Nokea
A client who has a strong family history of breast cancer tells the nurse that she is taking a drug to prevent breast cancer. The nurse expects the drug that she is receiving is:
- A. Tamoxifen (Nolvadex)
- B. Cyclophosphamide (Cytoxan)
- C. Estrogen (Premarin)
- D. Doxorubicin (Adriamycin)
Correct Answer: A
Rationale: Tamoxifen is used for breast cancer prevention in high-risk individuals due to its anti-estrogenic effects. Cyclophosphamide and Doxorubicin are chemotherapy drugs, not preventive, so B and D are incorrect. Estrogen can increase breast cancer risk, making C incorrect.
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The family of a 48-year-old woman who has multiple sclerosis and spends most of her time in bed or in a chair asks the nurse why they have been told they should have her take deep breaths and cough frequently. What should the nurse include in the reply?
- A. Deep breathing and coughing will help her to move her secretions so she will not develop pneumonia.
- B. Deep breathing and coughing help to prevent clots from developing in the lung.
- C. When she coughs, she increases the amount of oxygen going to the brain, preventing confusion.
- D. Deep breathing increases blood flow to the brain and helps to keep her from getting depressed.
Correct Answer: A
Rationale: Immobility in multiple sclerosis increases pneumonia risk; deep breathing and coughing mobilize secretions, preventing respiratory infections.
An adult is admitted with pernicious anemia. Which factor in the client's history is most likely related to the development of pernicious anemia?
- A. The client had an upper gastrointestinal (GI) bleed a year ago.
- B. The client had chemotherapy three months ago.
- C. The client had a gastrectomy six months ago.
- D. The client's mother had iron deficiency anemia
Correct Answer: C
Rationale: Gastrectomy removes the stomach's intrinsic factor-producing cells, leading to vitamin B12 malabsorption, a primary cause of pernicious anemia.
The client who is receiving hydantoin (Dilantin) tells the nurse his urine is pink-colored. What action should the nurse take?
- A. Report this serious side effect immediately to the physician
- B. Reassure the client that this occurs often in persons taking Dilantin
- C. Ask the client if he drank cranberry juice or ate red gelatin recently
- D. Strain the client's urine for possible urinary tract stones
Correct Answer: C
Rationale: Pink urine may result from dietary factors like cranberry juice or red gelatin, which should be ruled out before assuming a Dilantin-related issue.
The nurse is assessing the mental status of a client admitted with possible organic brain disorder. Which of these questions will best assess the functioning of the client's recent memory?
- A. Name the year. What season is this?
- B. Subtract 7 from 100 and then subtract 7 from that. Now continue to subtract 7 from the new number.
- C. I am going to say the names of three things and I want you to repeat them after me: blue, ball, pen.
- D. What is this on my wrist? Then ask, What is the purpose of it?
Correct Answer: C
Rationale: I am going to say the names of three things and I want you to repeat them after me: blue, ball, pen. This tests immediate recall, a component of recent memory.
A client who has overdosed on a large quantity of diazepam (Valium).
Which of the following nursing actions should take priority during the first several days of this client's inpatient treatment?
- A. Complete a full psychiatric assessment.
- B. Get in touch with the client's family to involve them in treatment.
- C. Observe and record vital signs frequently, including neurological symptoms.
- D. Determine whether this client may need long-term therapy after this hospitalization.
Correct Answer: C
Rationale: Strategy: Think Maslow. (1) psychosocial, can be done after the client has been medically stabilized (2) psychosocial, can be done after the client has been medically stabilized (3) correct-physical, because of potentially life-threatening complications of depressant overdose such as respiratory failure, pulmonary edema, and seizures, nurse's priority is observation and documentation of vital signs (4) psychosocial, can be done after the client has been medically stabilized