Nokea
The nurse is assessing the client newly diagnosed with endometrial cancer. Which common findings would the nurse expect?
- A. Abnormal vaginal bleeding and pain in the pelvic area
- B. Weight loss and profuse sweating, especially at night
- C. Anorexia and enlarged supraclavicular lymph nodes
- D. Unexplained spikes in temperature and splenomegaly
Correct Answer: A
Rationale: A. Abnormal vaginal bleeding and pain in the pelvic region appear as the most common presenting symptoms in the client with endometrial cancer. B. Weight loss is not a common presenting symptom unless the cancer is advanced. Night sweats may occur with hormone changes. C. Supraclavicular lymph nodes are located just above the clavicle, lateral to where it joins the sternum, and not near the uterus. D. Unexplained temperature spikes and splenomegaly are not common presenting symptoms.
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The 24-year-old female client is diagnosed with idiopathic thrombocytopenic purpura (ITP). Which question would be important for the nurse to ask during the admission interview?
- A. Do you become short of breath during activity?'
- B. How heavy are your menstrual periods?'
- C. Do you have a history of deep vein thrombosis?'
- D. How often do you have migraine headaches?'
Correct Answer: B
Rationale: ITP causes bleeding; heavy menstrual periods (B) assess bleeding severity. Dyspnea (A), DVT (C), and migraines (D) are unrelated.
The client who received 50 mL from a unit of whole blood has low back pain. In response to this client’s symptom, which action should be taken by the nurse first?
- A. Reposition the client.
- B. Assess the pain further.
- C. Administer an analgesic.
- D. Stop the blood transfusion.
Correct Answer: D
Rationale: A. Repositioning focuses on treating the client’s back pain and not on the blood transfusion, which could be the cause of the back pain. B. Further assessment should occur after stopping the blood transfusion. C. The client may need an analgesic for pain control, but this should occur after stopping the blood transfusion. D. Low back pain is a symptom of a potentially life-threatening acute hemolytic reaction. The pain is caused from agglutination of RBCs in the kidneys and renal vasoconstriction. Hemolytic reactions occur most often within the first 50 mL of the infusion.
The male client with sickle cell anemia comes to the emergency department with a temperature of 101.4°F and tells the nurse that he is having a sickle cell crisis. Which diagnostic test should the nurse anticipate the emergency department doctor ordering for the client?
- A. Spinal tap.
- B. Hemoglobin electrophoresis.
- C. Sickle-turbidity test (Sickledex).
- D. Blood cultures.
Correct Answer: D
Rationale: Fever (101.4°F) in SCA crisis suggests infection; blood cultures (D) identify the cause. Spinal tap (A) is for meningitis, electrophoresis (B) confirms SCA, and Sickledex (C) screens for sickle trait.
The nurse is completing a care plan for a client diagnosed with leukemia. Which independent problem should be addressed?
- A. Infection.
- B. Anemia.
- C. Nutrition.
- D. Grieving.
Correct Answer: A
Rationale: Infection (A) is critical in leukemia due to neutropenia, requiring independent nursing actions (e.g., hygiene). Anemia (B), nutrition (C), and grieving (D) are collaborative or secondary.
Which of the following would be the most appropriate snack for a client who has iron deficiency anemia?
- A. Half of a grapefruit
- B. A carrot raisin salad
- C. A cup of yogurt
- D. Apple slices and cheese
Correct Answer: B
Rationale: Carrot raisin salad contains raisins, which are a good source of iron, making it appropriate for iron deficiency anemia.