Adult II Exam #1

A 32-year-old woman meets with the nurse on her first office visit since undergoing a left mastectomy. When asked how she is doing, the woman states her appetite is still not good, she is not getting much sleep because she doesn’t go to bed until her husband is asleep, and she is really anxious to get back to work. Which of the following nursing interventions should the nurse explore to support the client’s current needs?

• Ask open-ended questions about sexuality issues related to her mastectomy

• Suggest that the client learn relaxation techniques to help with her insomnia

• Call the physician to discuss allowing the client to return to work earlier

• Perform a nutritional assessment to assess for anorexia

A female client with cancer is scheduled for radiation therapy. The nurse knows that radiation at any treatment site may cause a certain adverse effect. Therefore, the nurse should prepare the client to expect:

• Fatigue

• Vomiting

• Hair loss

• excessive hunger

Nurse April is teaching a client who suspects that she has a lump in her breast. The nurse instructs the client that a diagnosis of breast cancer is confirmed by:

• Breast self-examination

• Mammography

• biopsy

• Chest X-ray

When the nurse is administering a vesicant chemotherapeutic agent intravenously, an important consideration is to

• Stop the infusion if swelling is observed at the site

• Infuse the medication over a short period

• Administer the chemotherapy through a small-bore catheter

• Hold the medication unless a central venous line is available

A chemotherapeutic agent known to cause alopecia is prescribed for a patient. To maintain the patient’s self-esteem, the nurse plans to

• Suggest that the patient limit social contacts until regrowth of the hair occurs

• Encourage the patient to purchase a wig or hat and wear it once hair loss begins

• Have the patient wash the hair gently with a mild shampoo to minimize hair loss

• Inform the patient that hair loss will not be permanent and that the hair will grow back

A patient who has terminal cancer of the liver and is cared for by family members at home tells the nurse, “I have intense pain most of the time now.” The nurse recognizes that teaching regarding pain management has been effective when the patient

• States that nonopioid analgesics may be used when the maximal dose of the opioid is reached without adequate pain relief

• Uses the ordered opioid pain medication whenever the pain is greater than 5 on a 10-point scale

• Agrees to take the medications by the IV route to improve effectiveness

• Takes opioids around the clock on a regular schedule and uses additional doses when breakthrough pain occurs

The home health care nurse is caring for a male client with cancer and the client is complaining of acute pain. The appropriate nursing assessment of the client’s pain would include which of the following?

• The client’s pain rating

• The nurse’s impression of the client’s pain

• Nonverbal cues from the client

• Pain relief after appropriate nursing intervention

A client taking a chemotherapeutic agent understands the effects of therapy by stating:

• “I should stay in my room all the time.”

• “I will avoid eating hot and spicy foods.”

• “I should limit my fluid intake to about 500 ml per day.”

• “I should notify the physician immediately if a urine color change is observed.”

In teaching about cancer prevention to a community group, the nurse stresses the promotion of exercise, normal body weight, and a low-fat diet because

• Obesity and lack of exercise cause cancer in susceptible people

• People who exercise and eat healthy will make other lifestyle changes

• Most people are willing to make these changes to avoid cancer

• Dietary fat and obesity promote growth of many types of cancer

When reviewing the chart for a patient with cervical cancer, the nurse notes that the cancer is staged as Tis, N0, M0. The nurse will teach the patient that

• The cancer cells are well-differentiated

• It is difficult to determine the original site of cervical cancer

• The cancer is localized to the cervix

• Further testing is needed to determine the spread of the cancer