Nokea
The client is admitted with a diagnosis of colon cancer. Which finding in the client’s admission information should prompt the nurse to consider that the cancer may be located in the client’s descending colon?
- A. Pain in the lower abdomen
- B. Change in bowel habits
- C. Bright red blood in the stool
- D. Nausea and vomiting
Correct Answer: C
Rationale: A. Pain may be a symptom of a tumor located on the left side of the colon, but it is not exclusive and could be a symptom of a tumor elsewhere in the colon. B. Change of bowel habits may be a symptom of a tumor located on the left side of the colon, but this is not exclusive and could be a symptom of a tumor elsewhere in the colon. C. Bright red blood in the stool is a sign or symptom of a colorectal tumor located in the descending colon. D. Nausea and vomiting are not symptoms specific to colon cancer.
You may also like to solve these questions
Which action should the nurse expect to perform after a client has a bone marrow biopsy taken from the iliac crest?
- A. Apply pressure to the site for one minute
- B. Administer a narcotic analgesic
- C. Apply an adhesive bandage to the site
- D. Place the client in a recumbent position
Correct Answer: C
Rationale: Applying an adhesive bandage to the site after a bone marrow biopsy prevents bleeding and protects the area. Pressure is typically applied for longer, narcotics are not routine, and recumbent positioning is not required.
The nurse is caring for a client who is thought to have pernicious anemia. What signs and symptoms would the nurse expect in this person?
- A. Easy bruising
- B. Beefy-red tongue
- C. Fine red rash on the extremities
- D. Pruritus
Correct Answer: B
Rationale: A beefy-red tongue is a hallmark symptom of pernicious anemia due to vitamin B12 deficiency.
The client diagnosed with leukemia is scheduled for bone marrow transplantation. Which interventions should be implemented to prepare the client for this procedure? Select all that apply.
- A. Administer high-dose chemotherapy.
- B. Teach the client about autologous transfusions.
- C. Have the family members' HLA typed.
- D. Monitor the complete blood cell count daily.
- E. Provide central line care per protocol.
Correct Answer: A,C,D,E
Rationale: High-dose chemotherapy (A) ablates marrow, HLA typing (C) identifies donors, CBC monitoring (D) tracks counts, and central line care (E) prevents infection. Autologous transfusions (B) are irrelevant (donor marrow used).
A client who receives a diagnosis of pernicious anemia asks why she must receive vitamin shots. What is the best answer for the nurse to give?
- A. Shots work faster than pills.'
- B. Your body cannot absorb vitamin B12 from foods.'
- C. Vitamins are necessary to make the blood cells.'
- D. You can get more vitamins in a shot than a pill.'
Correct Answer: B
Rationale: In pernicious anemia, the lack of intrinsic factor prevents absorption of vitamin B12 from foods, necessitating injections.
Which sign would the nurse expect to assess in the client diagnosed with idiopathic thrombocytopenic purpura (ITP)?
- A. Petechiae on the anterior chest, arms, and neck.
- B. Capillary refill of less than three (3) seconds.
- C. An enlarged spleen.
- D. Pulse oximeter reading of 95%.
Correct Answer: A
Rationale: ITP causes low platelets, leading to petechiae (A). Capillary refill (B) is normal, splenomegaly (C) is not primary, and SpO2 95% (D) is normal.