The nurse is discussing the prevention of bladder cancer with the client. Which factors that increase the client’s risk for bladder cancer should the nurse emphasize?
- A. Consuming caffeine beverages
- B. Smoking tobacco products
- C. Consuming multivitamins daily
- D. Prolonged exposure to paint smells
- E. Prolonged exposure to rubber smells
Correct Answer: B, D, E, A
Rationale: Consumption of caffeine is not associated with an increased risk for bladder cancer. B. Smoking is the number one cause of bladder cancer in the world. C. Studies show a protective effect with an increased intake of vitamins A, B6, and E. D. Exposure to aromatic amines in the textile and paint industries is clearly associated with bladder cancer. E. Exposure to aromatic amines in the rubber industry is clearly associated with bladder cancer.
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The client diagnosed with esophageal cancer is having work-related problems that are interfering with the client's treatment. Which organization should the nurse advise the client to contact for assistance with these issues?
- A. National Cancer Institute
- B. Leukemia Society of America
- C. Corporate Angel Network
- D. Patient Advocate Foundation
Correct Answer: D
Rationale: A. The National Cancer Institute answers questions and has free information about cancer. B. The Leukemia Society of America provides education regarding leukemia. C. The Corporate Angel Network provides free plane transportation for cancer clients going to and from treatment centers. D. The Patient Advocate Foundation provides counseling to resolve job-related problems.
The nurse and an unlicensed assistive personnel (UAP) are caring for clients on a medical unit. Which task should the nurse delegate to the UAP?
- A. Check on the bowel movements of a client diagnosed with melena.
- B. Take the vital signs of a client who received blood the day before.
- C. Evaluate the dietary intake of a client who has been noncompliant with eating.
- D. Shave the client diagnosed with severe hemolytic anemia.
Correct Answer: B
Rationale: Taking vital signs post-transfusion (B) is within UAP scope. Checking melena (A), evaluating diet (C), and shaving with anemia (D) require nursing judgment due to bleeding risks.
The client diagnosed with leukemia has received a bone marrow transplant. The nurse monitors the client’s absolute neutrophil count (ANC). What is the client’s neutrophil count if the WBCs are 2.2 (x103/mm3), neutrophils are 25%, and bands are 5%?
Correct Answer: 660
Rationale: ANC = WBC × (neutrophils% + bands%). WBC = 2,200/mm3, neutrophils = 25%, bands = 5%. ANC = 2,200 × (0.25 + 0.05) = 2,200 × 0.3 = 660/mm3.
Which collaborative treatment would the nurse anticipate for the client diagnosed with DIC?
- A. Administer oral anticoagulants.
- B. Prepare for plasmapheresis.
- C. Administer frozen plasma.
- D. Calculate the intake and output.
Correct Answer: C
Rationale: Frozen plasma (C) replaces clotting factors in DIC. Oral anticoagulants (A) worsen bleeding, plasmapheresis (B) is rare, and I&O (D) is routine.
The client asks the nurse to look at a lesion on the client’s body. Which characteristics should prompt the nurse to consider that the client may have a basal cell carcinoma (BCC)?
- A. Nodular in appearance, depression in the center, and has a “pearly” characteristic
- B. Irregular color, surface, and border, less than one centimeter, and appears eroded
- C. Dry, hyperkeratotic scaly-like papule and has the appearance similar to a wart
- D. Vesiculopustular lesion with a thick, honey-colored crust and pruritic in nature
Correct Answer: A
Rationale: BCC is nodular and ulcerative. Clinical manifestations include small, slowly enlarging papule; borders are translucent or “pearly” with overlying telangiectasia; erosion, ulceration, and depression of center. B. Clinical manifestations of malignant melanoma (not BCC) include irregular color, surface, and border; variegation of color including red, white, blue, black, gray, brown; flat or elevated; eroded or ulcerated. C. Actinic keratosis (not BCC) is characterized by being horny and “wartlike.” D. Impetigo is characterized by thick, honey-colored crusts and is treated with antibiotics and topical treatment.
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