The nurse is reviewing new prescriptions for a client who has tumor lysis syndrome. The nurse should clarify the prescription for

• IV furosemide
• IV 0.9% sodium chloride
• PO sevelamer
• PO spironolactone
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A client with throat cancer receives radiation therapy to the head and neck. Which of the following strategies are appropriate to decrease the adverse effects associated with radiation therapy? Select all that apply.

• Avoid irritants such as acidic, spicy foods
• Discourage the use of topical analgesics
• Encourage liquid nutritional supplements
• Perform oral hygiene once per day
• Use artificial saliva to control dryness

A nurse is screening clients at a community health event. Which of the following client statements should the nurse recognize as a warning sign of cancer? Select all that apply.

• For the past few years, I get a productive cough in the winter that goes away in spring.
• I occasionally have heartburn an hour after I eat fried foods and sausage.
• Last month when I was doing my breast self-examination, I noticed a marble-sized lump.
• My mole is itchy, and the borders have become uneven with a blackish to bluish color.
• Recently I have noticed that my bowel movements appear black.

The nurse is caring for a 3-year-old client with Wilms tumor who is scheduled for a nephrectomy. Which of the following actions would be a priority for the nurse to take?

• Monitor the client's blood pressure
• Assess the client's emotional maturity level
• Instruct the parents to avoid palpating the client's abdomen
• Auscultate the client's lungs for adventitious breath sounds
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The nurse has attended a staff education program about various types of diets. The nurse recognizes that which diet would place a client at the highest risk for megaloblastic anemia?

• lactoovovegetarian
• lactovegetarian
• ovovegetarian
• vegan
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A student nurse is caring for a client with iron deficiency anemia who is newly prescribed ferrous sulfate. Which action by the student nurse requires the supervising nurse to intervene?

• Encourages the client to drink extra fluids while taking ferrous sulfate
• Offers the client orange juice for administration of ferrous sulfate
• Plans to administer ferrous sulfate one hour before breakfast
• Prepares to administer a prescribed calcium supplement with ferrous sulfate
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The nurse provides care for a client diagnosed with polycythemia vera. Which statement by the client would require immediate follow-up?

• I am trying to find makeup to cover my unattractive, ruddy facial complexion.
• I must have injured my leg in some way because it is sore, swollen, and red.
• I take low-dose aspirin to relieve my occasional headaches.
• My skin itches so severely, and no lotion or cream seems to help.
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The nurse is talking with a client who has breast cancer and is receiving tamoxifen. Which of the following statements by the client would require immediate follow-up?

• I have been experiencing frequent hot flashes.
• I have been experiencing vaginal dryness.
• I have had a decreased interest in sexual intercourse.
• I have noticed that my menses are heavy.
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The home health nurse is teaching a client who underwent a right mastectomy with lymph node removal. The client is experiencing lymphedema in the affected arm. Which of the following information should the nurse include? Select all that apply.

• Apply a heating pad to your right arm for 15 minutes several times a day.
• Avoid receiving injections in your right arm.
• Keep your right arm elevated at the level of your heart as much as possible.
• Perform isometric exercises with your right arm daily.
• Wear a compression sleeve on your right arm during the day.

A nurse is caring for a client 1 day after a left-sided mastectomy with lymph node dissection. Which nursing intervention is the priority in caring for this client?

• Apply an ice pack to the left shoulder
• Elevate the affected arm on a pillow
• Help the client ambulate frequently
• Obtain a pneumatic compression sleeve
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