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An emergency department nurse is caring for a child in sickle cell crisis. The nurse suspects the etiology of the crisis as being thrombotic in nature because of which clinical manifestations? Select all that apply.


A) The client has profound pallor and fatigue.
B) The client is in extreme pain.
C) The client has profound hypotension and shock.
D) The client has a fever.
E) The client's chest CT reveals a pulmonary infarct.

F) A) and D)
G) A) and C)

Correct Answer

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The nurse instructs a client recovering from a mastectomy on ways to prevent lymphedema. Which client statement indicates that teaching has been successful?


A) "I should do the exercises on my affected arm every day."
B) "I have to take no special precautions."
C) "I should avoid cleansing my skin with soap."
D) "Eating fresh fruits and vegetables will prevent my arm from swelling."

E) C) and D)
F) A) and B)

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A

The nurse is assisting the healthcare provider with a bone marrow aspiration and biopsy on a client who has leukemia. The client also has thrombocytopenia. Upon completing the test, which intervention is a priority for the nurse?


A) Dispose of the equipment used, and clean the area properly.
B) Label and refrigerate the specimen obtained by the physician.
C) Hold pressure on the wound for approximately 5 minutes.
D) Make certain the client understands the purpose of the test.

E) None of the above
F) A) and B)

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A nursing student is preparing an educational program on hemolytic anemia for the residents of an assisted living center. Which extrinsic causes of hemolytic anemia should the student include in the program? Select all that apply.


A) Bacterial infection
B) Thalassemia
C) Blood transfusion reaction
D) Prosthetic heart valves
E) Acetaminophen use

F) C) and E)
G) A) and E)

Correct Answer

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Parents of a newborn infant are concerned that their baby may have sickle cell disease. The nurse reviews the medical record and finds that both parents have the sickle cell trait. Which is the best response for the nurse to give the parents?


A) "Since neither of you actually has sickle cell disease, your baby is not at risk."
B) "Your baby has the disease, as you both carry the trait."
C) "We are required to test all babies for sickle cell disease."
D) "Have you talked to a genetic counselor about your concerns?"

E) A) and C)
F) None of the above

Correct Answer

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A pediatric nurse is educating the client with sickle cell disease and the client's family regarding the genetic implications of the disease. Which information is inappropriate for the nurse to share with the client's family?


A) If both parents have the trait, then with each pregnancy, the risk of having a child with the disease is 50%.
B) The disorder is transmitted as an autosomal recessive genetic defect.
C) The sickle cell gene may have originated to protect against lethal forms of malaria.
D) In African Americans, sickle cell disease occurs in 1 of every 365 births.

E) B) and C)
F) A) and D)

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A nurse educator is explaining the term hyperplasia to a group of nursing students. Which statement, made by a nursing student, indicates an understanding of why hyperplasia occurs with myocardial infarction?


A) "Heart muscle cells experience hyperplasia with the prolonged need for oxygen."
B) "Heart muscle cells are hyperplastic in response to muscle damage."
C) "Heart muscle cells are hyperplastic when they have lost fluid."
D) "Heart muscle cells experience hyperplasia when they respond to decreased metabolic demands."

E) All of the above
F) B) and C)

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During a treatment meeting on an oncology unit, the nurse learns that a client is scheduled for chemotherapy before and after surgery. What are the purposes for this client to receive chemotherapy at these specific times? Select all that apply.


A) Eradicate all cancer cells.
B) Shrink the tumor.
C) Kill remaining cancer cells.
D) Allow the immune system to kill cancer cells.
E) Improve wound healing.

F) D) and E)
G) B) and E)

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The nurse is caring for a client who was admitted to a medical-surgical unit in sickle cell crisis. Which medication should the nurse expect to administer to this client?


A) Acetaminophen (Tylenol)
B) Ibuprofen (Advil)
C) Meperidine (Demerol)
D) Hydroxyurea

E) A) and C)
F) A) and B)

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The nurse provides an educational session for community members about the risk factors for colorectal cancer. Which participant statement indicates that teaching has been effective? Select all that apply.


A) "There is a genetic link in the development of colorectal cancer."
B) "People with other bowel diseases are at increased risk for developing this cancer."
C) "Eating a diet high in red meat reduces the risk for developing this type of cancer."
D) "Eating cereal fiber reduces the risk of developing colorectal cancer."
E) "Taking aspirin and a multivitamin each day reduces the risk of colorectal cancer."

F) A) and B)
G) B) and D)

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The home healthcare nurse is preparing a care plan for a client with severe anemia. The client currently lives alone and states, "I can't even walk to the kitchen without getting winded." What would be the priority nursing diagnosis for this client?


A) Hopelessness
B) Activity Intolerance
C) Imbalanced Nutrition, Less than Body Requirements
D) Anxiety

E) All of the above
F) A) and B)

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B

A client in sickle cell crisis reports taking a recent skiing trip that caused a respiratory infection from the cold weather. The client reports a pain level of 8 on a pain scale from 1 to 10. Which nursing diagnosis is a priority for this client?


A) Fluid Volume Excess
B) Risk for Self-Mutilation
C) Knowledge Deficit
D) Acute Pain

E) A) and C)
F) A) and B)

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For clients with cancer, what should the nurse regularly monitor to assess for cachexia?


A) Weight
B) Blood pressure
C) Heart rate
D) Temperature

E) A) and D)
F) C) and D)

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What independent nursing intervention is important for the nurse to implement for clients who have alterations in cellular regulation?


A) Administer pain and other medications
B) Help the client identify support systems
C) Design a diet that provides proper nutrition
D) Suggest contacting the nurse's spiritual leader

E) C) and D)
F) A) and B)

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The nurse is planning care for a young child who is admitted with sickle cell crisis. The parents are with the child, and neither has much information about the disease. When planning care for this family, the nurse will set which goal with this family?


A) The child will drink adequate amounts of fluid each day.
B) The child will play outside in the sun.
C) The family will not have the child vaccinated.
D) The family will plan vacations in high-altitude areas.

E) A) and B)
F) A) and C)

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The nurse is planning care to address ineffective airway clearance for a client with lung cancer. Which interventions should the nurse include in the client's plan of care? Select all that apply.


A) Suction the airway as needed.
B) Help the client turn, cough, and deep breathe as needed.
C) Provide chest percussion as ordered.
D) Educate the client about smoking cessation.
E) Administer pneumococcal vaccine.

F) A) and B)
G) None of the above

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A nurse is providing discharge instructions to a client with iron deficiency anemia who is experiencing glossitis. Which statements will the nurse include in the discharge teaching for this client? Select all that apply.


A) Monitor the condition of the lips and tongue daily.
B) Use an alcohol-based mouthwash every 2 to 4 hours.
C) Provide frequent oral hygiene.
D) Apply a non-petroleum-based lubricating jelly or ointment to the lips after oral care.
E) Use a soft toothbrush or sponge to provide oral care.

F) A) and E)
G) C) and D)

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Which form of breast cancer is the most malignant form?


A) Infiltrating ductal carcinoma
B) Inflammatory carcinoma of the breast
C) Carcinoma of the mammary ducts
D) Paget disease

E) A) and C)
F) B) and C)

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B

The nurse is providing community teaching related to risk factors for breast cancer for a group of young women. Which woman might the nurse identify as being at a higher risk for developing breast cancer at a young age?


A) A 28-year-old woman who received radiation for a spinal cord tumor at L3 during childhood
B) A 26-year-old woman who had a 32-year-old brother with breast cancer
C) A 34-year-old woman who has breastfed four children
D) A 42-year-old woman who has a second cousin diagnosed with breast cancer at age 58.

E) A) and B)
F) A) and C)

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The nurse is caring for a thin, older adult client who is diagnosed with cancer and is receiving aggressive chemotherapy. The client is experiencing severe side effects from the therapy and has lost 10 pounds in the past week. What should the nurse teach the client to do? Select all that apply.


A) Purchase fast foods and prepared foods.
B) Eat cold foods rather than hot foods.
C) Keep a food diary and record intake.
D) Eat large frequent meals high in calories.
E) Drink liquid supplements to increase intake of nutrients.

F) None of the above
G) C) and D)

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