Concept 10: Cellular Regulation My Nursing Test Banks

Concept 10: Cellular Regulation

Test Bank

MULTIPLE CHOICE

1. The nurse would incorporate which of the following into the plan of care as a primary prevention strategy for reduction of the risk for cancer?

a.

Yearly mammography for women aged 40 years and older

b.

Using skin protection during sun exposure while at the beach

c.

Colonoscopy at age 50 and every 10 years as follow-up

d.

Yearly prostate specific antigen (PSA) and digital rectal exam for men aged 50 and over

ANS: B

Primary prevention of cancer involves avoidance to known causes of cancer, such as sun exposure. Secondary screening involves physical and diagnostic examination.

REF: 97 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance

2. While collecting a health history on a patient admitted for colon cancer, which of the following questions would be a priority to ask this patient?

a.

Have you noticed any blood in your stool?

b.

Have you been experiencing nausea?

c.

Do you have back pain?

d.

Have you noticed any swelling in your abdomen?

ANS: A

Early colon cancer is often asymptomatic, with occult or frank blood in the stool being an assessment finding in a patient diagnosed with colon cancer. If pain is present, it is usually lower abdominal cramping. Constipation and diarrhea are more frequent findings than nausea or ascites.

REF: 95 OBJ: NCLEX Client Needs Category: Physiological Integrity

3. While planning care for a patient experiencing fatigue due to chemotherapy, which of the following is the most appropriate nursing intervention?

a.

Prioritization and administration of nursing care throughout the day

b.

Completing all nursing care in the morning so the patient can rest the remainder of the day

c.

Completing all nursing care in the evening when the patient is more rested

d.

Limiting visitors, thus promoting the maximal amount of hours for sleep

ANS: A

Pacing activities throughout the day conserves energy, and nursing care should be paced as well. Fatigue is a common side effect of cancer and treatment; and while adequate sleep is important, an increase in the number of hours slept will not resolve the fatigue. Restriction of visitors does not promote healthy coping and can result in feelings of isolation.

REF: 100 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance

4. The nurse is caring for a patient who received a bone marrow transplant 10 days ago. The nurse would monitor for which of the following clinical manifestations that could indicate a potentially life-threatening situation?

a.

Mucositis

b.

Confusion

c.

Depression

d.

Mild temperature elevation

ANS: D

During the first 100 days after a bone marrow transplant, patients are at high risk for life-threatening infections. The earliest sign of infection in an immunosuppressed patient can be a mild fever. Mucositis, confusion, and depression are possible clinical manifestations but are representative of less life-threatening complications.

REF: 98-99 OBJ: NCLEX Client Needs Category: Physiological Integrity

5. While the nurse is obtaining the health history of a 75-year-old female patient, which of the following has the greatest implication for the development of cancer?

a.

Being a 75-year-old woman

b.

Family history of hypertension

c.

Cigarette smoking as a teenager

d.

Advancing age

ANS: D

According to the American Cancer Society, 2007, the most important risk factor for cancer development is advancing age.

REF: 93 OBJ: NCLEX Client Needs Category: Physiological Integrity

6. In caring for a patient following lobectomy for lung cancer, which of the following should the nurse include in the plan of care?

a.

Position the patient on the operative side only.

b.

Avoid administering narcotic pain medications.

c.

Keep the patient on strict bed rest.

d.

Instruct the patient to cough and deep breathe.

ANS: D

Postoperative deep breathing and coughing is important to promote oxygenation and clearing of secretions. Pain medications will be given to lessen pain and allow for deep breathing and coughing. Strict bed rest is not instituted, because early ambulation will help lessen postoperative complications such as deep vein thrombosis. Prolonged lying on the operative side is avoided.

REF: 97-98 OBJ: NCLEX Client Needs Category: Physiological Integrity

7. A female patient complains of a scab that just wont heal under her left breast. During your conversation, she also mentions chronic fatigue, loss of appetite, and slight cough, attributed to allergies. What are the nurses next steps?

a.

Continue to conduct a symptom analysis to better understand the patients symptoms and concerns.

b.

End the appointment and tell the patient to use skin protection during sun exposure.

c.

Suggest further testing with a cancer specialist and provide the appropriate literature.

d.

Tell her to put a bandage on the scab and set a follow-up appointment in one week.

ANS: A

A comprehensive health history is vital to treating and caring for the patient. Often times, symptoms are vague. The nurse should conduct a symptom analysis to gather as much information as possible. Questions should address the duration of the symptoms and include the location, characteristics, aggravating and relief factors, and any treatments taken thus far.

REF: 95 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance

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