95 notecards = 24 pages (4 cards per page)
Pain is best described as
a. a creation of a person's imagination.
A patient is receiving a PCA infusion after surgery to repair a hip fracture. She is sleeping soundly but awakens when the nurse speaks to her in a normal tone of voice. Her respirations are 8 breaths/minute. The most appropriate nursing action in this situation is to
a. stop the PCA infusion.
Unrelieved pain is
a. expected after major surgery.
A cancer patient who reports ongoing, constant moderate pain with short periods of severe pain during dressing changes is
a. probably exaggerating his pain.
An example of distraction to provide pain relief is
An important nursing responsibility related to pain is to
a. leave the patient alone to rest.
Providing opioids to a dying patient who is experiencing moderate to severe pain
a. may cause addiction.
A nurse believes that patients with the same type of tissue injury should have the same amount of pain. This statement reflects
a. a belief that will contribute to appropriate pain management.
Transmission of HIV from an infected individual to another most commonly occurs as a result of
a. unprotected anal or vaginal sexual intercourse.
During HIV infection
a. reverse transcriptase helps HIV fuse with the CD4+ T cell.
A diagnosis of AIDS is made when an HIV-infected patient has
a. a CD4+ T cell count below 200/μL.
Screening for HIV infection generally involves
a. detecting CD8+ cytotoxic T cells in saliva.
HIV antiretroviral drugs are used to
a. cure acute HIV infection.
Opportunistic diseases in HIV infection
a. are usually benign.
Which strategy can the nurse teach the patient to eliminate the risk of HIV transmission?
a. Using sterile equipment to inject drugs
What is the most appropriate nursing intervention to help an HIV-infected patient adhere to a treatment regimen?
a. “Set up” a drug pillbox for the patient every week.
Trends in the incidence and death rates of cancer include the fact that
a. lung cancer is the most common type of cancer in men.
A characteristic of the stage of progression in the development of cancer is
a. oncogenic viral transformation of target cells.
The primary protective role of the immune system related to malignant cells is
a. surveillance for cells with tumor-associated antigens.
The nurse is caring for a 59-year-old woman who had surgery 1 day ago for removal of a malignant abdominal mass. The patient is awaiting the pathology report. She is tearful and says that she is scared to die. The most effective nursing intervention at this point is to use this opportunity to
a. motivate change in an unhealthy lifestyle.
The goals of cancer treatment are based on the principle that
a. surgery is the single most effective treatment for cancer.
The most effective method of administering a chemotherapy agent that is a vesicant is to
a. give it orally.
The nurse explains to a patient undergoing brachytherapy of the cervix that she
a. must undergo simulation to locate the treatment area.
A patient on chemotherapy and radiation for head and neck cancer has a WBC count of 1.9 × 103/μL, hemoglobin of 10.8 g/dL, and a platelet count of 99 × 103/ μL. Based on the CBC results, what is the most serious clinical finding?
a. Cough, rhinitis, and sore throat
To prevent fever and shivering during an infusion of rituximab (Rituxan), the nurse should premedicate the patient with
The nurse counsels the patient receiving radiation therapy or chemotherapy that
a. effective birth control methods should be used for the rest of
the patient's life.
A patient on chemotherapy for 10 weeks started at a weight of 121 lb. She now weighs 118 lb and has no sense of taste. Which nursing intervention would be a priority?
a. Advise the patient to eat foods that are fatty, fried, or high
A 70-year-old male patient has multiple myeloma. His wife calls to report that he sleeps most of the day, is confused when awake, and complains of nausea and constipation. Which complication of cancer is this most likely caused by?
A patient has recently been diagnosed with early stages of breast cancer. What is most appropriate for the nurse to focus on?
a. Maintaining the patient's hope
In a severely anemic patient, the nurse would expect to find
a. dyspnea and tachycardia.
When obtaining assessment data from a patient with a microcytic, hypochromic anemia, the nurse would question the patient about
a. folic acid intake.
A complication of the hyperviscosity of polycythemia is
When caring for a patient with thrombocytopenia, the nurse instructs the patient to
a. dab his or her nose instead of blowing.
The nurse would anticipate that a patient with von Willebrand disease undergoing surgery would be treated with administration of vWF and
DIC is a disorder in which
a. the coagulation pathway is genetically altered, leading to
thrombus formation in all major blood vessels.
Because myelodysplastic syndrome arises from the pluripotent
hematopoietic stem cell in the bone marrow, laboratory results the
nurse would expect to find
a. excess of T cells.
The most common type of leukemia in older adults is
a. acute myelocytic leukemia.
Multiple drugs are often used in combinations to treat leukemia and lymphoma because
a. there are fewer toxic and side effects.
The nurse is aware that a major difference between Hodgkin's lymphoma and non-Hodgkin's lymphoma is that
a. Hodgkin's lymphoma occurs only in young adults.
A patient with multiple myeloma becomes confused and lethargic. The nurse would expect that these clinical manifestations may be explained by diagnostic results that indicate
When reviewing the patient's hematologic laboratory values after a splenectomy, the nurse would expect to find
Complications of transfusions that can be decreased by the use of leukocyte depletion or reduction of RBC transfusion are
a. chills and hemolysis.
In teaching a patient who wants to perform BSE, you inform her that the technique involves both the palpation of the breast tissue and
a. palpation of cervical lymph nodes.
You are caring for a young woman who has painful fibrocystic breast changes. Management of this patient would include
a. scheduling a biopsy to rule out malignant changes.
When discussing risk factors for breast cancer with a group of women, you emphasize that the greatest known risk factor for breast cancer is
a. being a woman over age 60.
A simple mastectomy has been scheduled for your patient with breast cancer. Postoperatively, to restore arm function on the affected side, you would
a. apply heating pads or blankets to increase circulation.
Preoperatively, to meet the psychologic needs of a woman scheduled for a simple mastectomy, you would
a. discuss the limitations of breast reconstruction.
To prevent capsular formation after breast reconstruction with implants, teach the patient to
a. gently massage the area around the implant.
The individual with the lowest risk for sexually transmitted pelvic inflammatory disease is a woman who uses
a. oral contraceptives.
The nurse is obtaining a subjective data assessment from a woman reported as a sexual contact of a man with chlamydial infection. The nurse understands that symptoms of chlamydial infection in women
a. are frequently absent.
Explain to the patient with gonorrhea that treatment will include both ceftriaxone and azithromycin because
a. azithromycin helps prevent recurrent infections.
To prevent the infection and transmission of STIs, the nurse's teaching plan would include an explanation of
a. the appropriate use of oral contraceptives.
Provide emotional support to a patient with an STI by
a. offering information on how safer sexual practices can prevent
In telling a patient with infertility what she and her partner can expect, the nurse explains that
a. ovulatory studies can help determine tube patency.
An appropriate question to ask the patient with painful menstruation to differentiate primary from secondary dysmenorrhea is
a. “Does your pain become worse with activity or
The nurse should advise the woman recovering from surgical treatment of an ectopic pregnancy that
a. she has an increased risk for salpingitis.
To prevent or decrease age-related changes that occur after menopause in a patient who chooses not to take hormone therapy, the most important self-care measure to teach is
a. maintaining usual sexual activity.
Nursing responsibilities related to the patient with endometrial cancer who has a total abdominal hysterectomy and salpingectomy and oophorectomy include
a. maintaining absolute bed rest.
The first nursing intervention for the patient who has been sexually assaulted is to
a. treat urgent medical problems.
Symptoms of BPH are primarily caused by
a. obstruction of the urethra.
Postoperatively, a patient who has had a laser prostatectomy has continuous bladder irrigation with a three-way urinary catheter with a 30-mL balloon. When he complains of bladder spasms with the catheter in place, the nurse should
a. deflate the balloon to 10 mL to decrease bulk in the bladder.
A patient scheduled for a prostatectomy for prostate cancer expresses the fear that he will have erectile dysfunction. In responding to this patient, the nurse should keep in mind that
a. erectile dysfunction can occur even with a nerve-sparing
In assessing a patient for testicular cancer, the nurse understands that the manifestations of this disease often include
a. acute back spasms and testicular pain.
To decrease the patient's discomfort related to discussing his reproductive organs, the nurse should
a. relate his sexual concerns to his sexual partner.
The nurse suspects an ankle sprain when a patient at the urgent care center describes
a. being hit by another soccer player during a game.
A patient with a humeral fracture is returning for a 4-week checkup. The nurse explains that initial evidence of healing on x-ray is indicated by
a. formation of callus.
A patient with a comminuted fracture of the tibia is to have an open reduction with internal fixation (ORIF) of the fracture. The nurse explains that ORIF is indicated when
a. the patient is unable to tolerate prolonged
The nurse suspects a neurovascular problem based on assessment of
a. exaggerated strength with movement.
A patient with a stable, closed humeral fracture has a temporary splint with bulky padding applied with an elastic bandage. The nurse notifies the surgeon of possible early compartment syndrome when the patient experiences
a. increasing edema of the limb.
A patient with a pelvic fracture should be monitored for
a. changes in urine output.
The nurse instructs the patient with an above-the-knee amputation that the residual limb should not be routinely elevated because this position promotes
a. hip flexion contracture.
A patient is scheduled for total ankle replacement. The nurse should tell the patient that after surgery he should avoid
a. lifting heavy objects.
A patient diagnosed with osteosarcoma of the humerus demonstrates understanding of his treatment options when he states
a. “I accept that I have to lose my arm with surgery.”
A patient with suspected disc herniation is experiencing acute pain and muscle spasms. The nurse's responsibility is to
a. encourage total bed rest for several days.
In caring for a patient after a spinal fusion, the nurse would immediately report which of the following to the surgeon?
a. The patient experiences a single episode of emesis.
A patient who has had surgical correction of bilateral hallux valgus is being discharged from the same-day surgery unit. The nurse will instruct the patient to
a. expect continued pain in the feet.
What is important to include in the teaching plan for a patient with osteopenia?
a. Lose weight.
In assessing the joints of a patient with osteoarthritis, the nurse understands that Bouchard's nodes
a. are often red, swollen, and tender.
When administering medications to the patient with chronic gout, the nurse would recognize which drug is used as a treatment for this disease?
The nurse should teach the patient with ankylosing spondylitis the importance of
a. regularly exercising and maintaining proper posture.
In teaching a patient with SLE about the disorder, the nurse knows the pathophysiology of SLE includes
a. circulating immune complexes formed from IgG autoantibodies
reacting with IgG.
In teaching a patient with Sjögren's syndrome about drug therapy for this disorder, the nurse includes instruction on use of which drug?
a. Pregabalin (Lyrica)
A patient has a spinal cord injury at T4. Vital signs include falling blood pressure with bradycardia. The nurse recognizes that the patient is experiencing
a. a relative hypervolemia.
A 78-yr-old man has confusion and temperature of 104° F (40° C). He is a diabetic with purulent drainage from his right heel. After an infusion of 3 L of normal saline solution, his assessment findings are BP 84/40 mm Hg; heart rate 110; respiratory rate 42 and shallow; CO 8 L/minute; and PAWP 4 mm Hg. This patient's symptoms are most likely indicative of
The most accurate assessment parameters for the nurse to use to determine adequate tissue perfusion in the patient with MODS are
a. blood pressure, pulse, and respirations.
The O2 delivery system chosen for the patient in acute respiratory failure should
a. always be a low-flow device, such as a nasal cannula or face
The most common early clinical manifestations of ARDS that the nurse may observe are
a. dyspnea and tachypnea.
Maintenance of fluid balance in the patient with ARDS involves
a. hydration using colloids.
Which intervention is most likely to prevent or limit barotrauma in the patient with ARDS who is mechanically ventilated?
a. Decreasing PEEP
Certification in critical care nursing (CCRN) by the American Association of Critical-Care Nurses indicates that the nurse
a. is an advanced practice nurse who cares for acutely and
critically ill patients.
The critical care nurse recognizes that an ideal plan for caregiver involvement includes
a. a caregiver at the bedside at all times.
To establish hemodynamic monitoring for a patient, the nurse zeros the
a. cardiac output monitoring system to the level of the left
The purpose of adding PEEP to positive pressure ventilation is to
a. increase functional residual capacity and improve
The nursing management of a patient with an artificial airway includes
a. maintaining ET tube cuff pressure at 30 cm H2O.
The nurse monitors the patient with positive pressure mechanical ventilation for
a. paralytic ileus because pressure on the abdominal contents
affects bowel motility.