What property is found in clients with metastatic cancer?
- A. Tumors that are well encapsulated
- B. Tumors with slow, stable growth
- C. Cells that are genetically stable
- D. Cells invading local tissue and overrunning neighboring cells
Correct Answer: D
Rationale: Metastatic cancer is characterized by cells that invade local tissue and overrun neighboring cells. Therefore, the correct answer is D. Choices A, B, and C are incorrect because metastatic cancer is associated with aggressive behavior where cells invade and spread to other parts of the body, rather than being well encapsulated, growing slowly, or being genetically stable.
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A 30-year-old woman is taking an oral contraceptive and is concerned about the potential side effects. What should the nurse include in the patient education?
- A. Oral contraceptives can cause weight loss and increased energy levels.
- B. Oral contraceptives can cause increased appetite and weight gain.
- C. Oral contraceptives can cause headaches and breast tenderness.
- D. Oral contraceptives have no side effects.
Correct Answer: C
Rationale: The correct answer is C: 'Oral contraceptives can cause headaches and breast tenderness.' It is essential for the nurse to educate the patient about common side effects of oral contraceptives, such as headaches and breast tenderness. Choices A, B, and D are incorrect. Weight loss and increased energy levels (Choice A) are not common side effects of oral contraceptives. Similarly, increased appetite and weight gain (Choice B) are not typical side effects. Finally, stating that oral contraceptives have no side effects (Choice D) is inaccurate as they can have various side effects, albeit usually mild and manageable.
A client with a history of hypertension presents with a severe headache and blurred vision. What is the nurse's priority action?
- A. Administer pain relief medication.
- B. Obtain a stat head CT scan.
- C. Administer antihypertensive medications as prescribed.
- D. Call the healthcare provider immediately.
Correct Answer: C
Rationale: The correct answer is to administer antihypertensive medications as prescribed. In a client with a history of hypertension presenting with severe headache and blurred vision, these symptoms could indicate a hypertensive crisis. The priority action is to lower the blood pressure promptly to prevent complications such as stroke, heart attack, or organ damage. Administering antihypertensive medications is crucial in this situation. Administering pain relief medication (Choice A) may temporarily alleviate symptoms but does not address the underlying issue of elevated blood pressure. Obtaining a stat head CT scan (Choice B) may be necessary to rule out other causes but should not delay the administration of antihypertensive medications. Calling the healthcare provider immediately (Choice D) is important but may not address the immediate need to lower blood pressure in a hypertensive crisis.
What symptoms would the nurse expect to see in a client with chronic obstructive pulmonary disease (COPD)?
- A. Dyspnea on exertion
- B. Normal lung sounds
- C. Normal arterial blood gases
- D. Onset of the disease during young adulthood
Correct Answer: A
Rationale: The correct answer is A: Dyspnea on exertion. COPD typically manifests with symptoms like dyspnea on exertion due to impaired lung function. This symptom is a result of the airways being obstructed and the lungs not being able to expel air effectively. Choices B and C are incorrect because in COPD, abnormal lung sounds such as wheezing, crackles, or diminished breath sounds are often heard upon auscultation, and arterial blood gases are usually abnormal, showing low oxygen levels and high carbon dioxide levels. Choice D is incorrect as COPD is more commonly diagnosed in individuals over 40 who have a history of smoking or exposure to lung irritants.
Which of the following might result from severe diarrhea?
- A. Respiratory acidosis
- B. Metabolic alkalosis
- C. Respiratory alkalosis
- D. Metabolic acidosis
Correct Answer: D
Rationale: The correct answer is D: Metabolic acidosis. Severe diarrhea can lead to metabolic acidosis because the loss of bicarbonate ions in the stool results in an overall decrease in the body's bicarbonate levels. Respiratory acidosis (choice A) is caused by retention of carbon dioxide, usually due to inadequate alveolar ventilation. Metabolic alkalosis (choice B) is characterized by elevated pH and bicarbonate levels, usually caused by conditions like vomiting. Respiratory alkalosis (choice C) is a condition of low blood carbon dioxide levels and high pH, often due to hyperventilation.
Following a spinal cord injury suffered in a motor vehicle accident, a 22-year-old male has lost fine motor function of his finger and thumb, but is still able to perform gross motor movements of his hand and arm. Which component of his 'white matter' has most likely been damaged?
- A. The inner layer (archilayer)
- B. The middle layer (paleolayer)
- C. The outer layer (neolayer)
- D. The reticular formation
Correct Answer: C
Rationale: The correct answer is C: The outer layer (neolayer). The white matter of the spinal cord consists of three layers: the outer layer (neolayer), the middle layer (paleolayer), and the inner layer (archilayer). Damage to the outer layer (neolayer) is likely to affect fine motor skills, explaining the loss of fine motor function in the finger and thumb while gross motor movements remain intact. Choices A, B, and D are incorrect as they do not correspond to the specific layer of the white matter that is typically associated with fine motor control.