Nokea
The nurse is teaching the client who is to undergo diagnostic testing for possible gastric cancer. Teaching the client about which specific diagnostic test would be most helpful?
- A. Bronchoscopy
- B. Sigmoid colonoscopy
- C. Esophagogastroduodenoscopy
- D. Multigated acquisition (MUGA) scan
Correct Answer: C
Rationale: A. Bronchoscopy includes insertion of a bronchoscope to examine the lungs. B. Colonoscopy is used to inspect the large intestines. C. EGD is an invasive procedure in which a lighted instrument (scope) is lowered into the stomach and duodenum to examine gastric tissues and obtain biopsies for cancer cell analysis. Because it is the preferred test to diagnose gastric cancer, the nurse should teach the client about this test. D. A MUGA scan creates video images of the ventricles of the heart to evaluate their correct function in pumping blood. A person who is to receive chemotherapy for cancer treatment may have a MUGA scan completed to identify preexisting heart conditions.
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The nurse is assessing a client diagnosed with acute myeloid leukemia. Which assessment data support this diagnosis?
- A. Fever and infections.
- B. Nausea and vomiting.
- C. Excessive energy and high platelet counts.
- D. Cervical lymph node enlargement and positive acid-fast bacillus.
Correct Answer: A
Rationale: AML causes neutropenia, leading to fever/infections (A). Nausea (B) is nonspecific, high platelets/energy (C) are incorrect (AML causes thrombocytopenia/fatigue), and acid-fast bacillus (D) indicates TB, not AML.
When assessing the client who is recovering from a radical hysterectomy with vulvectomy, the nurse notes lymphedema of the lower extremities. Which intervention should be implemented by the nurse?
- A. Elevate the head of the client’s bed to 45 degrees.
- B. Increase the client’s intake of fluids high in sodium.
- C. Encourage the client to exercise the lower extremities.
- D. Apply splints to both of the client’s lower extremities.
Correct Answer: C
Rationale: A. Elevating the head of the bed to a 45-degree angle may increase lymphedema of the lower extremities. B. Intake of fluids high in sodium will cause fluid retention. C. Leg exercises will improve drainage when lymphedema is present. D. Lower-extremity splints can cause skin breakdown of edematous tissue.
The client’s nephew has just been diagnosed with sickle cell anemia (SCA). The client asks the nurse, 'How did my nephew get this disease?' Which statement would be the best response by the nurse?
- A. Sickle cell anemia is an inherited autosomal recessive disease.'
- B. He was born with it and both his parents were carriers of the disease.'
- C. At this time, the cause of sickle cell anemia is unknown.'
- D. Your sister was exposed to a virus while she was pregnant.'
Correct Answer: A
Rationale: SCA is an autosomal recessive disorder (A), the most precise explanation. Parents as carriers (B) is partial, cause is known (C), and viral exposure (D) is incorrect.
The nurse identifies a concept of hematologic regulation for a client diagnosed with leukemia. Which clinical manifestations support the concept?
- A. The client has petechiae on the trunk and extremities.
- B. The client complains of pain and swelling in the joints.
- C. The client has an Hbg of 9.7 and Hct of 32%.
- D. The client complains of a headache and slurred speech.
Correct Answer: A,C
Rationale: Petechiae (A) and low Hb/Hct (C) reflect leukemia’s impact on hematologic regulation (thrombocytopenia, anemia). Joint pain (B) is less common, and headache/slurred speech (D) suggest stroke.
The client diagnosed with sickle cell anemia asks the nurse, 'Why should I take those shots? I hate shots.' Which statement by the nurse is the best response?
- A. These vaccines promote health in clients with chronic illnesses.'
- B. You are susceptible to infections. These shots may help prevent a crisis.'
- C. The vaccines will help your blood from sickling secondary to viruses.'
- D. The doctor wanted to make sure that I discussed the vaccines with you.'
Correct Answer: B
Rationale: Flu/pneumonia vaccines (B) reduce infection risk, a common SCA crisis trigger. General health (A) is vague, sickling (C) is indirect, and HCP mention (D) avoids explanation.