Question 1

The nurse is providing discharge instructions to a client being treated for cancer.For which symptoms should the client be instructed to call for help at home? Select all that apply.
A) Difficulty breathing
B) Significant increase in vomiting
C) Desire to end life
D) Improved sense of well-being
E) New onset of bleeding

Accepted Answer

A) The client should be instructed to call for help with any difficulty breathing, significant increase in vomiting, a desire to end life, or a new onset of bleeding. An increased sense of well-being would be a desired effect of treatment for cancer.
B) The client should be instructed to call for help with any difficulty breathing, significant increase in vomiting, a desire to end life, or a new onset of bleeding. An increased sense of well-being would be a desired effect of treatment for cancer.
C) The client should be instructed to call for help with any difficulty breathing, significant increase in vomiting, a desire to end life, or a new onset of bleeding. An increased sense of well-being would be a desired effect of treatment for cancer.
D) The client should be instructed to call for help with any difficulty breathing, significant increase in vomiting, a desire to end life, or a new onset of bleeding. An increased sense of well-being would be a desired effect of treatment for cancer.
E) The client should be instructed to call for help with any difficulty breathing, significant increase in vomiting, a desire to end life, or a new onset of bleeding. An increased sense of well-being would be a desired effect of treatment for cancer.

Question 2

The nurse is caring for a thin,older adult client who is diagnosed with cancer and is receiving aggressive chemotherapy.The client is experiencing severe side effects from the therapy and has lost 10 pounds in the past week.What should the nurse teach the client to do? Select all that apply.
A) Purchase fast foods and prepared foods.
B) Eat cold foods rather than hot foods, because they are better tolerated.
C) Keep a food diary and record intake.
D) Eat large frequent meals high in calories.
E) Drink liquid supplements to increase intake of nutrients.

Accepted Answer

A) Nutrition is an essential part of caring for all client with cancer but takes on even greater importance in the frail elderly, who may already have nutritional challenges such as poor dentition, inefficient absorption of nutrients, and mediation side effects. The goal of nutritional teaching is to help the client increase caloric and nutrient intake through the use of liquid supplements, small frequent meals, and a food diary that will help the nurse evaluate strengths and weaknesses of the current plan. The client receiving chemotherapy may tolerate cold foods better than hot foods. Fast foods and prepared foods tend to be high in fat and sodium and are not the best choice because they do not contain adequate healthy nutrients. Instead, involving the family in preparing meals or in enrolling in Meals on Wheels may be better options for easy ways of obtaining meals.
B) Nutrition is an essential part of caring for all client with cancer but takes on even greater importance in the frail elderly, who may already have nutritional challenges such as poor dentition, inefficient absorption of nutrients, and mediation side effects. The goal of nutritional teaching is to help the client increase caloric and nutrient intake through the use of liquid supplements, small frequent meals, and a food diary that will help the nurse evaluate strengths and weaknesses of the current plan. The client receiving chemotherapy may tolerate cold foods better than hot foods. Fast foods and prepared foods tend to be high in fat and sodium and are not the best choice because they do not contain adequate healthy nutrients. Instead, involving the family in preparing meals or in enrolling in Meals on Wheels may be better options for easy ways of obtaining meals.
C) Nutrition is an essential part of caring for all client with cancer but takes on even greater importance in the frail elderly, who may already have nutritional challenges such as poor dentition, inefficient absorption of nutrients, and mediation side effects. The goal of nutritional teaching is to help the client increase caloric and nutrient intake through the use of liquid supplements, small frequent meals, and a food diary that will help the nurse evaluate strengths and weaknesses of the current plan. The client receiving chemotherapy may tolerate cold foods better than hot foods. Fast foods and prepared foods tend to be high in fat and sodium and are not the best choice because they do not contain adequate healthy nutrients. Instead, involving the family in preparing meals or in enrolling in Meals on Wheels may be better options for easy ways of obtaining meals.
D) Nutrition is an essential part of caring for all client with cancer but takes on even greater importance in the frail elderly, who may already have nutritional challenges such as poor dentition, inefficient absorption of nutrients, and mediation side effects. The goal of nutritional teaching is to help the client increase caloric and nutrient intake through the use of liquid supplements, small frequent meals, and a food diary that will help the nurse evaluate strengths and weaknesses of the current plan. The client receiving chemotherapy may tolerate cold foods better than hot foods. Fast foods and prepared foods tend to be high in fat and sodium and are not the best choice because they do not contain adequate healthy nutrients. Instead, involving the family in preparing meals or in enrolling in Meals on Wheels may be better options for easy ways of obtaining meals.
E) Nutrition is an essential part of caring for all client with cancer but takes on even greater importance in the frail elderly, who may already have nutritional challenges such as poor dentition, inefficient absorption of nutrients, and mediation side effects. The goal of nutritional teaching is to help the client increase caloric and nutrient intake through the use of liquid supplements, small frequent meals, and a food diary that will help the nurse evaluate strengths and weaknesses of the current plan. The client receiving chemotherapy may tolerate cold foods better than hot foods. Fast foods and prepared foods tend to be high in fat and sodium and are not the best choice because they do not contain adequate healthy nutrients. Instead, involving the family in preparing meals or in enrolling in Meals on Wheels may be better options for easy ways of obtaining meals.

Question 3

A client complaining of mouth soreness had gastric bypass surgery 1 year ago.During the assessment,the nurse notes the client's tongue is beefy,red,and smooth and the client's skin appears yellowish.Which additional information is most likely needed before diagnosing this client? A) Vitamin B₆ levels B) Vitamin B₁₂ levels C) Potassium levels D) Iron levels

Accepted Answer

A) Vitamin B₁₂ deficiency is associated with gastric bypass surgery. A deficiency of vitamin B₁₂ levels will result in pernicious anemia. This deficiency will manifest as pallor, jaundice, and weakness, and a beefy, smooth red tongue. Iron deficiency anemia will manifest with weakness and fatigue. Vitamin B₆ deficiencies are not typically seen with gastric bypass surgeries and are not manifested with a beefy, red, smooth tongue. The client's reports are not consistent with a potassium deficiency. B) Vitamin B₁₂ deficiency is associated with gastric bypass surgery. A deficiency of vitamin B₁₂ levels will result in pernicious anemia. This deficiency will manifest as pallor, jaundice, and weakness, and a beefy, smooth red tongue. Iron deficiency anemia will manifest with weakness and fatigue. Vitamin B₆ deficiencies are not typically seen with gastric bypass surgeries and are not manifested with a beefy, red, smooth tongue. The client's reports are not consistent with a potassium deficiency. C) Vitamin B₁₂ deficiency is associated with gastric bypass surgery. A deficiency of vitamin B₁₂ levels will result in pernicious anemia. This deficiency will manifest as pallor, jaundice, and weakness, and a beefy, smooth red tongue. Iron deficiency anemia will manifest with weakness and fatigue. Vitamin B₆ deficiencies are not typically seen with gastric bypass surgeries and are not manifested with a beefy, red, smooth tongue. The client's reports are not consistent with a potassium deficiency. D) Vitamin B₁₂ deficiency is associated with gastric bypass surgery. A deficiency of vitamin B₁₂ levels will result in pernicious anemia. This deficiency will manifest as pallor, jaundice, and weakness, and a beefy, smooth red tongue. Iron deficiency anemia will manifest with weakness and fatigue. Vitamin B₆ deficiencies are not typically seen with gastric bypass surgeries and are not manifested with a beefy, red, smooth tongue. The client's reports are not consistent with a potassium deficiency.

Question 4

A nurse is educating a client with anemia about the pathophysiological mechanisms of anemia.Which should be excluded in the nurse's teaching plan for this client?
A) Altered hemoglobin synthesis.
B) Altered DNA synthesis.
C) Decreased hemolysis.
D) Bone marrow failure.

Accepted Answer

A) The pathophysiological mechanisms of anemia include altered hemoglobin synthesis, altered DNA synthesis, bone marrow failure, and increased hemolysis. Altered hemoglobin synthesis is the mechanism involved in iron deficiency anemia, Thalassemia, and chronic inflammation. Altered DNA synthesis is the mechanism involved in Vitamin B₁₂ malabsorption or deficiency, and folic acid malabsorption or deficiency. Bone marrow failure is the mechanism in aplastic anemia, red cell aplasia, myeloproliferative leukemias, and lymphomas. B) The pathophysiological mechanisms of anemia include altered hemoglobin synthesis, altered DNA synthesis, bone marrow failure, and increased hemolysis. Altered hemoglobin synthesis is the mechanism involved in iron deficiency anemia, Thalassemia, and chronic inflammation. Altered DNA synthesis is the mechanism involved in Vitamin B₁₂ malabsorption or deficiency, and folic acid malabsorption or deficiency. Bone marrow failure is the mechanism in aplastic anemia, red cell aplasia, myeloproliferative leukemias, and lymphomas. C) The pathophysiological mechanisms of anemia include altered hemoglobin synthesis, altered DNA synthesis, bone marrow failure, and increased hemolysis. Altered hemoglobin synthesis is the mechanism involved in iron deficiency anemia, Thalassemia, and chronic inflammation. Altered DNA synthesis is the mechanism involved in Vitamin B₁₂ malabsorption or deficiency, and folic acid malabsorption or deficiency. Bone marrow failure is the mechanism in aplastic anemia, red cell aplasia, myeloproliferative leukemias, and lymphomas. D) The pathophysiological mechanisms of anemia include altered hemoglobin synthesis, altered DNA synthesis, bone marrow failure, and increased hemolysis. Altered hemoglobin synthesis is the mechanism involved in iron deficiency anemia, Thalassemia, and chronic inflammation. Altered DNA synthesis is the mechanism involved in Vitamin B₁₂ malabsorption or deficiency, and folic acid malabsorption or deficiency. Bone marrow failure is the mechanism in aplastic anemia, red cell aplasia, myeloproliferative leukemias, and lymphomas.

Question 5

The nurse suspects that a client with severe shortness of breath in the absence of cyanosis is experiencing anemia.Which laboratory tests should the nurse review to confirm anemia? Select all that apply.
A) Serum electrolytes
B) Cardiac enzymes
C) Hemoglobin
D) Blood sugar
E) Hematocrit

Accepted Answer

A) In order to exhibit cyanosis, the client's blood must contain about 5 g or more of unoxygenated hemoglobin per 100 mL of blood and the surface blood capillaries must be dilated. Severe anemia will interfere with the development of cyanosis, so the nurse should review the hemoglobin and hematocrit. Blood sugar, cardiac enzymes, and serum electrolytes are not implicated in this phenomenon.
B) In order to exhibit cyanosis, the client's blood must contain about 5 g or more of unoxygenated hemoglobin per 100 mL of blood and the surface blood capillaries must be dilated. Severe anemia will interfere with the development of cyanosis, so the nurse should review the hemoglobin and hematocrit. Blood sugar, cardiac enzymes, and serum electrolytes are not implicated in this phenomenon.
C) In order to exhibit cyanosis, the client's blood must contain about 5 g or more of unoxygenated hemoglobin per 100 mL of blood and the surface blood capillaries must be dilated. Severe anemia will interfere with the development of cyanosis, so the nurse should review the hemoglobin and hematocrit. Blood sugar, cardiac enzymes, and serum electrolytes are not implicated in this phenomenon.
D) In order to exhibit cyanosis, the client's blood must contain about 5 g or more of unoxygenated hemoglobin per 100 mL of blood and the surface blood capillaries must be dilated. Severe anemia will interfere with the development of cyanosis, so the nurse should review the hemoglobin and hematocrit. Blood sugar, cardiac enzymes, and serum electrolytes are not implicated in this phenomenon.
E) In order to exhibit cyanosis, the client's blood must contain about 5 g or more of unoxygenated hemoglobin per 100 mL of blood and the surface blood capillaries must be dilated. Severe anemia will interfere with the development of cyanosis, so the nurse should review the hemoglobin and hematocrit. Blood sugar, cardiac enzymes, and serum electrolytes are not implicated in this phenomenon.

Question 6

An older adult client with renal failure is diagnosed with anemia.Based on this data,which cause of anemia will the nurse plan for when providing care?
A) Loss of the kidney hormone erythropoietin
B) A loss of appetite related to elevated blood urea nitrogen (BUN) and creatinine levels
C) The renal dialysis used to treat the chronic renal failure
D) Loss of blood through the urine because the failing kidney does not function properly

Accepted Answer

A) The anemia associated with renal failure is related to the loss of erythropoietin, which is produced by the healthy kidney and stimulates bone marrow to produce red blood cells. The anemia is not directly related to anorexia or hemodialysis, although these factors may be somewhat associated with the anemia. Renal failure causes the loss of protein, not blood, through the urine.
B) The anemia associated with renal failure is related to the loss of erythropoietin, which is produced by the healthy kidney and stimulates bone marrow to produce red blood cells. The anemia is not directly related to anorexia or hemodialysis, although these factors may be somewhat associated with the anemia. Renal failure causes the loss of protein, not blood, through the urine.
C) The anemia associated with renal failure is related to the loss of erythropoietin, which is produced by the healthy kidney and stimulates bone marrow to produce red blood cells. The anemia is not directly related to anorexia or hemodialysis, although these factors may be somewhat associated with the anemia. Renal failure causes the loss of protein, not blood, through the urine.
D) The anemia associated with renal failure is related to the loss of erythropoietin, which is produced by the healthy kidney and stimulates bone marrow to produce red blood cells. The anemia is not directly related to anorexia or hemodialysis, although these factors may be somewhat associated with the anemia. Renal failure causes the loss of protein, not blood, through the urine.

Question 7

A client experiencing fatigue,pallor,and dyspnea on exertion has a complete blood count drawn.Which red blood cell disorder should the nurse anticipate the client is experiencing?
A) Polycythemia
B) Erythropoiesis
C) Herpes simplex
D) Anemia

Accepted Answer

A) Anemia is the most common red blood cell disorder, involving a low count and decreased hemoglobin content. Signs and symptoms of anemia can include pallor of the skin and mucous membranes and dyspnea on exertion. Polycythemia is an abnormally high RBC count. Herpes simplex is not a red blood cell disorder; erythropoiesis is the term for RBC production.
B) Anemia is the most common red blood cell disorder, involving a low count and decreased hemoglobin content. Signs and symptoms of anemia can include pallor of the skin and mucous membranes and dyspnea on exertion. Polycythemia is an abnormally high RBC count. Herpes simplex is not a red blood cell disorder; erythropoiesis is the term for RBC production.
C) Anemia is the most common red blood cell disorder, involving a low count and decreased hemoglobin content. Signs and symptoms of anemia can include pallor of the skin and mucous membranes and dyspnea on exertion. Polycythemia is an abnormally high RBC count. Herpes simplex is not a red blood cell disorder; erythropoiesis is the term for RBC production.
D) Anemia is the most common red blood cell disorder, involving a low count and decreased hemoglobin content. Signs and symptoms of anemia can include pallor of the skin and mucous membranes and dyspnea on exertion. Polycythemia is an abnormally high RBC count. Herpes simplex is not a red blood cell disorder; erythropoiesis is the term for RBC production.

Question 8

The nurse is reviewing data collected during a health history and physical assessment and determines that a client is at risk for developing breast cancer.Which data supports this client's risk for developing breast cancer? Select all that apply.
A) Age 60
B) Breastfed both children
C) Sister had breast cancer
D) Body mass index 22
E) Menopause at age 58

Accepted Answer

A) The risk for developing breast cancer increases with age. Having a first-degree relative with breast cancer increases the risk. Menopause after the age of 55 also increases the risk for developing breast cancer. Breastfeeding and maintaining a normal body weight lower a person's risk for developing breast cancer.
B) The risk for developing breast cancer increases with age. Having a first-degree relative with breast cancer increases the risk. Menopause after the age of 55 also increases the risk for developing breast cancer. Breastfeeding and maintaining a normal body weight lower a person's risk for developing breast cancer.
C) The risk for developing breast cancer increases with age. Having a first-degree relative with breast cancer increases the risk. Menopause after the age of 55 also increases the risk for developing breast cancer. Breastfeeding and maintaining a normal body weight lower a person's risk for developing breast cancer.
D) The risk for developing breast cancer increases with age. Having a first-degree relative with breast cancer increases the risk. Menopause after the age of 55 also increases the risk for developing breast cancer. Breastfeeding and maintaining a normal body weight lower a person's risk for developing breast cancer.
E) The risk for developing breast cancer increases with age. Having a first-degree relative with breast cancer increases the risk. Menopause after the age of 55 also increases the risk for developing breast cancer. Breastfeeding and maintaining a normal body weight lower a person's risk for developing breast cancer.

Question 9

A client with a history of anemia has started a vegan diet.Which addition to meals should the nurse recommend to help ensure that this client has adequate amounts of iron in the diet? Select all that apply.
A) Legumes
B) Orange juice
C) Brewer's yeast
D) Okra
E) Peas

Accepted Answer

A) While all these options are good ones for someone on a vegan diet, the ones that would best prevent iron deficiency are legumes, peas, and orange juice. Legumes and peas are good sources of nonheme iron. Orange juice supports iron absorption from foods since it is high in vitamin C. Brewer's yeast is a good source of vitamin B₁₂, which is often low in vegan diets. Okra is not a good source of iron. B) While all these options are good ones for someone on a vegan diet, the ones that would best prevent iron deficiency are legumes, peas, and orange juice. Legumes and peas are good sources of nonheme iron. Orange juice supports iron absorption from foods since it is high in vitamin C. Brewer's yeast is a good source of vitamin B₁₂, which is often low in vegan diets. Okra is not a good source of iron. C) While all these options are good ones for someone on a vegan diet, the ones that would best prevent iron deficiency are legumes, peas, and orange juice. Legumes and peas are good sources of nonheme iron. Orange juice supports iron absorption from foods since it is high in vitamin C. Brewer's yeast is a good source of vitamin B₁₂, which is often low in vegan diets. Okra is not a good source of iron. D) While all these options are good ones for someone on a vegan diet, the ones that would best prevent iron deficiency are legumes, peas, and orange juice. Legumes and peas are good sources of nonheme iron. Orange juice supports iron absorption from foods since it is high in vitamin C. Brewer's yeast is a good source of vitamin B₁₂, which is often low in vegan diets. Okra is not a good source of iron. E) While all these options are good ones for someone on a vegan diet, the ones that would best prevent iron deficiency are legumes, peas, and orange juice. Legumes and peas are good sources of nonheme iron. Orange juice supports iron absorption from foods since it is high in vitamin C. Brewer's yeast is a good source of vitamin B₁₂, which is often low in vegan diets. Okra is not a good source of iron.

Question 10

The nurse is instructing a client with iron deficiency anemia about appropriate menu choices.Which diet choice indicates that teaching has been effective?
A) Tofu with mixed vegetables in curry, milk, whole-wheat bun
B) Broiled fish, lettuce salad, grapefruit half, carrot sticks
C) Pork chop, mashed potatoes and gravy, cauliflower, tea
D) Roast beef, steamed spinach, tomato soup, orange juice

Accepted Answer

A) This client is anemic and needs iron. This meal contains iron in the beef, folic acid in the spinach, and vitamin C in the tomato soup and orange juice. Vitamin C helps absorption of the iron; folic acid is needed for production of red cells. The meal of tofu with mixed vegetables in curry, milk, and a whole-wheat bun is high in calcium, but the client has iron deficiency anemia and requires a high-iron diet. The meal with a pork chop, mashed potatoes and gravy, cauliflower, and tea has a moderate amount of protein, but no vitamin C. The meal of fish, lettuce, grapefruit, and carrot sticks is high in fiber, low in fat, and moderately high in protein, but low in iron.
B) This client is anemic and needs iron. This meal contains iron in the beef, folic acid in the spinach, and vitamin C in the tomato soup and orange juice. Vitamin C helps absorption of the iron; folic acid is needed for production of red cells. The meal of tofu with mixed vegetables in curry, milk, and a whole-wheat bun is high in calcium, but the client has iron deficiency anemia and requires a high-iron diet. The meal with a pork chop, mashed potatoes and gravy, cauliflower, and tea has a moderate amount of protein, but no vitamin C. The meal of fish, lettuce, grapefruit, and carrot sticks is high in fiber, low in fat, and moderately high in protein, but low in iron.
C) This client is anemic and needs iron. This meal contains iron in the beef, folic acid in the spinach, and vitamin C in the tomato soup and orange juice. Vitamin C helps absorption of the iron; folic acid is needed for production of red cells. The meal of tofu with mixed vegetables in curry, milk, and a whole-wheat bun is high in calcium, but the client has iron deficiency anemia and requires a high-iron diet. The meal with a pork chop, mashed potatoes and gravy, cauliflower, and tea has a moderate amount of protein, but no vitamin C. The meal of fish, lettuce, grapefruit, and carrot sticks is high in fiber, low in fat, and moderately high in protein, but low in iron.
D) This client is anemic and needs iron. This meal contains iron in the beef, folic acid in the spinach, and vitamin C in the tomato soup and orange juice. Vitamin C helps absorption of the iron; folic acid is needed for production of red cells. The meal of tofu with mixed vegetables in curry, milk, and a whole-wheat bun is high in calcium, but the client has iron deficiency anemia and requires a high-iron diet. The meal with a pork chop, mashed potatoes and gravy, cauliflower, and tea has a moderate amount of protein, but no vitamin C. The meal of fish, lettuce, grapefruit, and carrot sticks is high in fiber, low in fat, and moderately high in protein, but low in iron.

Question 11

The nurse instructs a group of community members on the difference between benign and malignant neoplasms.Which participant statements indicate that teaching has been effective? Select all that apply.
A) "Benign tumors grow slowly."
B) "Malignant tumors are easy to remove."
C) "Benign tumors stay in one area."
D) "Malignant tumors push other tissue out of the way."
E) "Malignant tumors can grow back."

Accepted Answer

A) Benign tumors are slow-growing, stay in one area, are easy to remove, and push other tissue out of the way. Malignant tumors are more difficult to remove. They invade neighboring tissue and can return once removed.
B) Benign tumors are slow-growing, stay in one area, are easy to remove, and push other tissue out of the way. Malignant tumors are more difficult to remove. They invade neighboring tissue and can return once removed.
C) Benign tumors are slow-growing, stay in one area, are easy to remove, and push other tissue out of the way. Malignant tumors are more difficult to remove. They invade neighboring tissue and can return once removed.
D) Benign tumors are slow-growing, stay in one area, are easy to remove, and push other tissue out of the way. Malignant tumors are more difficult to remove. They invade neighboring tissue and can return once removed.
E) Benign tumors are slow-growing, stay in one area, are easy to remove, and push other tissue out of the way. Malignant tumors are more difficult to remove. They invade neighboring tissue and can return once removed.

Question 12

A nurse is providing discharge teaching for a client with iron deficiency anemia.The client has been prescribed ferrous sulfate and has been told to increase the intake of foods that are naturally high in iron.Which client statements indicate a need for further education? Select all that apply.
A) "I will take my ferrous sulfate tablet with my morning oatmeal."
B) "I will decrease my intake of green leafy vegetables while taking my ferrous sulfate tablet."
C) "I will increase my fluid intake while I am taking my ferrous sulfate."
D) "I will take my ferrous sulfate tablet on an empty stomach."
E) "I will decrease milk intake while taking my ferrous sulfate tablet."

Accepted Answer

A) Ferrous sulfate can cause gastric irritation and constipation. Taking it with a meal can help minimize gastrointestinal distress. The client should not decrease milk or green leafy vegetables from the diet as these are natural sources of iron and should be encouraged. Increasing fiber (oatmeal) and fluid intake can also help prevent constipation.
B) Ferrous sulfate can cause gastric irritation and constipation. Taking it with a meal can help minimize gastrointestinal distress. The client should not decrease milk or green leafy vegetables from the diet as these are natural sources of iron and should be encouraged. Increasing fiber (oatmeal) and fluid intake can also help prevent constipation.
C) Ferrous sulfate can cause gastric irritation and constipation. Taking it with a meal can help minimize gastrointestinal distress. The client should not decrease milk or green leafy vegetables from the diet as these are natural sources of iron and should be encouraged. Increasing fiber (oatmeal) and fluid intake can also help prevent constipation.
D) Ferrous sulfate can cause gastric irritation and constipation. Taking it with a meal can help minimize gastrointestinal distress. The client should not decrease milk or green leafy vegetables from the diet as these are natural sources of iron and should be encouraged. Increasing fiber (oatmeal) and fluid intake can also help prevent constipation.
E) Ferrous sulfate can cause gastric irritation and constipation. Taking it with a meal can help minimize gastrointestinal distress. The client should not decrease milk or green leafy vegetables from the diet as these are natural sources of iron and should be encouraged. Increasing fiber (oatmeal) and fluid intake can also help prevent constipation.

Question 13

The nurse is teaching a 34-year-old client with client who has a sister and mother with a history of breast cancer about early screening for the health problem.Which should the nurse include in this teaching? Select all that apply.
A) Routine monthly breast self-examination
B) Annual screening mammography
C) Routine breast exams to begin after age 35
D) Clinical breast examination every 3 years
E) Reporting of any changes in breast tissue to the health provider at the next routine visit

Accepted Answer

A) American Cancer Society guidelines for cancer screening include routine breast self-examination starting at age 20; prompt reporting of any change in breast tissue to healthcare provider; clinical breast examination every 3 years from ages 20 to 39, and yearly thereafter; and annual screening mammography starting at age 40, except in women at increased risk, who may have more frequent mammography or other tests such as breast ultrasound exams. Since this client's mother and sister both have a history of breast cancer, she would be eligible for annual mammography.
B) American Cancer Society guidelines for cancer screening include routine breast self-examination starting at age 20; prompt reporting of any change in breast tissue to healthcare provider; clinical breast examination every 3 years from ages 20 to 39, and yearly thereafter; and annual screening mammography starting at age 40, except in women at increased risk, who may have more frequent mammography or other tests such as breast ultrasound exams. Since this client's mother and sister both have a history of breast cancer, she would be eligible for annual mammography.
C) American Cancer Society guidelines for cancer screening include routine breast self-examination starting at age 20; prompt reporting of any change in breast tissue to healthcare provider; clinical breast examination every 3 years from ages 20 to 39, and yearly thereafter; and annual screening mammography starting at age 40, except in women at increased risk, who may have more frequent mammography or other tests such as breast ultrasound exams. Since this client's mother and sister both have a history of breast cancer, she would be eligible for annual mammography.
D) American Cancer Society guidelines for cancer screening include routine breast self-examination starting at age 20; prompt reporting of any change in breast tissue to healthcare provider; clinical breast examination every 3 years from ages 20 to 39, and yearly thereafter; and annual screening mammography starting at age 40, except in women at increased risk, who may have more frequent mammography or other tests such as breast ultrasound exams. Since this client's mother and sister both have a history of breast cancer, she would be eligible for annual mammography.
E) American Cancer Society guidelines for cancer screening include routine breast self-examination starting at age 20; prompt reporting of any change in breast tissue to healthcare provider; clinical breast examination every 3 years from ages 20 to 39, and yearly thereafter; and annual screening mammography starting at age 40, except in women at increased risk, who may have more frequent mammography or other tests such as breast ultrasound exams. Since this client's mother and sister both have a history of breast cancer, she would be eligible for annual mammography.

Question 14

The nurse is caring for an older adult client with hemolytic anemia.When planning care for this client,which should the nurse take into consideration regarding this diagnosis? Select all that apply.
A) It causes the red blood cells to be microcytic.
B) It is associated with an increase in the reticulocyte count.
C) It is the result of blood loss.
D) It is a result of the premature destruction of red blood cells.
E) It always requires treatment with folic acid.

Accepted Answer

A) Hemolytic anemia is more common with aging and is caused by the premature destruction of the red blood cells. The normal life span of a red blood cell is 120 days. All hemolytic anemias require treatment with folic acid because this vitamin is consumed by the increased bone marrow production of red blood cells in response to the anemia. It is not associated with blood loss. There is an increase, not a decrease, in the reticulocyte (immature red blood cells) count because they are released early from the bone marrow to compensate. Hemolytic anemias are normocytic (red blood cells are normal size), not microcytic.
B) Hemolytic anemia is more common with aging and is caused by the premature destruction of the red blood cells. The normal life span of a red blood cell is 120 days. All hemolytic anemias require treatment with folic acid because this vitamin is consumed by the increased bone marrow production of red blood cells in response to the anemia. It is not associated with blood loss. There is an increase, not a decrease, in the reticulocyte (immature red blood cells) count because they are released early from the bone marrow to compensate. Hemolytic anemias are normocytic (red blood cells are normal size), not microcytic.
C) Hemolytic anemia is more common with aging and is caused by the premature destruction of the red blood cells. The normal life span of a red blood cell is 120 days. All hemolytic anemias require treatment with folic acid because this vitamin is consumed by the increased bone marrow production of red blood cells in response to the anemia. It is not associated with blood loss. There is an increase, not a decrease, in the reticulocyte (immature red blood cells) count because they are released early from the bone marrow to compensate. Hemolytic anemias are normocytic (red blood cells are normal size), not microcytic.
D) Hemolytic anemia is more common with aging and is caused by the premature destruction of the red blood cells. The normal life span of a red blood cell is 120 days. All hemolytic anemias require treatment with folic acid because this vitamin is consumed by the increased bone marrow production of red blood cells in response to the anemia. It is not associated with blood loss. There is an increase, not a decrease, in the reticulocyte (immature red blood cells) count because they are released early from the bone marrow to compensate. Hemolytic anemias are normocytic (red blood cells are normal size), not microcytic.
E) Hemolytic anemia is more common with aging and is caused by the premature destruction of the red blood cells. The normal life span of a red blood cell is 120 days. All hemolytic anemias require treatment with folic acid because this vitamin is consumed by the increased bone marrow production of red blood cells in response to the anemia. It is not associated with blood loss. There is an increase, not a decrease, in the reticulocyte (immature red blood cells) count because they are released early from the bone marrow to compensate. Hemolytic anemias are normocytic (red blood cells are normal size), not microcytic.

Question 15

A nurse is providing discharge instructions to a client with iron deficiency anemia who is experiencing glossitis.Which statements will the nurse include in the discharge teaching for this client? Select all that apply.
A) Monitor the condition of the lips and tongue daily.
B) Use an alcohol-based mouthwash every 2-4 hours.
C) Provide frequent oral hygiene.
D) Apply a non-petroleum-based lubricating jelly or ointment to the lips after oral care.
E) Use a soft toothbrush or sponge to provide oral care.

Accepted Answer

A) Glossitis, inflammation of the tongue that may cause the tongue and lips to turn red, and cheilosis (fissures or cracks at the corners of the mouth) may occur with nutritional deficiencies of iron, folate, and vitamin B₁₂. Client education should include monitoring the condition of lips and tongue daily and providing frequent oral hygiene with a soft-bristle toothbrush or sponge. The client should not use an alcohol-based mouthwash, as this would worsen the glossitis. The client should use a petroleum-based lubricating jelly or ointment to the lips after oral care. B) Glossitis, inflammation of the tongue that may cause the tongue and lips to turn red, and cheilosis (fissures or cracks at the corners of the mouth) may occur with nutritional deficiencies of iron, folate, and vitamin B₁₂. Client education should include monitoring the condition of lips and tongue daily and providing frequent oral hygiene with a soft-bristle toothbrush or sponge. The client should not use an alcohol-based mouthwash, as this would worsen the glossitis. The client should use a petroleum-based lubricating jelly or ointment to the lips after oral care. C) Glossitis, inflammation of the tongue that may cause the tongue and lips to turn red, and cheilosis (fissures or cracks at the corners of the mouth) may occur with nutritional deficiencies of iron, folate, and vitamin B₁₂. Client education should include monitoring the condition of lips and tongue daily and providing frequent oral hygiene with a soft-bristle toothbrush or sponge. The client should not use an alcohol-based mouthwash, as this would worsen the glossitis. The client should use a petroleum-based lubricating jelly or ointment to the lips after oral care. D) Glossitis, inflammation of the tongue that may cause the tongue and lips to turn red, and cheilosis (fissures or cracks at the corners of the mouth) may occur with nutritional deficiencies of iron, folate, and vitamin B₁₂. Client education should include monitoring the condition of lips and tongue daily and providing frequent oral hygiene with a soft-bristle toothbrush or sponge. The client should not use an alcohol-based mouthwash, as this would worsen the glossitis. The client should use a petroleum-based lubricating jelly or ointment to the lips after oral care. E) Glossitis, inflammation of the tongue that may cause the tongue and lips to turn red, and cheilosis (fissures or cracks at the corners of the mouth) may occur with nutritional deficiencies of iron, folate, and vitamin B₁₂. Client education should include monitoring the condition of lips and tongue daily and providing frequent oral hygiene with a soft-bristle toothbrush or sponge. The client should not use an alcohol-based mouthwash, as this would worsen the glossitis. The client should use a petroleum-based lubricating jelly or ointment to the lips after oral care.

Question 16

The home healthcare nurse is preparing a care plan for a client with severe anemia.The client currently lives alone and states,"I can't even walk to the kitchen without getting winded." What would be the priority nursing diagnosis for this client?
A) Hopelessness
B) Activity Intolerance
C) Altered Nutrition, Less than Body Requirements
D) Anxiety

Accepted Answer

A) Activity Intolerance would be a priority diagnosis for this client. While anxiety, hopelessness, and altered nutrition may be appropriate nursing diagnoses for this client, they are not the priority.
B) Activity Intolerance would be a priority diagnosis for this client. While anxiety, hopelessness, and altered nutrition may be appropriate nursing diagnoses for this client, they are not the priority.
C) Activity Intolerance would be a priority diagnosis for this client. While anxiety, hopelessness, and altered nutrition may be appropriate nursing diagnoses for this client, they are not the priority.
D) Activity Intolerance would be a priority diagnosis for this client. While anxiety, hopelessness, and altered nutrition may be appropriate nursing diagnoses for this client, they are not the priority.

Question 17

A nursing student is preparing an educational program on hemolytic anemia for the residents of an assisted-living center.Which extrinsic causes of hemolytic anemia should the student include in the program? Select all that apply.
A) Bacterial infection
B) Thalassemia
C) Ibuprofen use
D) Prosthetic heart valves
E) Acetaminophen use

Accepted Answer

A) Prosthetic heart valves, medications such as ibuprofen, and bacterial infections are all extrinsic causes of hemolytic anemia. Acetaminophen use is not associated with hemolytic anemia. Thalassemia is considered an intrinsic cause of hemolytic anemia and would not be appropriate to include in this particular teaching.
B) Prosthetic heart valves, medications such as ibuprofen, and bacterial infections are all extrinsic causes of hemolytic anemia. Acetaminophen use is not associated with hemolytic anemia. Thalassemia is considered an intrinsic cause of hemolytic anemia and would not be appropriate to include in this particular teaching.
C) Prosthetic heart valves, medications such as ibuprofen, and bacterial infections are all extrinsic causes of hemolytic anemia. Acetaminophen use is not associated with hemolytic anemia. Thalassemia is considered an intrinsic cause of hemolytic anemia and would not be appropriate to include in this particular teaching.
D) Prosthetic heart valves, medications such as ibuprofen, and bacterial infections are all extrinsic causes of hemolytic anemia. Acetaminophen use is not associated with hemolytic anemia. Thalassemia is considered an intrinsic cause of hemolytic anemia and would not be appropriate to include in this particular teaching.
E) Prosthetic heart valves, medications such as ibuprofen, and bacterial infections are all extrinsic causes of hemolytic anemia. Acetaminophen use is not associated with hemolytic anemia. Thalassemia is considered an intrinsic cause of hemolytic anemia and would not be appropriate to include in this particular teaching.

Question 18

The nurse is instructing a group of women between the ages of 40 and 50 about early detection of breast cancer.What should the nurse include in this teaching?
A) Perform monthly breast self-exams.
B) See a healthcare provider if there is a strong family history of breast cancer.
C) Have a yearly mammogram.
D) Have a clinical breast exam performed by a healthcare provider every 5 years.

Accepted Answer

A) Yearly mammography for all women over the age of 40 is encouraged, as it decreases the mortality from breast cancer. Breast self-exam is no longer recommended for all women. The American Cancer Society recommends that young women who choose to do breast self-exams have their technique validated by a healthcare practitioner at a yearly physical exam. The earlier a lump is discovered, the greater the effectiveness of treatment. Discussing a family history of breast cancer would be part of the annual breast exam performed by a healthcare provider. It is inappropriate for women in this age group to have a clinical breast exam every 5 years.
B) Yearly mammography for all women over the age of 40 is encouraged, as it decreases the mortality from breast cancer. Breast self-exam is no longer recommended for all women. The American Cancer Society recommends that young women who choose to do breast self-exams have their technique validated by a healthcare practitioner at a yearly physical exam. The earlier a lump is discovered, the greater the effectiveness of treatment. Discussing a family history of breast cancer would be part of the annual breast exam performed by a healthcare provider. It is inappropriate for women in this age group to have a clinical breast exam every 5 years.
C) Yearly mammography for all women over the age of 40 is encouraged, as it decreases the mortality from breast cancer. Breast self-exam is no longer recommended for all women. The American Cancer Society recommends that young women who choose to do breast self-exams have their technique validated by a healthcare practitioner at a yearly physical exam. The earlier a lump is discovered, the greater the effectiveness of treatment. Discussing a family history of breast cancer would be part of the annual breast exam performed by a healthcare provider. It is inappropriate for women in this age group to have a clinical breast exam every 5 years.
D) Yearly mammography for all women over the age of 40 is encouraged, as it decreases the mortality from breast cancer. Breast self-exam is no longer recommended for all women. The American Cancer Society recommends that young women who choose to do breast self-exams have their technique validated by a healthcare practitioner at a yearly physical exam. The earlier a lump is discovered, the greater the effectiveness of treatment. Discussing a family history of breast cancer would be part of the annual breast exam performed by a healthcare provider. It is inappropriate for women in this age group to have a clinical breast exam every 5 years.

Question 19

The nurse is evaluating a client's understanding of dietary needs to treat dietary deficiency anemia.Which client statement indicates a need for additional teaching?
A) "I will eat more fruits and vegetables, especially green leafy ones, to get more iron in my diet."
B) "I will need to include more protein foods in my diet such as meats, dried beans, and whole-grain breads."
C) "I will decrease foods high in vitamin C, as they decrease my absorption of iron."
D) "I will take vitamins with extra iron in addition to eating a balanced diet with meat to correct my anemia."

Accepted Answer

A) Increasing foods high in vitamin C will increase absorption of iron. The lack of iron is the problem that needs to be addressed. Extra iron is needed to help replace RBCs and treat the dietary deficiency anemia. Green leafy vegetables will increase iron in the diet. Protein foods such as meats, dried beans, and whole-grain breads do contain iron that will help dietary deficiency anemia.
B) Increasing foods high in vitamin C will increase absorption of iron. The lack of iron is the problem that needs to be addressed. Extra iron is needed to help replace RBCs and treat the dietary deficiency anemia. Green leafy vegetables will increase iron in the diet. Protein foods such as meats, dried beans, and whole-grain breads do contain iron that will help dietary deficiency anemia.
C) Increasing foods high in vitamin C will increase absorption of iron. The lack of iron is the problem that needs to be addressed. Extra iron is needed to help replace RBCs and treat the dietary deficiency anemia. Green leafy vegetables will increase iron in the diet. Protein foods such as meats, dried beans, and whole-grain breads do contain iron that will help dietary deficiency anemia.
D) Increasing foods high in vitamin C will increase absorption of iron. The lack of iron is the problem that needs to be addressed. Extra iron is needed to help replace RBCs and treat the dietary deficiency anemia. Green leafy vegetables will increase iron in the diet. Protein foods such as meats, dried beans, and whole-grain breads do contain iron that will help dietary deficiency anemia.

Question 20

A client recovering from a hysterectomy does not want to take the prescribed estrogen replacement therapy because of the fear of developing breast cancer.Which response by the nurse is the most appropriate?
A) "The risk of breast cancer is slightly increased for women who opt to take estrogen replacement therapy."
B) "Perhaps you should consider an estrogen-progestin combination therapy."
C) "The risk of breast cancer is not increased for women who have had a hysterectomy and take estrogen replacement medications."
D) "Taking estrogen replacement is required after a hysterectomy."

Accepted Answer

A) The risk for the development of breast cancer is not greater for women who take estrogen replacement therapy after undergoing a hysterectomy. Progestin therapies are not used for women who are in surgical menopause. Further, it is inappropriate for the nurse to make suggestions of a prescriptive nature, as it violates the scope of practice. While it is not mandatory for the client to take estrogen replacement therapy after surgery, the nurse should clarify and correct misconceptions of the client. Estrogen replacement therapy is not associated with breast cancer for women who have undergone a hysterectomy. Taking estrogen after a hysterectomy is optional, not required.
B) The risk for the development of breast cancer is not greater for women who take estrogen replacement therapy after undergoing a hysterectomy. Progestin therapies are not used for women who are in surgical menopause. Further, it is inappropriate for the nurse to make suggestions of a prescriptive nature, as it violates the scope of practice. While it is not mandatory for the client to take estrogen replacement therapy after surgery, the nurse should clarify and correct misconceptions of the client. Estrogen replacement therapy is not associated with breast cancer for women who have undergone a hysterectomy. Taking estrogen after a hysterectomy is optional, not required.
C) The risk for the development of breast cancer is not greater for women who take estrogen replacement therapy after undergoing a hysterectomy. Progestin therapies are not used for women who are in surgical menopause. Further, it is inappropriate for the nurse to make suggestions of a prescriptive nature, as it violates the scope of practice. While it is not mandatory for the client to take estrogen replacement therapy after surgery, the nurse should clarify and correct misconceptions of the client. Estrogen replacement therapy is not associated with breast cancer for women who have undergone a hysterectomy. Taking estrogen after a hysterectomy is optional, not required.
D) The risk for the development of breast cancer is not greater for women who take estrogen replacement therapy after undergoing a hysterectomy. Progestin therapies are not used for women who are in surgical menopause. Further, it is inappropriate for the nurse to make suggestions of a prescriptive nature, as it violates the scope of practice. While it is not mandatory for the client to take estrogen replacement therapy after surgery, the nurse should clarify and correct misconceptions of the client. Estrogen replacement therapy is not associated with breast cancer for women who have undergone a hysterectomy. Taking estrogen after a hysterectomy is optional, not required.

Quiz 2: Cellular Regulation

The nurse is providing discharge instructions to a client being treated for cancer.For which symptoms should the client be instructed to call for help at home? Select all that apply.

The nurse is caring for a thin,older adult client who is diagnosed with cancer and is receiving aggressive chemotherapy.The client is experiencing severe side effects from the therapy and has lost 10 pounds in the past week.What should the nurse teach the client to do? Select all that apply.

A client complaining of mouth soreness had gastric bypass surgery 1 year ago.During the assessment,the nurse notes the client's tongue is beefy,red,and smooth and the client's skin appears yellowish.Which additional information is most likely needed before diagnosing this client?

A nurse is educating a client with anemia about the pathophysiological mechanisms of anemia.Which should be excluded in the nurse's teaching plan for this client?

The nurse suspects that a client with severe shortness of breath in the absence of cyanosis is experiencing anemia.Which laboratory tests should the nurse review to confirm anemia? Select all that apply.

An older adult client with renal failure is diagnosed with anemia.Based on this data,which cause of anemia will the nurse plan for when providing care?

A client experiencing fatigue,pallor,and dyspnea on exertion has a complete blood count drawn.Which red blood cell disorder should the nurse anticipate the client is experiencing?

The nurse is reviewing data collected during a health history and physical assessment and determines that a client is at risk for developing breast cancer.Which data supports this client's risk for developing breast cancer? Select all that apply.

A client with a history of anemia has started a vegan diet.Which addition to meals should the nurse recommend to help ensure that this client has adequate amounts of iron in the diet? Select all that apply.

The nurse is instructing a client with iron deficiency anemia about appropriate menu choices.Which diet choice indicates that teaching has been effective?

The nurse instructs a group of community members on the difference between benign and malignant neoplasms.Which participant statements indicate that teaching has been effective? Select all that apply.

A nurse is providing discharge teaching for a client with iron deficiency anemia.The client has been prescribed ferrous sulfate and has been told to increase the intake of foods that are naturally high in iron.Which client statements indicate a need for further education? Select all that apply.

The nurse is teaching a 34-year-old client with client who has a sister and mother with a history of breast cancer about early screening for the health problem.Which should the nurse include in this teaching? Select all that apply.

The nurse is caring for an older adult client with hemolytic anemia.When planning care for this client,which should the nurse take into consideration regarding this diagnosis? Select all that apply.

A nurse is providing discharge instructions to a client with iron deficiency anemia who is experiencing glossitis.Which statements will the nurse include in the discharge teaching for this client? Select all that apply.

The home healthcare nurse is preparing a care plan for a client with severe anemia.The client currently lives alone and states,"I can't even walk to the kitchen without getting winded." What would be the priority nursing diagnosis for this client?

A nursing student is preparing an educational program on hemolytic anemia for the residents of an assisted-living center.Which extrinsic causes of hemolytic anemia should the student include in the program? Select all that apply.

The nurse is instructing a group of women between the ages of 40 and 50 about early detection of breast cancer.What should the nurse include in this teaching?

The nurse is evaluating a client's understanding of dietary needs to treat dietary deficiency anemia.Which client statement indicates a need for additional teaching?

A client recovering from a hysterectomy does not want to take the prescribed estrogen replacement therapy because of the fear of developing breast cancer.Which response by the nurse is the most appropriate?