I will bend my neck down to help ease the pain.”move and reapply nasal packing daily.”  “I will bend my neck down to help ease the pain.”  I will sneeze as strongly as I can.” 30) A nurse who is caring for patient with a tracheostomy tube in place has just auscultated rhonchi (coarse crackles) bilaterally. If the patient is unsuccessful in coughing up secretions, what action should the nurse take? 1.53/1.53 Points  Encourage increased incentive spirometer use.  Put on sterile gloves and use a sterile catheter to suction.  Encourage the patient to increase oral fluid intake.  Hyperoxygenate the patient twice before suctioning. 31) A patient scheduled for a total laryngectomy and radical neck dissection for cancer of the larynx asks the nurse, “Will I be able to talk normally after surgery?” What is the best response by the nurse? 1.53/1.53 Points  “With a cuffed permanent tracheostomy you will be able to talk.”  “You won’t be able to talk right after surgery, but you will be able to speak again after the tracheostomy tube is removed.”  “With an uncuffed permanent tracheostomy you will be able to talk.”.”  “You won’t be able to speak and eat as you used to.” 32) The nurse provides discharge instructions to a patient who was hospitalized for pneumonia. Which statement, if made by the patient, indicates a good understanding of the instructions? 1.53/1.53 Points  “I will continue to do the deep breathing and coughing exercises at home.”  “I’ll cancel my chest x-ray appointment if I’m feeling better in a couple weeks.”  “I will schedule two appointments for the pneumonia and influenza vaccines.”  “I will call the doctor if I still feel tired after a week.” 33) A patient is admitted with active tuberculosis (TB). The nurse should question a health care provider’s order to discontinue airborne isolation unless which assessment finding is documented? 1.53/1.53 Points  Chest x-ray shows no upper lobe infiltrates.  TB medications have been taken for 6 months.  Three sputum cultures for acid-fast bacilli are negative.  Mantoux testing (PPD) shows an induration of 10 mm.  Adjust the dial on the wall regulator to decrease suction.  Document the presence of a large air leak.  Notify the surgeon of a possible pneumothorax. 40) After change-of-shift report, which patient should the nurse assess first? 1.53/1.53 Points  64-year-old with severe dyspnea and trachea deviating from mid-line  40-year-old with a pleural effusion who is complaining of severe chest pain when coughing  28-year-old with a history of a lung transplant and a cough  72-year-old with cor pulmonale who has 4+ bilateral edema in his legs and feet 41) Which instruction should the nurse include for a patient with a diagnosis of exercise induced asthma prevention? 1.53/1.53 Points  “Use the corticosteroid before you start to exercise.”  “Use cromolyn sodium before you start to exercise.”  “Upper body exercise should be avoided to prevent dyspnea.”  “Stop exercising if you start to feel short of breath.” 42) The nurse takes an admission history on a patient with possible asthma who has new-onset wheezing and shortness of breath. Which information may indicate a need for concern with asthma diagnosis? 1.53/1.53 Points  The patient takes propranolol (Inderal) for hypertension.  The patient uses acetaminophen (Tylenol) for headaches.  The patient has a history of pneumonia 6 months ago.  The patient has chronic inflammatory bowel disease. 43) The nurse in the emergency department receives arterial blood gas results for four recently admitted patients with obstructive pulmonary disease. Which patient will require the most rapid action by the nurse? 1.53/1.53 Points  65-year-old with ABG results: pH 7.31, PaCO2 58 mm Hg, and PaO2 64 mm Hg  34-year-old with ABG results: pH 7.48, PaCO2 30 mm Hg, and PaO2 65 mm Hg  22-year-old with ABG results: pH 7.28, PaCO2 60 mm Hg, and PaO2 58 mm Hg  45-year-old with ABG results: pH 7.34, PaCO2 33 mm Hg, and PaO2 80 mm Hg 44) The nurse would explain to a client with complaints of wheezing and chest tightness due to asthma that wheezing occurs when? 1.53/1.53 Points  sputum production is increased.  an allergic reaction is taking place.  air is passing through a narrowed airway.  air is trapped in the alveoli. 45) A client being treated for emphysema has a shortness of breath.What assessment finding is characteristic feature of clients with long-term emphysema? 1.53/1.53 Points  erythematous ear lobes.  barrel chest.  broken vessels in the nose.  expiratory wheezing. 46) In collecting a sputum specimen for acid-fast bacteria and culture, the nurse would be sure to do what? 1.53/1.53 Points  collect sputum in the morning before breakfast.  collect the specimen after meal.  collect the specimen after antibiotic therapy is initiated.  instruct the client to spit the specimen into a clean container. 47) A client recuperating from a lung resection is encouraged to deep-breathe and cough several times a day and has not needed supplemental oxygen. ABG results are pH 7.65, CO2 30, HCO3 28 PaO2 89. The ABG imbalance the nurse would anticipate is what? 1.53/1.53 Points  metabolic acidosis  respiratory alkalosis  metabolic alkalosis  pneumonia.  pleural effusion.  plural effusion. 54) The nurse is educating a client recently diagnosed with active TB. What information should be included regarding TB medications? 1.53/1.53 Points  medications are generally given for 6 to 8 weeks.  TB is usually treated with two or more medications to prevent organism resistance.  clients are not required to finish their medication treatment.  clients must report daily to the health department to receive their medication. 55) When a client is admitted to the ED with tension pneumothorax and right mediastinal flutter following an automobile accident, the nurse would know that the client will exhibit 1.53/1.53 Points  movement of the mediastinum in the direction of the shift.  movement of nearby organs; trachea, esophagus, heart, stomach in the direction of the shift during expiration  a sucking chest wound called flail chest.  movement of nearby organs; trachea, esophagus, heart, stomach in the direction of the shift during inspiration. 56) A client admitted with chest tube, the nurse notices that distal tube is disconnected from collection chamber. The nurse initially would do what? 1.53/1.53 Points  Clamp the tube  obtain a sterile gauze petroleum dressing from the supply room to cover the wound.  insert distal end of chest tubing connection into a sterile water container at 2 cm level as emergency water seal.  Pull remaining tube out of chest 57) What is the major difference in pathophysiology between asthma and emphesema? 1.53/1.53 Points  Emphysema is caused by chronic exposure to inhalation irritants and the major cause of Asthma is cigarette smoking.  Asthma is a restrictive disorder and Emphesema is an obstructive disorder.  Emphysema results in permanent irreversible airway obstruction and Asthma is a condition of reversible airway obstruction.  Asthma is the result of only inflammatory process and Emphesema is a result of inflammatory, infectious, and hypersensitivity processes. 58) The first line of treatment for tuberculosis include the following drugs EXEPT? 1.53/1.53 Points  Rifampin  Isoniazid  Ethambutol  Theophylline The second line of treatment for tuberculosis include the following drugs EXCEPT: 0/1.53 Points 59)  Pyridoxine  PAS  Kanamycin  Ethionamide 60) Which of the following medications will the nurse expect the physician to order for a patient with bacteria pneumonia? SELECT ALL THAT APPLY 1.53/1.53 Points  Mucolytic agent to help loosen up thick secretions  Antipyretic as needed for fever  Corticosteroids  Analgesic as needed for pain  Antibiotic 61) Identify the purposes of chest drainage: (Select all that apply) 0/1.53 Points  Drains air, blood and fluid from pleural space  Restores positive pressure in chest cavity  Cardiovascular, Hematology History Test Score 81.34% (B-) Start Time Sep 28, 2020 4:23pm End Time Sep 28, 2020 5:44pm 1) When instructing the patient taking an oral liquid iron preparation, what should the nurse include? 1.66/1.66 Points  Instruct to take with milk to prevent nausea  If taking liquid, take preparation through a straw to prevent staining of teeth  Inform that bowel movement can turn dark red  Inform that medication must be taken on empty stomach 2) When the 14-year-old African American boy comes into the emergency room in sickle cell crisis, what should be the primary focus of care? SELECT ALL THAT APPLY 1.66/1.66 Points  Oxygen administration  Starting of IV fluids  Pain control  Chemotherapy 3) A 13-year-old male patient with hemophilia says, “How did I developed hemophilia?” Which of the following is the most informative response? 1.66/1.66 Points  “You need to select a very dependable mode of birth control”  “Males are the carriers of disease, but not affected themselves”  “Your mom must be a carrier and male children will have hemophilia.”  “You can only pass hemophilia trait to your sons.” 4) In caring for a patient with multiple myeloma, what should the nurse include in the daily care? 1.66/1.66 Points  Provisions for no pain medication  Provisions for straining all urine  Provisions for pain medication and careful when turning and repositioning the patient  Provisions for limiting fluid intake to less than 1000 mL/day 5) The nurse is aware that a person with Hodgkin disease, who has two or more abnormal lymph nodes on the same side of the diaphragm and cancer extending locally from one lymph node area into a nearby organ, would be in: 0/1.66 Points  stage I.  stage III.  stage II.  stage IV. 6) Which of the following is the most common type of sickle cell crisis: 0/1.66 Points  hemolytic crisis  aplastic crisis  spleenic sequestration  vasoocclusive crisis 7) Which of the following is the most common type of nutritional type of anemia: 0/1.66 Points  iron-deficiency anemia.  sickle cell anemia.  pernicious anemia  leukemia. 8) The nurse explains that the treatment of hemophilia A will be based upon the missing of what clotting factor: 0/1.66 Points  large doses of testosterone.  factor VIII.  factor IX.  transfusion with packed red cells. 9) Which of the following are associated with of a patient with Hodgkin disease? (Select all that apply.) vascular spasm  paresthesia  arterial insufficiency 15) A nurse is assessing patient's lower extremities, she notes decreased pulses and cool temperature bilaterally. Left foot has a well demarcated ulcer (punched out appearance). What vascular disease patient is likely to have? 1.66/1.66 Points  Buerger's disease  peripheral arterial disease  venous insufficiency  Raynaud's disease 16) What health teaching should be included in the continuing plan of care for a client with chronic venous stasis (venous insufficiency)? 1.66/1.66 Points  “Apply antiembolism stockings before getting out of bed in the morning.”  "Avoid exercise, rest your legs as often as possible"  “You can cut your nalis yourself or go to salon"  “Dangle the legs often” 17) A nurse is taking the history of a client with suspected coronary artery disease. Recently, the client has had episodes of chest discomfort while mowing the lawn with a push mower. The chest discomfort subsides when the client rests. What conclusion can the nurse draw from this information? 1.66/1.66 Points  The client may have had an unstable angina or myocardial infarction  The client may have variant angina.  The client need not be concerned about this pain, because it is relieved with rest.  The client may have stable angina. 18) The client is diagnosed with acute myocardial infarction. Which laboratory test is most specific in diagnosing acute MI due to myocardial cell damage? 1.66/1.66 Points  serum LDH  myoglobin  CK  CPK-MB 19) The nurse is reviewing the lab report of a client diagnosed with Aplastic anemia and notes platelet count of 40,000 and white blood cell count of 2,500. The nurse would instruct the client about which of the following? SELECT ALL THAT APPLY 0/1.66 Points  Avoid crowded area  Take rectal temperature daily  Use firm toothbrush to promote oral hygiene  Avoid flossing teeth  Avoid fresh flowers 20) A patient is to begin taking iron supplements. The nurse evaluates the patient's understanding of the use of this drug. Which of the following indicates that he has an adequate knowledge base? 1.66/1.66 Points  Avoiding flossing  Understanding that black stools while taking iron is a sign of complication  Increasing intake of fiber and fluid helps to prevent constipation from the Iron  Checking her gums for bleeding 21) The nurse is assigned in the hospital to work with a younger patient diagnosed as having pernicious anemia due to intrinsic factor deficiency. Which of the following statements made by the patient shows she understands the treatment plan for pernicious anemia? 0/1.66 Points  I will need to take vitamin Bl2 Injection for life  Increasing whole grains and cereals will help my anemia  I will need to take oral vitamin Bl2 supplement for life  Increasing my intake of meat and cheese will help my anemia 22) The nurse determines that a client is at risk for developing which type of anemia if they have a history of a gastrectomy (partial removal of stomach)? 1.66/1.66 Points  sickle cell anemia  Iron deficiency  Yellow-tinged sclera  Gum bleeding and tenderness  Pink tongue  Paresthesia of the extremities 29) The nurse caring for a patient with type A hemophilia being admitted to the hospital with severe pain and swelling in the right knee will: 1.66/1.66 Points  use RICE to help immobilize the joint  apply heat to the knee  perform passive range of motion to the knee  assist the patient with light weight bearing 30) A patient in the emergency department complains of back pain and difficulty breathing 15 minutes after a transfusion of packed red blood cells is started. The nurse’s first action should be to 1.66/1.66 Points  obtain a urine specimen to send to the laboratory.  notify the health care provider about the symptoms.  stop the transfusion and start infusing normal saline through different line.  administer oxygen therapy at a high flow rate. 31) 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)? 1.66/1.66 Points  No fresh fruits or flowers in the room.  Use rectal suppositories if needed for constipation.  Eat low fiber, low residue foods.  Avoid crowded areas  Do not assign sick nurses to care for the patient 32) The client with coronary artery disease is prescribed a Holter monitor. Which intervention should the nurse implement? 1.66/1.66 Points  Discuss the need to remove the Holter monitor during a.m. care and showering.  Explain that all medications should be withheld while wearing a Holter monito  Teach the client the importance of decreasing activity while wearing the monitor.  Instruct the client to keep a diary of activity, especially when having chest pain. 33) The client with a mechanical valve replacement asks the nurse, "why do I have to take prophylactic antibiotics before getting my teeth cleaned?" Which response by the nurse is most, appropriate? 1.66/1.66 Points  "Antibiotics will prevent vegetative growth on your gums."  "This procedure may cause your valve to malfunction.’  "Your teeth will not bleed as much if you have antibiotics."  "You are at risk of developing an infection in your heart." 34) The client is diagnosed with pericarditis. Which are the most common signs/symptoms the nurse would expect to find when assessing the client? 1.66/1.66 Points  Increased chest pain with inspiration and friction rub on auscultation  Splenomegaly  Osler nodes  Petechiae and splinter hemorrhages 35) A nurse observes that the client, whose blood type is AB negative, is receiving a transfusion with type O negative packed red blood cells. What is the nurse’s best first action? 1.66/1.66 Points  Continue with the administration of the blood transfusion and monitor the client's vital signs.  Document the observation as wrong administration.  Stop the transfusion.  Call the blood bank. 36) While palpating a client's abdomen, the nurse notes a pulsating abdominal mass. This may indicate which condition? 1.66/1.66 Points  Abdominal aortic aneurysm Rh factor incompatibility is seen with which patient? 1.66/1.66 Points  Rh positive mom and Rh positive baby  Rh negative mom and Rh positive baby  Rh positive mom and Rh negative baby 43) In ABO blood type, which of the following is considered the universal recipient? 1.66/1.66 Points  Blood type A  Blood type O  Blood type AB  Blood type B 44) The amount of blood that remains after the filling in of blood is known as what: 1.66/1.66 Points  After load  Cardiac output  Stroke volume  Preload 45) The following are non specific cardiac markers except? 1.66/1.66 Points  LDH  Myoglobin  CPK-MB  C-reactive protein 46) A patient admitted with diagnosis of sinus tachycardia will have a pulse rate of what: 1.66/1.66 Points  140 bpm  40 bpm  60 bpm  100 bpm 47) Atypical signs and symptoms of myocardial infarction include what: 1.66/1.66 Points  epigastric pain  cool clammy skin  feeling of impending doom  chest pain 48) This complication is associated with what type of heart failure? 0/1.66 Points  Cor Pulmonale seen with left sided heart failure  Cor Pulmonale seen with ischemic heart failure  Cor Pulmonale seen with right sided heart failure  Cor Pulmonale seen with myocardial heart failure 49) The patient with a mechanical mitral valve replacement will need the following: 1.66/1.66 Points  Thrombolytic agent for one to two years  Thrombolytic agent for the rest of their lives  Anticoagulants agents for one to two years  Anticoagulants agents for the rest of their lives 50) The patient with Raynaud's disease will be taught to avoid the following except: 1.66/1.66 Points  stress  wearing gloves or mitten when going outside in the cold weather  caffeinatedproducts  smoking 51) Which of the following condition is known as a silent killer due to it's asymptomatic features? 1.66/1.66 Points  Pulmonary Embolism The nurse will encourage the patient with Iron deficiency anemia to consume the following food sources of iron except: 1.66/1.66 Points  raisins  green leafy vegetables  milk  meats 58) The following findings are associated with infectious Mononucleosis? Select all that apply. 0/1.66 Points  Transmitted through oral secretions  High fever  Swollen lymph nodes  Hepatomegaly and Spleenomegaly  Cause by Epstein Barr Virus 59) A life threatening lung damage related complication from sickle cell anemia is known as what? 0/1.66 Points  Vaso-occlusive crisis  Spleenic sequestration  Aplastic crisis  Acute chest syndrome 60) The Pulmonic heart sound can be auscultated where within the thoracic region? 0/2.06 Points  Fifth intercostal space midclavicular to the left  Third intercostal space midclavicular to the left  Fourth intercostal space midclavicular to the left  First intercostal space midclavicular to the right  Second intercostal space midclavicular to the left PN Medical Surgical Nursing Cardiovascular Disorders History Test Score 81.45% (B-) Start Time Sep 24, 2020 4:30pm End Time Sep 24, 2020 5:58pm 1) The nurse performs a blood pressure evaluation, with a result of 90/60. According to the recording, the pulse pressure assessment is: 1.81/1.81 Points  24.  30.  20.  88. 2) Laboratory tests are performed to identify damage to the heart muscle. The test that is elevated the earliest with cardiac muscle damage is: 1.81/1.81 Points  Lipid profile.  Troponin.  LDH.  CPK-MB. 3) A 42 year old adult male patient is receiving digoxin, 0.25 mg daily. Before giving the medication, the nurse would: 1.81/1.81 Points  Check the apical pulse for one full minute and hold the dose if the apical pulse is less than100 beats/min.  Check the apical pulse for one full minute and hold the dose if the apical pulse is less than 60 beats/min.  Give the dose if the apical rate is 58 beats/min.  Count the apical pulse for 15 seconds. 4) A 69-year-old patient reports burning, sharp, aching pain in the lower legs when mowing the lawn. These symptoms are relieved with rest. The nurse would conclude that the patient is experiencing: 1.81/1.81 Points increasing blood pressure. A 53-year-old patient with a history of dysrhythmias is to wear a Holter monitor. The nurse should explain that the Holter monitoring device is what kind of a device? 1.81/1.81 Points 10)  is a form of stress test.  is an ambulatory portable electrocardiographic device that records the rhythm of the heart.  regulates heart rate.  amplifies heart sound waves and blood flow. 11) A patient, age 65, has chronic angina pectoris. Her daughter had questions about the proper use of nitroglycerin for pain management. She was unsure about how many times she should take nitroglycerin for an episode of angina. The best reply the nurse could make is? 1.81/1.81 Points  “continue to take nitroglycerin sublingually every 5-minute continuously until the pain is relieved.”  “take nitroglycerin sublingually every 5-minute x 3 doses.”  “if nitroglycerin is not relieving the pain after 3 doses, lie down and sleep.”  “take nitroglycerin sublingually every 3-minute x 5 doses 12) Dependent edema of the extremities, enlargement of the liver, ascites, oliguria, jugular vein distention, peripheral edema and abdominal distention are all signs and symptoms of what type of heart failure? 1.81/1.81 Points  left-sided heart failure.  cardiac dysrhythmia failure.  valvular heart disease failure.  right-sided heart failure. 13) A client’s heart rate and rhythm are sinus bradycardia at 45 beats/minute. The cardiac conduction system that will initiate a heart rhythm and it is also known as the heart pacemaker is call what? 1.81/1.81 Points  Purkinje fibers  Atrioventricular node  Bundle of His  Sinoatrial (SA) node 14) What is the definition of a stroke volume? 1.81/1.81 Points  The amount of blood pumped by the heart in one beat  The amount of blood pumped by the heart in one hour  The amount of blood pumped by the heart in one second  The amount of blood pumped by the heart in one minute 15) With which of the following clients is the nurse alert for the possibility of the development of hypertension and coronary artery disease? 1.81/1.81 Points  65-year-old white woman that runs five miles on a daily basis  45-year-old African American man, that smokes five packs a day with history of sedentary lifestyle  60-year-old Asian American woman with breast cancer  50-year-old white man with history of asthma 16) The nurse assessing the client with cardiovascular disease observes the following clinical manifestations. Which one of the following indicates venous insufficiency disorder? 1.81/1.81 Points  Paradoxical blood pressure  Legs appear rubor in a dependent position.  Clubbing of the fingers and toes  Legs appear cyanotic in a dependent position. 17) A nurse is preparing a client to undergo cardiac catheterization. What specific assessment should the nurse make before the procedure? 1.81/1.81 Points  Ascertain if the client has a history of diabetes mellitus.  Ascertain if the client is able to roll side to side.  Assess if the client has allergies to iodine-containing substances.  Assess if the client will require sedation. 18)  Hyperkalemia  Headache  Bradycardia  Hypokalemia 24) A nurse is providing care to a client who is complaining of sudden chest pain with a high pitched scratchy sound upon inspiration. What is the nurse’s best plan of action? 1.81/1.81 Points  Notify the physician as this indicate of symptoms of pericarditis.  Use a Doppler to assess heart sounds and notify the physician as patient is experiencing endocarditis.  Increase the intravenous flow rate.  Notify the physician as patient might be experiencing cardiac tamponade 25) Which clinical manifestation in a client with pericarditis will show that the client have developed cardiac tamponade when performing a cardiac assessment? 1.81/1.81 Points  The presence of a gallop rhythm  An irregular heart rate that speeds up and slows down with pericardial fluid of 50 ml.  A medical emerge\ncy with excessive pleural fluid and decrease cardiac output.  Excessive pericardial fluid with a decrease in blood pressure and cardiac output. 26) A nurse is caring for a client admitted with tachycardia and the development of a new heart murmur. Which element of the client’s history would lead the nurse to suspect this client has endocarditis? 1.81/1.81 Points  The client was vacationing in the tropics 2 weeks ago.  The client has a history of alcoholism.  The client has had sore throat within the past week.  The client is currently taking antibiotics. 27) Which intervention suggested to the client with Buerger’s disease is aimed at slowing the disease progression? 1.81/1.81 Points  Keeping environmental temperatures comfortably warm  Taking aspirin daily  Avoiding injury to the hands or feet  Quit smoking 28) What health teaching should be included in the plan of care for a client with varicose veins? 1.81/1.81 Points  “Apply elastic stockings before getting out of bed in the morning.”  “Clean the veins with Betadine before applying a dressing.”  “Apply elastic stockings after getting out of bed in the morning.”  “Remove and reapply the Duoderm dressing daily.” A nurse is taking the history of a client with suspected coronary artery disease. Recently, the client has had episodes of chest discomfort while mowing the lawn with a push mower. The 29) chest discomfort subsides when the client rest. What conclusion can the nurse draw from this information? 1.81/1.81 Points  The client may have developed unstable angina or myocardial infarction.  The client may have developed variant angina.  The client need not be concerned about this pain, because it is relieved with rest.  The client may have developed stable angina. 30) The client is diagnosed with acute myocardial infarction. Which laboratory test is most specific in diagnosing acute MI due to myocardial cell damage? 1.81/1.81 Points  Serum LDH  CPK-MB  Myoglobin  Troponin 31) The atrioventricular valves include the following except? 1.81/1.81 Points  Bicuspid valve  Pulmonic valve   Sedentary life style  Race  Diet 38) The procedure that will be performed if the client is diagnosed with cardiac tamponade is known as what? 1.81/1.81 Points  thoracentesis  paracentesis  arthrocentesis  pericardiocentesis 39) The blood that remains in the ventricle after filling in of blood is known as what? 1.81/1.81 Points  cardiac output  after load  preload  stroke volume 40) A preoperative nursing care that the nurse needs to tell the patient prior to the administration of the contrast dye for cardiac catheterization include what? 1.81/1.81 Points  severe chest pain is common  an NPO status is not needed  a flushing feeling and metallic taste in mouth is normal  a slight headache is common 41) All of the following can be seen with the 6 P's associated with a peripheral vascular disease except: 1.81/1.81 Points  pulselessness  poikilothermy  prothrombin  paralaysis  paresthesia 42) All of the following are non specific cardiac markers except? 0/1.81 Points  Myoglobin  C- reactive protein  Troponin  Erythrocyte Sedimentation Rate ESR 43) The longest time the troponin levels can stay in the blood causing damage to the heart is what? 0/1.81 Points  5 days  21 days  96 hours  72 hours 44) The patient EKG shows a heart rhythm of 130 beats/minute. The patient is said to have developed what type of dysrhythmia? 1.81/1.81 Points  third degree heart block  premature ventricular contraction  sinus tachycardia  sinus bradycardia 45) In which of the following dysrhythmias the patient is said to be at risk for the development of clot formation? 1.81/1.81 Points  ventricular tachycardia  sinus tachycardia  sinus bradycardia  atrial fibrillation 1 P wave that comes after a QRS wave  1 QRS that comes after a P wave  1 T wave that comes after the QRS wave 52) A client who has experienced a myocardial infarction now shows signs of poor tissue perfusion and blood circulation. Which of the following will the nurse considers as signs and symptoms of a right sided heart failure? (Select all that apply.) 0/1.81 Points  Decrease urine output  Jugular neck vein distention.  Dyspnea and crackles  Peripheral edema  Cor pulmonale 53) A medication, simvastatin (Zocor), is administered to lower a patient’s cholesterol level. Follow-up lipid levels are reviewed by the nurse. Which of the following lipid levels that indicates hyperlipidemia? Select all that apply. 1.81/1.81 Points  HDL, 28 mg/dL; LDL, 140 mg/dL.  HDL, 30 mg/dL; LDL, 126 mg/dL.  HDL, 50 mg/dL; LDL, 86 mg/dL.  HDL, 16 mg/dL; LDL, 186 mg/dL.  HDL, 60 mg/dL; LDL, 78 mg/dL. The following are associated with venous insufficiency. Select all that apply. 1.81/1.81 Points 54)  slightly painful  pallor on elevation  cyanotic when dependent  ulcer on medial leg and ankle  strong bound pulse 55) Choose the correct class of antihypertensive and an example of a drug for that class. Select all that apply. 0/2.26 Points  Alpha adrenergic blocker e.g Prazosin  Loop diuretic e.g Aldactone  Angiotensin II Receptor blockers ARB's e.g Valsartan  Beta adrenergic blocker e.g Lisinopril  Calcium channel blocker e.g Amlodipine GI Disorders History Test Score 88% (B+) Start Time Oct 14, 2020 4:20pm End Time Oct 14, 2020 5:24pm 1) The goals of diet management in a patient with inflammatory bowel disease, Ulcerative Colitis are: (Select all that apply.) 0/2 Points  Monitor intake and output.  Correct dehydration.  Offer psychological and emotional support  Provide diet high in fat and high in fiber.  Restrict fluids to decrease peristalsis. 2) A patient is admitted with a diagnosis of Dumping Syndrome. What nursing interventions would be appropriate when caring for this patient? (Select all that apply.) 2/2 Points  Diet should be high in protein and low in sodium  Monitor for feelings of dizziness and fainting  Probanthine can be given as antispasmodic agent  Monitor for hyperglcemia  Monitor the client’s oral food intake.  Administer an oral hypoglycemic. 8) The client diagnosed with acute appendicitis is complaining of severe abdominal pain. On assessment, the nurse finds a hard, rigid abdomen and T 102 F. Which intervention should the nurse implement? 2/2 Points  Prepare to administer a Fleet’s enema.  Apply deep abdominal palpation.  Maintain NPO status and notify the health-care provider.  Administer an antipyretic suppository. 9) Which assessment data should the nurse expect to find for the client who had a barium enema? 2/2 Points  Hyperactive bowel sounds.  Increased heart rate.  White chalky stools.  Green stools. 10) The client has had a liver biopsy. Which post-procedure intervention should the nurse expect to implement immediately after the biopsy? 2/2 Points  Monitor blood urea nitrogen (BUN) and Creatinine level.  Keep the client NPO for eight (8) hours.  Place the client on the left side.  Place the client on the right side. 11) Which laboratory result, if elevated, is most indicative that the client may develop ascites? 2/2 Points  Serum bilirubin  Blood ammonia  Blood albumin  Serum creatinine 12) A 40-year-old client is admitted to the unit with diagnosis of a duodenal ulcer. The client has a history of night pain. Which would be an appropriate entry on this client’s care plan? 2/2 Points  Teach the client some relaxation techniques to decrease pain sensations  Give the client a light snack for night pain  Advise the client not to eat to decrease the incidence of pain  Offer a mild pain reliever such as aspirin at this time 13) Until a physician can see the client, which suggestion should the nurse offer to provide some relief from the symptoms GERD? 2/2 Points  Drink caffeinated beverages to promote peristalsis  Avoid acidic foods such as tomatoes and orange juice  Eat three large meals a day.  Lie flat after eating. 14) Too much hydrochloric acid is found on the gastric content in basal cell secretion test indicates what condition? 2/2 Points  Pyloric Stenosis  Peptic Ulcer Disease  Prolapse Rectum  Pernicious Anemia 15) Which advice would the nurse offer a client recovering from gastric surgery to prevent symptoms associated with dumping syndrome is appropriate? 2/2 Points  To avoid drinking fluids with meals.  Sit up for 30 min after a meal  To drink with meals  To eat salty food 16) Which nursing action is most appropriate prior to assisting with the paracentesis? 2/2 Points  Cleaning the client’s abdomen with povidone-iodine (Betadine)