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WorksheetsReproductive/Cellular Regulation
Total questions: 50
Worksheet time: 2hrs 44mins
A nurse is reviewing a patient’s chart and notes that the patient has a cancerous tumor that has invaded other organs. Based on this information, at which stage is this patient’s cancer classified?
Stage O
Stage I
Stage III
Stage IV
A neutropenic child is admitted to the hospital and placed in protective isolation. Which instruction does the nurse give the family to help maintain a safe environment for the child?
Do not let the child have chewing gum
Flowers, plants, and produce are not allowed
The child can only have one visitor at a time
Toys and items from home cannot be brought in
A 7-year-old child presents to the emergency department, where the parent reports a 3-week history of pale skin, extreme fatigue, and dizziness. Which laboratory value would the nurse correlate with the patient’s current condition?
Hematocrit: 33%
Hemoglobin: 13.2 g/dL
Red blood cell count: 2.8/mm3
White blood cell count: 12.3/mm3
Prior to administering IV chemotherapy to a pediatric patient, which action by the nurse is most important?
Ensure the IV has a good blood return.
Provide diversionary activities.
Take and record a set of vital signs.
Weigh the child.
A child is receiving chemotherapy. The nurse assesses the child’s oral cavity and notes the following: raspy voice, thick saliva, and debris on the teeth. Which action by the nurse is the most appropriate?
Have the child use commercial mouthwash.
Hold the next dose of chemotherapy
Increase the frequency of oral care.
Place the child on NPO status.
A student is learning about the process of hematopoiesis and how it is affected by leukemia. Which information does the student discover? (Select all that apply.)
Blast cells multiply faster than mature cells.
Leukemia disrupts normal hematopoiesis.
Lymphoid cells differentiate into B and T cells.
Myeloid cells crowd out normal cells in bone marrow.
Pancytopenia occurs from proliferation of mast cells.
The clinic nurse explains to a student that the hormone responsible for limiting the maternal immune response to pregnancy is which of the following?
Human chorionic gonadotropin
Progesterone
Prostaglandin
Relaxin
The nurse explains to the student that the development of the lining of the uterus is mediated by which hormone?
Follicle-stimulating hormone
Luteinizing hormone
Progesterone
Prostaglandin
The nurse assessing a newborn’s umbilical cord stump would document which finding as normal anatomy?
One artery, one vein
One artery, two veins
Two veins, two arteries
One vein, two arteries
The perinatal nurse explains the function of Wharton’s jelly to a class of expectant parents. What description is most accurate?
Collection of blood from the maternal circulation
Gooey uterine substance that cushions the fetus
Precursor cells from which blood cells originate
Protects the umbilical cord from compression
The nurse discussing fetal development describes the hormone responsible for suppressing the maternal immunological response to the fetus, thereby facilitating physiological acceptance of the pregnancy. Which hormone is the nurse describing?
Estrogen
Human chorionic gonadotropin
Human placental lactogen
Progesterone
Patients who receive chemotherapy drugs often develop anemia because the drugs
damage the bone marrow.
prevent iron absorption.
interfere with folate metabolism.
destroy hemoglobin.
A good source of iron during pregnancy would be
watermelon
orange juice
macaroni and cheese
lean ground beef
Adequate folate in the periconceptional period helps prevent
cretinism.
mental retardation.
neural tube defects.
gestational diabetes.
A condition of severe, prolonged, and persistent vomiting during pregnancy is called
hyperemesis gravidarum.
placenta previa.
gestational diabetes.
preeclampsia.
The finding of glycosuria during a routine laboratory test may suggest that the woman has
anemia.
gestational diabetes.
phenylketonuria.
hypertension.
The persistent eating of nonfood items such as clay, laundry starch, insects, leaves, or pebbles that lasts for longer than 1 month is called:
Pica
Bulimia
Rumination
Regurgitation
The main focus of medical management for anorexia is to:
Encourage rapid weight gain.
Encourage the client to eat voluntarily.
Teach more appropriate food choices.
Keep the client from developing additional problems.
A woman’s obstetric history indicates that she is pregnant for the fourth time and all of her children from previous pregnancies are living. One was born at 39 weeks of gestation, twins were born at 34 weeks of gestation, and another child was born at 35 weeks of gestation. What is her gravidity and parity using the GTPAL system?
3-1-1-1-3
4-1-2-0-4
3-0-3-0-3
4-2-1-0-3
A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive signs and symptoms of pregnancy likely will have:
Amenorrhea.
Positive pregnancy test.
Chadwick’s sign.
Hegar’s sign.
During a client’s physical examination the nurse notes that the lower uterine segment is soft on palpation. The nurse would document this finding as:
Hegar’s sign
McDonald’s sign
Chadwick’s sign
Goodell’s sign
The musculoskeletal system adapts to the changes that occur during pregnancy. A woman can expect to experience what change?
Her center of gravity will shift backward.
She will have increased lordosis.
She will have increased abdominal muscle tone.
She will notice decreased mobility of her pelvic joints.
A woman is in her seventh month of pregnancy. She has been complaining of nasal congestion and occasional epistaxis. The nurse suspects that:
This is a normal respiratory change in pregnancy caused by elevated levels of estrogen.
This is an abnormal cardiovascular change, and the nosebleeds are an ominous sign.
The woman is a victim of domestic violence and is being hit in the face by her partner.
The woman has been using cocaine intranasally.
To reassure and educate pregnant clients about changes in their cardiovascular system, maternity nurses should be aware that:
A pregnant woman experiencing disturbed cardiac rhythm, such as sinus arrhythmia requires close medical and obstetric observation, no matter how healthy she otherwise may appear.
Changes in heart size and position and increases in blood volume create auditory changes from 20 weeks to term.
Palpitations are twice as likely to occur in twin gestations.
All of the above changes likely will occur.
The diagnosis of pregnancy is based on which positive signs of pregnancy (Select all that apply)?
Identification of fetal heartbeat
Palpation of fetal outline
Visualization of the fetus
Verification of fetal movement
Positive hCG test
The nurse caring for a client with cancer of the thyroid gland has a tumor classified as T2, N1, M0. The nurse explains that the “T” in this classification schema represents
number of years the tumor has been present.
site of the tumor.
size of the tumor.
virulence of malignancy.
The nurse administering granulocyte colony-stimulating factor (G-CSF; Neupogen) to a client who is also receiving chemotherapy should assess the client for
a rash.
bone pain.
fatigue.
muscle aches.
The nurse should closely assess a client undergoing chemotherapy for a tumor that is responding to the therapy for any indication of tumor lysis syndrome, which is marked by
hypercalcemia.
hyperkalemia.
increase in antidiuretic hormone (ADH).
platelet count below 20,000/mm3.
The nurse has assigned the nursing diagnosis Imbalanced Nutrition: Less than Body Requirements, Related to Anorexia for a client with colon cancer. Nursing goals include the maintenance of present body weight. To achieve this goal, the nurse should suggest a diet that is high in
calories and low in cholesterol.
fat and calories.
fat and low in bulk.
protein and calories.
A client undergoing a course of chemotherapy feels lonely and isolated and tells the nurse he wants to resume some normal activities. The precaution that the nurse should give the client when resuming activities is
avoid crowds.
do not eat outside the home.
drink only bottled water.
use only the client’s own bathroom.
The nurse assesses that the client most at risk for breast cancer is the
26-year-old multipara whose father died from lung cancer.
38-year-old primigravida who had menarche at age 9.
42-year-old multipara who had menarche at age 14.
68-year-old nullipara receiving treatment for osteoporosis.
After discussing the difference between benign and malignant tumors with a client, the nurse would know that the client understood the discussion when the client says
“A benign tumor does not invade other tissue.”
“Malignant tissue is not found far from the original site of the tumor.”
“Malignant tumors do not respond well to chemotherapy.”
“The control of growth is impaired only in malignant tissue.”
The nurse explains that acute leukemia is caused by
accumulation of immature blast cells.
excessively rapid mitosis of leukemic cells.
proliferation of neutrophils.
undifferentiated blast cells entering bone marrow.
When the nurse records a platelet count of 20,000/mm3, the most appropriate nursing action is to
encourage iron-rich foods.
increase fluid intake.
institute bleeding precautions.
place the client in protective isolation.
A client with leukemia has the nursing diagnosis Imbalanced Nutrition: Less Than Body Requirements. Which food offered by the nurse would the client be least likely to want?
Cold applesauce
Hot soup
Vanilla milkshake
A sandwich
The nurse is caring for a patient receiving intravesical bladder chemotherapy. The nurse should monitor for which adverse effect?
Nausea
Alopecia
Mucositis
Hematuria
A patient undergoing external radiation has developed a dry desquamation of the skin in the treatment area. The nurse teaches the patient about management of the skin reaction. Which statement, if made by the patient, indicates the teaching was effective?
“I can buy some aloe vera gel to use on the area.”
“I will expose the treatment area to a sun lamp daily.”
“I can use ice packs to relieve itching in the treatment area.”
“I will scrub the area with warm water to remove the scales.”
A patient with metastatic cancer of the colon experiences severe vomiting following each administration of chemotherapy. Which action, if taken by the nurse, is most appropriate?
Have the patient eat large meals when nausea is not present.
Offer dry crackers and carbonated fluids during chemotherapy.
Administer prescribed antiemetics 1 hour before the treatments.
Give the patient two ounces of a citrus fruit beverage during treatments.
The nurse administers an IV vesicant chemotherapeutic agent to a patient. Which action ismost important for the nurse to take?
Infuse the medication over a short period of time.
Stop the infusion if swelling is observed at the site.
Administer the chemotherapy through a small-bore catheter.
Hold the medication unless a central venous line is available.
A patient with leukemia is considering whether to have hematopoietic stem cell transplantation (HSCT). The nurse will include which information in the patient’s teaching plan?
Transplant of the donated cells is painful because of the nerves in the tissue lining the bone.
Donor bone marrow cells are transplanted through an incision into the sternum or hip bone.
The transplant procedure takes place in a sterile operating room to minimize the risk for infection.
Hospitalization will be required for several weeks after the stem cell transplant procedure is performed.
The nurse at the clinic is interviewing a 64-year-old woman who is 5 feet, 3 inches tall and weighs 125 pounds (57 kg). The patient has not seen a health care provider for 20 years. She walks 5 miles most days and has a glass of wine 2 or 3 times a week. Which topics will the nurse plan to include in patient teaching about cancer screening and decreasing cancer risk (select all that apply)?
Pap testing
Tobacco use
Sunscreen use
Mammography
Colorectal screening
The nurse caring for the laboring woman should know that meconium is produced by:
Fetal intestines.
Fetal kidneys.
Amniotic fluid.
The placenta.
The _____ is/are responsible for oxygen and carbon dioxide transport to and from the maternal bloodstream.
Decidua basalis
Blastocyst
Germ layer
Chorionic villi
The most basic information a maternity nurse should have concerning conception is that:
Ova are considered fertile 48 to 72 hours after ovulation.
Sperm remain viable in the woman’s reproductive system for an average of 12 to 24 hours.
Conception is achieved when a sperm successfully penetrates the membrane surrounding the ovum.
Implantation in the endometrium occurs 6 to 10 days after conception.
A maternity nurse should be aware of which fact about the amniotic fluid?
It serves as a source of oral fluid and a repository for waste from the fetus.
The volume remains about the same throughout the term of a healthy pregnancy.
A volume of less than 300 mL is associated with gastrointestinal malformations.
A volume of more than 2 L is associated with fetal renal abnormalities.
As relates to the structure and function of the placenta, the maternity nurse should be aware that:
As the placenta widens, it gradually thins to allow easier passage of air and nutrients.
As one of its early functions, the placenta acts as an endocrine gland.
The placenta is able to keep out most potentially toxic substances such as cigarette smoke to which the mother is exposed.
Optimal blood circulation is achieved through the placenta when the woman is lying on her back or standing.
The nurse caring for a pregnant client knows that her health teaching regarding fetal circulation has been effective when the client reports that she has been sleeping:
In a side-lying position.
On her back with a pillow under her knees.
With the head of the bed elevated.
On her abdomen.
The placenta allows exchange of oxygen, nutrients, and waste products between the mother and fetus by:
Contact between maternal blood and fetal capillaries within the chorionic villi.
Interaction of maternal and fetal pH levels within the endometrial vessels.
A mixture of maternal and fetal blood within the intervillous spaces.
Passive diffusion of maternal carbon dioxide and oxygen into the fetal capillaries.
A 22-year-old woman pregnant with a single fetus has a preconception body mass index (BMI) of 24. When she was seen in the clinic at 14 weeks of gestation, she had gained 1.8 kg (4 lb) since conception. How would the nurse interpret this?
This weight gain indicates possible gestational hypertension.
This weight gain indicates that the woman’s infant is at risk for intrauterine growth restriction (IUGR).
This weight gain cannot be evaluated until the woman has been observed for several more weeks.
The woman’s weight gain is appropriate for this stage of pregnancy.
A pregnant woman’s diet history indicates that she likes the following list of foods. The nurse would encourage this woman to consume more of which food to increase her calcium intake?
Fresh apricots
Canned clams
Spaghetti with meat sauce
Canned sardines
