The nurse is caring for a 39-year-old woman with a family history of breast cancer. She requested a breast tumor marking test and the results have come back positive. As a result, the patient is requesting a bilateral mastectomy. This surgery is an example of what type of oncologic surgery?
- A. Salvage surgery
- B. Palliative surgery
- C. Prophylactic surgery
- D. Reconstructive surgery
Correct Answer: C
Rationale: The correct answer is C: Prophylactic surgery. Prophylactic surgery involves removing tissue at risk of developing cancer to prevent the occurrence of cancer. In this case, the patient has a family history of breast cancer and has tested positive for a breast tumor marker, indicating a high risk of developing breast cancer. By opting for a bilateral mastectomy, the patient is proactively removing breast tissue to reduce her risk of developing breast cancer.
Salvage surgery (A) is performed to remove cancer that has recurred after initial treatment. Palliative surgery (B) aims to alleviate symptoms and improve quality of life but is not curative. Reconstructive surgery (D) is performed to restore the appearance and function of a body part after cancer treatment but is not the primary purpose in this scenario.
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A patient at high risk for breast cancer is scheduled for an incisional biopsy in the outpatient surgery department. When the nurse is providing preoperative education, the patient asks why an incisional biopsy is being done instead of just removing the mass. What would be the nurses best response?
- A. An incisional biopsy is performed because its known to be less painful and more accurate than other forms of testing.
- B. An incisional biopsy is performed to confirm a diagnosis and so that special studies can be done that will help determine the best treatment.
- C. An incisional biopsy is performed to assess the potential for recovery from a mastectomy.
- D. An incisional biopsy is performed on patients who are younger than the age of 40 and who are otherwise healthy.
Correct Answer: B
Rationale: The correct answer is B because an incisional biopsy is typically performed to confirm a diagnosis by obtaining a sample of the tissue in question. This allows for further analysis through special studies to determine the best course of treatment. The other choices are incorrect because:
A: The reason for performing an incisional biopsy is not primarily based on pain or accuracy comparisons with other testing methods.
C: An incisional biopsy is not done to assess potential recovery from a mastectomy but rather to diagnose the nature of the mass.
D: Age and general health status are not sole criteria for determining the need for an incisional biopsy.
A nurse wants to present information about fluimmunizations to the older adults in the community. Which type of communication should the nurse use?
- A. Public
- B. Small group
- C. Interpersonal
- D. Intrapersonal
Correct Answer: B
Rationale: The correct answer is B: Small group. When presenting information about flu immunizations to older adults in the community, using small group communication is most effective. In small group settings, the nurse can engage with the audience, encourage discussions, answer questions, and address individual concerns. This approach allows for personalized interaction, fosters trust, and facilitates better understanding and retention of information. Public communication (choice A) may not provide the same level of individualized attention. Interpersonal communication (choice C) typically refers to one-on-one interactions, which may not reach a larger audience efficiently. Intrapersonal communication (choice D) involves self-reflection and is not suitable for disseminating information to a group.
The patient with cardiovascular disease is receiving dietary instructions from the nurse. Which information from the patient indicates teaching is successful?
- A. Maintain a prescribed carbohydrate intake.
- B. Eat fish at least 5 times per week.
- C. Limittransfat to less than 1%.
- D. Avoid high-fiber foods.
Correct Answer: B
Rationale: Correct Answer: B - Eat fish at least 5 times per week.
Rationale:
1. Fish is rich in omega-3 fatty acids, which are beneficial for heart health.
2. Eating fish frequently can help reduce the risk of cardiovascular diseases.
3. Consuming fish aligns with dietary recommendations for cardiovascular health.
Summary of Incorrect Choices:
A: Maintaining carbohydrate intake is important, but it may not specifically indicate success in cardiovascular disease management.
C: Limiting trans fats is crucial, but it alone may not indicate overall success in dietary management for cardiovascular disease.
D: Avoiding high-fiber foods is not recommended, as fiber is beneficial for heart health and overall well-being.
The nurse is planning care for a group of patients. Which task will the nurse assign to the nursing assistive personnel?
- A. Measuring capillary blood glucose level
- B. Measuring nasoenteric tube for insertion
- C. Measuring pH in gastrointestinal aspirate
- D. Measuring the patient’s risk for aspiration
Correct Answer: A
Rationale: The correct answer is A because measuring capillary blood glucose level is a task that can be safely delegated to nursing assistive personnel. This task is within their scope of practice and does not require specialized nursing knowledge. Nursing assistive personnel can perform this task accurately with proper training and supervision.
Incorrect choices:
B: Measuring nasoenteric tube for insertion requires specialized training and assessment skills that nursing assistive personnel may not possess.
C: Measuring pH in gastrointestinal aspirate involves interpretation and clinical judgment that should be done by a licensed nurse.
D: Measuring the patient's risk for aspiration involves critical thinking and assessment skills that are beyond the scope of nursing assistive personnel.
A patient has returned to the floor from the PACU after undergoing a suprapubic prostatectomy. The nurse notes significant urine leakage around the suprapubic tube. What is the nurses most appropriate action?
- A. Cleanse the skin surrounding the suprapubic tube.
- B. Inform the urologist of this finding.
- C. Remove the suprapubic tube and apply a wet-to-dry dressing.
- D. Administer antispasmodic drugs as ordered.
Correct Answer: B
Rationale: The correct answer is B: Inform the urologist of this finding. In this scenario, significant urine leakage around the suprapubic tube indicates a potential issue with the tube placement or functioning. It is crucial to involve the urologist, who is the specialist managing the patient's urological interventions, to assess and address the cause of the leakage promptly. This action ensures timely and appropriate intervention to prevent complications such as infection or further damage.
Choice A is incorrect because simply cleansing the skin does not address the underlying issue of urine leakage. Choice C is incorrect and potentially harmful as removing the suprapubic tube without professional assessment can lead to serious complications. Choice D is incorrect as administering antispasmodic drugs may not be the appropriate action without further evaluation by the urologist.
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