test bank foundations of nursing

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A 35-year-old mother of three young children has been diagnosed with stage II breast cancer. After discussing treatment options with her physician, the woman goes home to talk to her husband, later calling the nurse for clarification of some points. The patient tells the nurse that the physician has recommended breast conservation surgery followed by radiation. The patients husband has done some online research and is asking why his wife does not have a modified radical mastectomy to be sure all the cancer is gone. What would be the nurses best response?

  • A. Modified radical mastectomies are very hard on a patient, both physically and emotionally and they really arent necessary anymore.
  • B. According to current guidelines, having a modified radical mastectomy is no longer seen as beneficial.
  • C. Modified radical mastectomies have a poor survival rate because of the risk of cancer recurrence.
  • D. According to current guidelines, breast conservation combined with radiation is as effective as a modified radical mastectomy.
Correct Answer: D

Rationale: The correct answer is D: According to current guidelines, breast conservation combined with radiation is as effective as a modified radical mastectomy.

1. Breast conservation surgery followed by radiation is a standard treatment option for early-stage breast cancer.
2. Studies have shown that breast conservation surgery combined with radiation therapy is equally effective in terms of long-term survival rates compared to mastectomy.
3. Current guidelines recommend considering breast conservation surgery as a viable option for patients with early-stage breast cancer.
4. Modified radical mastectomy is not necessarily needed to ensure complete removal of cancer, as breast conservation surgery followed by radiation can achieve the same goal.
5. Therefore, the nurse should reassure the patient's husband that the recommended treatment plan is based on current guidelines and is as effective as a modified radical mastectomy.

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A patient is postoperative day 6 following tympanoplasty and mastoidectomy. The patient has phoned the surgical unit and states that she is experiencing occasional sharp, shooting pains in her affected ear. How should the nurse best interpret this patients complaint?

  • A. These pains are an expected finding during the first few weeks of recovery.
  • B. The patients complaints are suggestive of a postoperative infection.
  • C. The patient may have experienced a spontaneous rupture of the tympanic membrane.
  • D. The patients surgery may have been unsuccessful.
Correct Answer: A

Rationale: The correct answer is A. Postoperative day 6 following tympanoplasty and mastoidectomy is still within the early phase of recovery, where occasional sharp, shooting pains in the affected ear can be expected due to the healing process. Here's a step-by-step rationale:
1. Timing: It is only day 6 post-surgery, so it is normal to experience some pain as part of the healing process.
2. Nature of pain: Sharp, shooting pains are common post-surgery due to tissue healing and nerve regeneration.
3. Lack of other symptoms: The patient did not report any other concerning symptoms like fever or discharge, which would be more indicative of an infection.
4. Unlikely complications: Spontaneous rupture of the tympanic membrane or unsuccessful surgery would typically present with more severe and consistent symptoms.

Summary:
- B: Unlikely as there are no other signs of infection.
- C: Unlikely as the pain is described as occasional and sharp.
- D:

An oncology nurse is caring for a patient who has developed erythema following radiation therapy. What should the nurse instruct the patient to do?

  • A. Periodically apply ice to the area.
  • B. Keep the area cleanly shaven.
  • C. Apply petroleum jelly to the affected area.
  • D. Avoid using soap on the treatment area.
Correct Answer: C

Rationale: The correct answer is C: Apply petroleum jelly to the affected area. This is because petroleum jelly helps to soothe and protect the skin, reducing dryness and irritation caused by radiation therapy. Ice (A) can further damage the skin, shaving (B) can increase the risk of infection, and soap (D) can be too harsh on the sensitive skin. Therefore, instructing the patient to apply petroleum jelly is the most appropriate recommendation to promote skin healing and comfort.

After mastoid surgery, an 81-year-old patient has been identified as needing assistance in her home. What would be a primary focus of this patients home care?

  • A. Preparation of nutritious meals and avoidance of contraindicated foods
  • B. Ensuring the patient receives adequate rest each day
  • C. Helping the patient adapt to temporary hearing loss
  • D. Assisting the patient with ambulation as needed to avoid falling
Correct Answer: A

Rationale: The correct answer is A: Preparation of nutritious meals and avoidance of contraindicated foods. After mastoid surgery, proper nutrition is crucial for healing and recovery. Nutritious meals support the immune system and aid in tissue repair. Avoiding contraindicated foods, such as those that may cause inflammation or interfere with medications, is essential for the patient's well-being. Choices B, C, and D are not the primary focus of home care after mastoid surgery. While rest, adaptation to hearing loss, and assistance with ambulation are important, they are secondary to ensuring proper nutrition for optimal recovery in this case.

A nurse in a long-term care setting that is fundedby Medicare and Medicaid is completing standardized protocols for assessment and care planning for reimbursement. Which task is the nurse completing?

  • A. A minimum data set
  • B. An admission assessment and acuity level
  • C. A focused assessment/specific body system
  • D. An intake assessment form and auditing phase
Correct Answer: A

Rationale: The correct answer is A: A minimum data set. In a long-term care setting funded by Medicare and Medicaid, completing standardized protocols for assessment and care planning for reimbursement involves using a minimum data set, which is a standardized instrument for assessing residents' health status. This set of data elements is necessary for comprehensive assessment and care planning to ensure appropriate reimbursement. The other choices (B, C, D) do not specifically address the standardized protocols required for reimbursement in this setting. An admission assessment and acuity level would be part of the process, but not the primary task being completed in this scenario. A focused assessment on a specific body system or an intake assessment form and auditing phase are not synonymous with the standardized protocols needed for reimbursement in a Medicare/Medicaid-funded long-term care facility.

Which form of heart disease in women of childbearing years usually has a benign effect on pregnancy?

  • A. Cardiomyopathy
  • B. Mitral valve prolapse
  • C. Rheumatic heart disease
  • D. Congenital heart disease
Correct Answer: B

Rationale: The correct answer is B: Mitral valve prolapse. This condition is usually benign during pregnancy because the heart's workload increases, and the mitral valve is a one-way valve that prevents blood from flowing back into the left atrium. Mitral valve prolapse typically does not significantly affect the heart's ability to pump blood efficiently during pregnancy.

Rationale:
1. Cardiomyopathy (A) can worsen during pregnancy, leading to complications for both the mother and the fetus.
2. Rheumatic heart disease (C) can cause valve damage, increasing the risk of complications during pregnancy.
3. Congenital heart disease (D) varies in severity and can pose risks during pregnancy, depending on the specific condition.

Summary: Mitral valve prolapse is the correct answer as it is less likely to cause significant issues during pregnancy compared to the other options provided.

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