Medsurg 2 Exam 1 Questions 45 version 1 2024 Questions

A nurse is caring for a client who is receiving brachytherapy. Which of the following measures should the nurse include in the client’s plan of care?

A. Plan to spend extra time with the client to provide emotional support.

B. Ensure that chemotherapy medications do not extravasate into the client’s tissues.

C. Keep the door to the client’s room closed. (Correct answer) Brachytherapy involves direct radiation contact with the tumor, and the client emits radiation, posing a risk to others. The door should remain closed for safety.

D. Encourage family members and friends to visit for at least 1 hour per day.

A nurse is planning a presentation for a group of older adults at a community center about risk factors for cancer. Which of the following factors increases the risk of developing cancer after age 60?

A. High protein diet

B. Insufficient calcium intake

C. Declining muscle mass

D. Weakened immune responses. (Correct answer) After age 60, a weakened immune system and long-term exposure to carcinogens increase cancer risk.

A nurse is talking to a group of women at a community center about the current recommendations for early detection of breast cancer. The nurse should explain which of the following options?

A. Begin monthly breast self-examinations at age 40.

B. Have a clinical breast examination each year after age 30.

C. Begin annual mammograms at age 40. (Correct answer) Women should start annual mammograms at age 40, alongside regular self-exams and clinical checks.

D. Have breast magnetic resonance imaging every 5 years after age 50.

A nurse is planning an educational program for a group of young adults about reducing the risk of cervical cancer. Which of the following interventions should the nurse include?

A. Get the human papillomavirus (HPV) immunization. (Correct answer) The HPV vaccine is recommended to prevent cervical cancer.

B. Avoid the use of tampons on a routine basis.

C. Avoid drinking alcohol.

D. Get a Papanicolaou test every year starting at age 30.

A nurse is obtaining a client’s health history who has cancer of the cervix. Which of the following manifestations should the nurse expect?

A. Weight gain

B. Oliguria

C. Vaginal bleeding. (Correct answer) The most common symptom of cervical cancer is painless vaginal bleeding.

D. Back pain

A nurse is teaching a client who has HIV about how the virus is transmitted. Which of the following statements should the nurse include in the teaching?

A. HIV can be transmitted as soon as a person develops manifestations.

B. HIV can be transmitted to anyone who has had contact with infected blood. (Correct answer) HIV is primarily transmitted through contact with infected blood and body fluids.

C. HIV is transmitted through the respiratory route via droplets.

D. HIV is transmitted only during the active phase of the virus.

A nurse is assessing a 66-year-old client during a routine physical examination. This is the client’s first clinic visit, and she does not have her medical records. When the nurse asks if she has received the pneumococcal immunization, the client replies “I’m not sure, but it’s been at least 5 years since I’ve had any immunizations.” Which of the following responses should the nurse provide?

A. “In case you had the immunization before, we can’t give you another one.”

B. “You’ll need a series of 3 injections.”

C. “This immunization is unsafe for people over the age of 65 years old.”

D. “Let’s go ahead and give you this immunization.” (Correct answer) The CDC recommends the pneumococcal vaccine for individuals over 65, and another dose can be administered if more than five years have passed since the last.

A nurse is planning care for a client who is receiving chemotherapy and has a protein deficiency. Which of the following interventions should the nurse include in the plan of care? Select all that apply.

A. Mix powdered skim milk into liquid milk. (Correct answer)

C. Add a slice of cheese to hot veggies. (Correct answer)

E. Mix yogurt into fresh fruit. (Correct answer)

A nurse is admitting a client who has multiple myeloma and a WBC of 2,200. Which of the following foods should the nurse prohibit the family members from bringing the client?

A. Fried chicken from a fast-food restaurant.

B. A case of canned nutritional supplements.

C. A factory-sealed box of chocolates.

D. A fresh fruit basket. (Correct answer) Fresh fruits are contraindicated in clients with neutropenia due to the risk of bacterial contamination from the skin of the fruits.

A home health nurse is planning care for a client who is receiving chemotherapy and has neutropenia. Which of the following foods should the nurse include in the client’s plan of care?

A. Soft boiled eggs.

B. Brie cheese made of unpasteurized milk.

C. Cold deli meat sandwiches.

D. Baked chicken. (Correct answer) Well-cooked meats like baked chicken are safe for clients with neutropenia as they do not pose a risk for infection.

A nurse is caring for a client whose surgeon informed him postoperatively that he has metastasizing malignant neoplasm in the colon. Which of the following statements by the client should the nurse identify as an indication that the client understands this information?

A. “I have cancer of the colon that has begun to spread.” (Correct answer) The term “metastasizing malignant neoplasm” refers to cancer that has spread to other parts of the body.

B. “I have growths in my bowel that the doctor can treat easily.”

C. “As long as my tumor doesn’t get any bigger, I’ll be okay.”

D. “There is not much point in having more treatments.”

A nurse is caring for a client who has human immunodeficiency virus (HIV). Which of the following types of isolation should the nurse implement to prevent the transmission of HIV?

A. Protective isolation.

B. Droplet precautions.

C. Standard precautions. (Correct answer) Standard precautions are necessary for all clients to prevent the spread of infections, including HIV.

D. Airborne precautions.

A nurse is providing teaching to a client who has a new prescription for alprazolam. Which of the following items is a priority for teaching?

A. “This medication can affect your ability to drive or handle mechanical equipment.” (Correct answer) Alprazolam is a central nervous system depressant that can cause drowsiness and impair motor function, making it unsafe to operate machinery or drive.

B. “You should avoid drinking beverages that contain caffeine with this medication.”

C. “You should avoid taking antacids within 2 hours of this medication.”

D. “This medication should be taken with or shortly after meals.”

A nurse is collecting a client’s health history. Which of the following findings is the highest risk factor for the client developing skin cancer?

A. Age over 60.

B. Genetic predisposition.

C. Light-skinned race.

D. Overexposure to sunlight. (Correct answer) Excessive exposure to sunlight is the most significant risk factor for developing skin cancer.

A nurse is teaching a client how to perform a breast self-examination (BSE). The nurse should identify which of the following findings as an indication for breast cancer?

A. Lumps that are mobile and tender on palpation prior to a menstrual period.

B. Multiple round masses that are tender and found on both breasts.

C. Bilateral darkened areolas.

D. A non-tender, hard lump that is palpated in a breast. (Correct answer) A hard, irregular, and non-tender lump can indicate the presence of a cancerous tumor.

A nurse is collecting a health history from a client. Which of the following findings is the highest risk factor for the client developing bladder cancer?

A. The client is a hairdresser.

B. The client uses tobacco. (Correct answer) Tobacco use is the most significant risk factor for bladder cancer.

C. The client is over 60 years of age.

D. The client has frequent UTIs.

A nurse is caring for a client who is postoperative following a urinary diversion to treat bladder cancer. Which of the following interventions should the nurse include in the plan of care?

A. Empty the collection pouch when it is 2/3 full.

B. Expect urine outflow into the pouch to begin 1-2 days after surgery.

C. Change the collection pouch in the early morning. (Correct answer) Changing the collection pouch in the early morning when urine output is reduced is the recommended practice.

D. Place an aspirin in the collection pouch to control odor.

A nurse is planning care for a client who has AIDS and has developed stomatitis. Which of the following interventions should the nurse include in the plan of care?

A. Rinse the mouth with chlorhexidine solution every 2 hours.

B. Limit fluid intake with meals.

C. Provide oral hygiene with a firm-bristled toothbrush after each meal.

D. Avoid salty foods. (Correct answer) Spicy, acidic, and salty foods should be avoided to prevent further irritation of the oral mucosa in clients with stomatitis.

A nurse is caring for a client who is receiving chemotherapy to treat cancer. Which of the following adverse effects should the nurse anticipate from the chemotherapy?

A. Gingival hyperplasia.

B. Hirsutism.

C. Pancytopenia. (Correct answer) Pancytopenia, a reduction in WBCs, RBCs, and platelets, is a common adverse effect of chemotherapy.

D. Weight gain.

A nurse is caring for a client who has breast cancer and is receiving a combination of chemotherapy medications. The client expresses confusion about the therapy. Which of the following explanations should the nurse provide?

A. “The risk of renal toxicity is lessened when a combination of chemotherapy medications is used.”

B. “The chemotherapy medications act at different stages of cell division so more tumor cells are destroyed.” (Correct answer) Combining chemotherapy agents allows for the destruction of cancer cells at different stages of cell division.

C. “The use of more chemotherapy medications will shorten the time you have to be in treatment.”

D. “The combinations of chemotherapy medications will eliminate the potential for bone marrow suppression.”

A nurse is planning care for a client who has cancer and has developed thrombocytopenia following chemotherapy. Which of the following precautions should the nurse offer to minimize the adverse effects of thrombocytopenia?

A. Monitor visitors for manifestations of infection.

B. Remind the client to use an electric razor. (Correct answer) Using an electric razor helps prevent cuts that could lead to bleeding in clients with thrombocytopenia.

C. Encourage frequent rest periods.

D. Instruct the client to rinse their mouth daily with normal saline.

A nurse is providing teaching to a client with cancer who is receiving external radiation therapy. Which of the following statements by the client indicates an understanding of the teaching?

A. “I need to protect the area from sunlight.” (Correct answer) Sunlight exposure can increase skin irritation, and the area receiving radiation should be protected.

B. “I’m going to apply a heating pad to the area after each treatment.”

C. “I’ll massage the area once per day.”

D. “I’ll wash off the markings after each therapy treatment.”

A nurse is performing an admission assessment for a client who has colorectal cancer. Which of the following manifestations should the nurse expect to find?

A. Hematuria.

B. Abdominal cramps. (Correct answer) Abdominal cramps, changes in bowel habits, and occult blood in the stool are common symptoms of colorectal cancer.

C. Weight gain.

D. Polycythemia.

A nurse is caring for a client who has lung cancer that has metastasized. Which of the following indicates the client is developing superior vena cava syndrome?

A. Irregular cardiac rhythm.

B. Numbness in the hands.

C. Muscle cramps.

D. Facial edema. (Correct answer) Superior vena cava syndrome is characterized by facial and upper extremity edema due to the obstruction of blood flow through the superior vena cava.

A charge nurse is observing a newly licensed nurse provide care for a client who is receiving internal radiation therapy for the treatment of cervical cancer. For which of the following actions by the newly licensed nurse should the charge nurse intervene?

A. Leave soiled linens in a container in the client’s room.

B. Instruct visitors to remain 3 feet away from the client.

C. Borrowing a dosimeter film badge from another nurse before entering the client’s room. (Correct answer) Each nurse should have their personal dosimeter film badge to monitor radiation exposure, and borrowing is not allowed.

D. Removing an extra IV pole from the client’s room to be used by another client.

A nurse is providing teaching to a client who has cervical cancer and is scheduled to receive brachytherapy in an ambulatory care clinic. Which of the following statements by the client indicates an understanding of the teaching?

A. “I need to lie still in bed during my brachytherapy treatment.” (Correct answer) Clients undergoing brachytherapy must lie still to prevent dislodging the radioactive implant.

B. “I will have an implant placed once a month during my brachytherapy treatment.”

C. “I must stay at least 3 feet away from others between brachytherapy treatments.”

D. “I should expect some blood in my urine after each brachytherapy treatment.”

A nurse is providing teaching to a client who is receiving chemotherapy and has developed neutropenia. Which of the following statements indicates that the client needs further instructions?

A. “I’ll keep an antibacterial hand gel in my purse.”

B. “My partner will have to take care of the cat’s litter boxes for a while.”

C. “I’m planning a large gathering of friends and family for the holidays.” (Correct answer) Clients with neutropenia should avoid large gatherings to reduce the risk of infection, so this statement indicates a need for further teaching.

D. “I will eat canned fruits and veggies.”

A nurse is planning a presentation at a community center about risk factors for cancer. Which of the following types of cancer should the nurse include when discussing familial clustering of specific types of cancer?

A. Skin

B. Prostate (Correct answer) Prostate cancer, along with breast, colorectal, and ovarian cancers, commonly shows familial clustering.

C. Bone

D. Bladder

A nurse is caring for a postmenopausal client who is concerned that she might have an elevated risk of breast cancer. After conducting a risk assessment, the nurse should identify which of the following factors as increasing the client’s breast cancer risk? Select all that apply.

A. Increased bone density (Correct answer) Higher bone density is associated with increased breast cancer risk.

B. BMI of 32 (Correct answer) Obesity increases breast cancer risk in postmenopausal women.

C. Having given birth to 5 children

D. Undergoing hormonal replacement therapy for 10 years (Correct answer) Long-term hormone replacement therapy increases breast cancer risk.

E. Having 1-2 alcoholic drinks per week

A nurse is collecting a health history from a female client who is undergoing screening for breast cancer. Which of the following factors increases the client’s risk of developing breast cancer?

A. Obesity

B. Oral contraceptive use

C. Alcohol use

D. Age over 50 years (Correct answer) Women over 50 years old have an increased risk of developing breast cancer due to age-related hormonal changes.

A nurse is providing teaching to a client who has cancer and is undergoing external radiation treatment. Which of the following statements by the client indicates an understanding of the teaching?

A. “I should use petroleum-based lotions on the areas being radiated.”

B. “I will dry the areas being radiated by rubbing in a circular pattern.”

C. “I will apply sunscreen to the areas being radiated when spending time in the sun.”

D. “I should use my hand, instead of a washcloth, to wash the areas being radiated.” (Correct answer) Washing with the hand is gentler than using a washcloth, which can irritate the radiated skin.

A nurse is caring for a client who is receiving radiation therapy for breast cancer and reports a metallic taste in the mouth. Which of the following dietary recommendations should the nurse share with the client?

A. Eat with metal utensils.

B. Limit coffee.

C. Avoid citrus foods.

D. Offer mints. (Correct answer) Mints can help neutralize the metallic taste that clients often experience during radiation therapy.

A nurse is caring for a client who has testicular cancer and is experiencing peripheral neuropathy as an adverse effect of chemotherapy. Which of the following client manifestations is an expected finding of peripheral neuropathy?

A. Thinning of the scalp hair.

B. Tingling of the hands and feet. (Correct answer) Peripheral neuropathy is commonly characterized by tingling or numbness in the extremities due to nerve damage caused by chemotherapy.

C. Reduced ability to concentrate.

D. Sores in mucous membranes.

A nurse is caring for a client who will receive brachytherapy to treat uterine cancer. The nurse should ensure the client understands that she will receive which of the following interventions?

A. Chemotherapy via a central venous access device.

B. Radiation to the tumor from an external source.

C. Precise delivery of high-dose radiation after tumor imaging.

D. Radioactive infusions or insertions into or near the tumor. (Correct answer) Brachytherapy involves the direct placement of radioactive material into or near the tumor.

A nurse is providing discharge teaching to a client who has AIDS about preventing infection while at home. Which of the following instructions should the nurse include in the teaching?

A. Wash your genitalia using an antimicrobial soap. (Correct answer) Using antimicrobial soap helps prevent the spread of infection in clients with compromised immune systems.

B. Rinse your dishes with cold water.

C. Clean your toothbrush once per month.

D. Incorporate raw fruits and vegetables into your diet.

A nurse in an oncology clinic is assessing a client who has early-stage Hodgkin’s lymphoma. Which of the following findings should the nurse expect?

A. Bone and joint pain.

B. Enlarged lymph nodes. (Correct answer) The hallmark sign of Hodgkin’s lymphoma is painless, enlarged lymph nodes.

C. Intermittent hematuria.

D. Productive cough.

A nurse is providing postop discharge teaching to a client following a panhysterectomy for uterine cancer. Which of the following pieces of information should the nurse include in the teaching?

A. “You will need to continue to use some form of birth control for 6 months.”

B. “You might experience manifestations of menopause.” (Correct answer) Removal of the uterus and ovaries can induce menopause symptoms such as hot flashes and night sweats.

C. “Do not lift anything heavier than 15 lbs.”

D. “Pain or burning with urination is an expected outcome of this surgery.”

A hospice nurse is providing education about palliative care to the partner of a client who has end-stage liver cancer. Which of the following statements by the partner indicates an understanding of the teaching?

A. “I will do my best to try to get him to eat something.”

B. “I will lay him flat if his breathing becomes shallow.”

C. “I will use an electric blanket to keep him warm.”

D. “I will continue to talk to him, even when he’s sleeping.” (Correct answer) Hearing is believed to be the last sense to go, so it’s important to continue talking to the client even when they appear to be unconscious.

A nurse is preparing a plan of care for a client who is postoperative following a modified radical mastectomy. Which of the following invasive devices should the nurse expect the client to have?

A. Chest tube.

B. Indwelling urinary catheter.

C. NG tube.

D. Jackson-Pratt drain. (Correct answer) Clients who undergo a mastectomy typically have Jackson-Pratt drains to remove excess fluid from the surgical site.

A nurse is providing preop teaching for a client with colorectal cancer who is scheduled to undergo colostomy placement with a peritoneal wound. Which of the following statements by the client indicates an understanding of the teaching?

A. “Not having any more rectal pain will be a relief.”

B. “I will need to sit on a rubber donut when I am in a chair.”

C. “I can only have liquids for 2 days before the surgery.” (Correct answer) Clients are typically instructed to follow a liquid diet for 24-48 hours before colostomy surgery to decrease bulk and reduce bowel activity.

A nurse is planning care for a client who is postoperative following a radical mastectomy. Which of the following interventions should the nurse include in the plan?

A. Rest the arm on the affected side on the bed when the client is sleeping.

B. Instruct the client to keep the affected arm flexed when ambulating.

C. Begin exercises with the client 1 day after the procedure. (Correct answer)Post-mastectomy exercises should begin as soon as the first postoperative day to promote lymphatic return and prevent stiffness.

D. Maintain the client on bed rest for 2 days after the procedure.

The nurse is providing teaching to a client who has stomatitis due to chemotherapy and radiation therapy. Which of the following statements by the client indicates a need for further teaching?

A. “I will use a soft toothbrush or foam swab for oral care.”

B. “I will use lemon and glycerin swabs after meals.” (Correct answer) Lemon and glycerin swabs should be avoided as they can dry and irritate the oral mucosa in clients with stomatitis.

C. “I will remove my dentures except while eating.”

D. “I will rinse my mouth frequently with hydrogen peroxide solution.”

A nurse is caring for a client who is receiving radiation therapy for mouth cancer and reports a dry mouth. Which of the following dietary recommendations should the nurse provide?

A. Offer graham crackers as a snack.

B. Avoid foods containing citrus.

C. Rinse the mouth with an alcohol-based mouthwash before eating.

D. Use gravies or sauces to soften food. (Correct answer) Softening foods with gravies or sauces can help clients with dry mouth swallow more easily.

A nurse is teaching a client who has leukemia and has developed thrombocytopenia. Which of the following instructions should the nurse include in the teaching?

A. “Limit flossing your teeth to once a week.”

B. “Gently blow your nose if needed.”

C. “Use an electric razor when shaving.” (Correct answer) Using an electric razor helps prevent cuts that could lead to bleeding in clients with thrombocytopenia.

D. “Wear shoes that have a soft sole.”

A nurse is caring for a client who has neutropenia. Which of the following findings indicates a need for intervention?

A. The client’s grandchild is visiting and telling the client about the first day of kindergarten. (Correct answer) Clients with neutropenia should avoid contact with young children, who may carry infections, as they are immunocompromised.

B. The client has a grilled ham and cheese sandwich, a banana, and yogurt on their lunch tray.

C. The family brings in a silk flower arrangement.

D. The client’s assistive personnel places paper cups and plastic utensils in the client’s room.