Set D

Review Results Assessment SET-D

Email Address: erikajanern@icloud.com

Full Name: Purificacion, Erika Jane
: mindwebph
Respondent ID: 38517
Date Started: 10/10/2023 05:27:02 PM
Date Completed: 10/10/2023 06:08:55 PM
Attempt: 1

Question Topic
Question
Num
Respondent's Answer Correct Answer
Set D
1. Which of the following classes of antineoplastic agents is cell- cycle specific?

( ) antimetabolites (X) antimetabolites

( ) antitumor antibiotics ( ) antitumor antibiotics
(X) alkylating agents ( ) alkylating agents
( ) nitrosoureas ( ) nitrosoureas
2. Which of the following does a nurse thoroughly evaluate before a bone marrow transplant(BMT) procedure?

( ) family history ( ) family history

( ) drug history ( ) drug history
( ) blood studies (X) blood studies
(X) allergy history ( ) allergy history
3. Following a BMT the patient should be monitored for at least:

(X) 3 days ( ) 3 days

( ) 4 weeks ( ) 4 weeks
( ) 3 months (X) 3 months
( ) 5 months ( ) 5 months
4. Which of the following is a type of procedure that uses liquid nitrogen to freeze tissue that causes cell destruction?

(X) electrosurgery ( ) electrosurgery

( ) cryosurgery (X) cryosurgery
( ) chemosurgery ( ) chemosurgery
( ) laser surgery ( ) laser surgery
5. Chemotherapeutic agents have which effect associated with the renal system?

( ) hypokalemia ( ) hypokalemia
( ) increased uric acid excretion (X) increased uric acid excretion
(X) hypophosphatemia ( ) hypophosphatemia
( ) hypercalcemia ( ) hypercalcemia
6. Which type of vaccine uses the patient's own cancer cells, which are prepared for injection , back into the patient?

( ) autologous (X) autologous

( ) prophylactic ( ) prophylactic
(X) therapeutic ( ) therapeutic
( ) allogenic ( ) allogenic

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 7. Which type of surgery is utilized in an attempt to relieve complications of cancer?

(X) palliative (X) palliative

( ) prophylactic ( ) prophylactic
( ) reconstructive ( ) reconstructive
( ) salvage ( ) salvage
8. Presently there are no diagnostic screening tools available for:

(X) pancreatic cancer (X) pancreatic cancer

( ) cervical cancer ( ) cervical cancer
( ) prostate cancer ( ) prostate cancer
( ) breast cancer ( ) breast cancer
9. Which of the following serum markers have proven to be beneficial in identifying ovarian cancer?

( ) prostate - specific antigen(PSA) ( ) prostate - specific antigen(PSA)

(X) CA 125 (X) CA 125
( ) Carcinoembryonic Antigen (CEA) ( ) Carcinoembryonic Antigen (CEA)
( ) Human chorionic Gonadotropin (hCG) ( ) Human chorionic Gonadotropin (hCG)
10. In what manner does dysfunctional apoptosis contribute to the development of cancer?

( ) apoptosis has no impact on malignant development
( ) cells that go trough apoptosis are the only ones that become
cancerous
( ) it increases the risk for mitochondrial dysfunction
(X) it allows for DNA - damaged cells and abnormal cells to
survive
11. Radiation therapy has the greatest impact on:
( ) apoptosis has no impact on malignant development
( ) cells that go trough apoptosis are the only ones that become
cancerous
( ) it increases the risk for mitochondrial dysfunction
(X) it allows for DNA - damaged cells and abnormal cells to
survive

(X) radiosensitive tumors that are slow growing ( ) radiosensitive tumors that are slow growing
( ) radiosensitive tumors that have hypoxic cells ( ) radiosensitive tumors that have hypoxic cells
( ) radiosensitive tumors that have extensive metastasis ( ) radiosensitive tumors that have extensive metastasis
( ) radiosensitive tumors that are fast growing (X) radiosensitive tumors that are fast growing
12. The antineoplastic agents affect normal and abnormal cells all over the body. That is the reason effects of these drug are routinely
seen in all of the following EXCEPT:

( ) bone marrow ( ) bone marrow

( ) hair follicles ( ) hair follicles
(X) cardiac (X) cardiac
( ) gastrointestinal system ( ) gastrointestinal system
13. Which side - effect of the alkylating agents should the nurse be most concerned about?

(X) leucopenia (X) leucopenia

( ) pulmonary emboli ( ) pulmonary emboli
( ) hemorrhagic cystitis ( ) hemorrhagic cystitis
( ) dizziness ( ) dizziness
14. The nurse knows that teaching about the plant alkaloids has been successful when the client states the following:

( ) " I will stay out of the sun" ( ) " I will stay out of the sun"
( ) " I won't eat aged cheese" ( ) " I won't eat aged cheese"
(X) " I will increase the fiber in my diet" (X) " I will increase the fiber in my diet"
( ) " I know my urine will turn red" ( ) " I know my urine will turn red"
15. All antineoplastic agents are contraindicated when the client has:

( ) pulmonary disease ( ) pulmonary disease

( ) cardiac disease ( ) cardiac disease
( ) liver cancer ( ) liver cancer
(X) bone marrow depression (X) bone marrow depression

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 16. Which of the following complications is common for victims of electrical burns?

( ) inhalation injury ( ) inhalation injury

( ) infection ( ) infection
(X) cardiac dysrhytmia (X) cardiac dysrhytmia
( ) hypovolemic shock ( ) hypovolemic shock
17. Which of the following is a quick assessment technique to assess the percentage of burn injury?

( ) observing the color of the patient's wound ( ) observing the color of the patient's wound
( ) checking the patient's vital signs ( ) checking the patient's vital signs
(X) comparing the patient's palm with the size of the burn wound (X) comparing the patient's palm with the size of the burn wound
( ) observing the patient's level of consciousness ( ) observing the patient's level of consciousness
18. Which of the following instructions should a nurse provide a patient with burns who has undergone a skin grafting?

( ) avoid sunscreen lotions ( ) avoid sunscreen lotions

( ) avoid products that claim they minimize the visibility of scars ( ) avoid products that claim they minimize the visibility of scars
(X) wear a pressure garment for up to 2 years (X) wear a pressure garment for up to 2 years
( ) increase the intake of calcium and phosphate ( ) increase the intake of calcium and phosphate
19. The nurse is caring for a patient with a burn injury. How often should the nurse change the dressing?

( ) once in 2 hours ( ) once in 2 hours

(X) once a day (X) once a day
( ) once in 3 days ( ) once in 3 days
( ) once a week ( ) once a week
20. Acticoat antimicrobial barrier dressings used in the treatment of burn wounds can be left in place for which time frame?

( ) 7 to 10 days ( ) 7 to 10 days
( ) 3 days ( ) 3 days
(X) 5 days (X) 5 days
( ) 2 days ( ) 2 days
21. Which zone of burn injury sustains the most damage?

( ) outer ( ) outer
( ) middle ( ) middle
(X) inner (X) inner
( ) protective ( ) protective
22. A patient comes in to get an ELISA test done because her physician suspects AIDS. Which of the following nursing actions is
essential before an ELISA test is performed?

( ) performing a western blot ( ) performing a western blot

( ) performing a polymerase chain reaction test ( ) performing a polymerase chain reaction test
( ) providing the patient with plenty of fluids. ( ) providing the patient with plenty of fluids.
(X) D. Obtaining a written consent from the patient (X) D. Obtaining a written consent from the patient
23. Which of the following microorganisms is known to cause retinitis in people with AIDS?

(X) cytomegalovirus (X) cytomegalovirus

( ) Cryptococcus neoformans ( ) Cryptococcus neoformans
( ) Mycobacterium avium ( ) Mycobacterium avium
( ) Pneumocystis carinii ( ) Pneumocystis carinii
24. When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean that?

(X) his body has not produced antibodies to the AIDS virus (X) his body has not produced antibodies to the AIDS virus
( ) he has not been infected with HIV ( ) he has not been infected with HIV
( ) he is immune to the AIDS virus ( ) he is immune to the AIDS virus
( ) antibodies to the AIDS virus are in his blood. ( ) antibodies to the AIDS virus are in his blood.

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 25. Which of the following substances may be used to lubricate a condom?

( ) skin lotion ( ) skin lotion

( ) baby oil ( ) baby oil
(X) K-Y jelly (X) K-Y jelly
( ) Petroleum jelly ( ) Petroleum jelly
26. When do most perinatal HIV infections occur?

( ) through breast feeding ( ) through breast feeding

( ) in utero ( ) in utero
(X) after exposure during delivery (X) after exposure during delivery
( ) through casual contact ( ) through casual contact
27. Which of the following is usually the most important consideration in decisions to initiate antiretroviral therapy?

(X) CD4 counts (X) CD4 counts

( ) HIV RNA ( ) HIV RNA
( ) Western blot ( ) Western blot
( ) ELISA ( ) ELISA
28. Antiretroviral medications should be offered to individuals with T- cell counts of less than:

( ) 50 cell/mm3 ( ) 50 cell/mm3
( ) 150 cell/mm3 ( ) 150 cell/mm3
( ) 250 cell/mm3 ( ) 250 cell/mm3
(X) 350 cell/mm3 (X) 350 cell/mm3
29. The nurse is assessing a client with polycythemia vera . The nurse should conduct a focused assessment because this client is at
risk for which of the following?

( ) hair loss ( ) hair loss

(X) thrombus formation (X) thrombus formation
( ) anemia ( ) anemia
( ) iron deficiency ( ) iron deficiency
30. A client with chronic myelogenous leukemia is experiencing leucopenia secondary to chemotherapy . The nurse should plan with
the client to do which of the following?

( ) cover the mouth when coughing ( ) cover the mouth when coughing
( ) avoid use of aspirin ( ) avoid use of aspirin
(X) stay out of public areas (X) stay out of public areas
( ) alternate activity with periods of rest ( ) alternate activity with periods of rest
31. A client with acute lymphocytic leukemia is receiving vincristine. Prior to infusing the drug, the nurse administers diphenhydramine.
The nurse should inform the client that the expected outcome of using diphenhydramine is which of the following?

( ) promotes sleep, while the vincristine is infusing ( ) promotes sleep, while the vincristine is infusing
(X) decreases incidence of a reaction to the vincristine (X) decreases incidence of a reaction to the vincristine
( ) potentiates the action of the vincristine ( ) potentiates the action of the vincristine
( ) reduce anxiety ( ) reduce anxiety
32. A female client is receiving chemotherapy and is experiencing pancytopenia. Which laboratory result most warrants that the nurse
immediately contact the physician?

(X) platelet count of 12,000/mm2 (X) platelet count of 12,000/mm2

( ) WBC count of 5,000/mm2 ( ) WBC count of 5,000/mm2
( ) Absolute neutrophil count of 1,500/mm2 ( ) Absolute neutrophil count of 1,500/mm2
( ) Hemoglobin of 12 g/100 mL ( ) Hemoglobin of 12 g/100 mL
33. A nurse is administering an IV antineoplastic agent when the client says, " My arm is burning by the IV site". What should the nurse
do first?

( ) slow the infusion and check the IV site ( ) slow the infusion and check the IV site
( ) call the physician to report the incident ( ) call the physician to report the incident
(X) stop infusing the medication (X) stop infusing the medication
( ) place a warm , moist pack on the IV site area ( ) place a warm , moist pack on the IV site area

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 34. A client undergoing antineoplastic therapy is prescribed subcutaneous epoetin(Procrit) . The nurse evaluates that the drug is
effective when:

( ) biopsies no longer show malignancy ( ) biopsies no longer show malignancy

(X) hemoglobin levels rise (X) hemoglobin levels rise
( ) nausea and vomiting stop ( ) nausea and vomiting stop
( ) a scan shows tumor shrinkage ( ) a scan shows tumor shrinkage
35. In what manner does dysfunctional apoptosis contribute to the development of cancer?

( ) apoptosis has no impact on malignant development
( ) cells that go through apoptosis are the only ones that
become cancerous
( ) it increases the risk for mitochondrial dysfunction
(X) it allows for DNA - damaged cells to survive
36. Radiation therapy has the greatest impact on:
( ) apoptosis has no impact on malignant development
( ) cells that go through apoptosis are the only ones that
become cancerous
( ) it increases the risk for mitochondrial dysfunction
(X) it allows for DNA - damaged cells to survive

( ) radiosensitive tumors that are slow growing ( ) radiosensitive tumors that are slow growing
( ) radiosensitive tumors that have hypoxic cells ( ) radiosensitive tumors that have hypoxic cells
( ) radiosensitive tumors that have extensive metastasis ( ) radiosensitive tumors that have extensive metastasis
(X) radiosensitive tumors that are fast growing (X) radiosensitive tumors that are fast growing
37. A client is currently receiving chemotherapy treatments. Which of the following adjunct interventions would be useful in decreasing
the risk of thrombocytopenia?

( ) keeping the patient in isolation ( ) keeping the patient in isolation

(X) administration of erythropoietin (X) administration of erythropoietin
( ) intravenous antibiotics ( ) intravenous antibiotics
( ) B and C ( ) B and C
38. The characteristic fatigue of cancer is generally a result of :

(X) the disease and treatment (X) the disease and treatment
( ) depression and anxiety ( ) depression and anxiety
( ) impaired sleep patterns and muscle wasting ( ) impaired sleep patterns and muscle wasting
( ) anorexia and neurologic impairment ( ) anorexia and neurologic impairment
39. An obese woman is at greater risk of developing breast cancer because of the resulting :

(X) increased sex hormone (X) increased sex hormone

( ) chronic inflammation ( ) chronic inflammation
( ) increased production of pancreatic insulin ( ) increased production of pancreatic insulin
( ) insulin resistance ( ) insulin resistance
40. When cancer cells metastasize, whether a tumor develops depends on:

(X) the establishment of a dedicated vascular system (X) the establishment of a dedicated vascular system
( ) the general health status of the individual ( ) the general health status of the individual
( ) early detection of the primary site ( ) early detection of the primary site
( ) aggressiveness of the cancer cells ( ) aggressiveness of the cancer cells
41. When treating breast cancer , identification of the sentinel node is important because:

( ) that will determine if the cancer has invaded the lymphatic
system
(X) this facilitates lymphatic mapping
( ) this identifies the node that requires biopsy
( ) doing so aides in determining the extent of the disease
42. Metastasis is defined as:
( ) that will determine if the cancer has invaded the lymphatic
system
( ) this facilitates lymphatic mapping
( ) this identifies the node that requires biopsy
(X) doing so aides in determining the extent of the disease

( ) crablike projections of cancer cells invading surrounding
tissue
(X) the development of a secondary tumor
( ) cancer cells deposited into body cavity
( ) transporting of cancer cells via the lymph system
( ) crablike projections of cancer cells invading surrounding
tissue
(X) the development of a secondary tumor
( ) cancer cells deposited into body cavity
( ) transporting of cancer cells via the lymph system

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 43. A patient with thrombocyte count of 60,000/uL would be at risk for which of the following conditions?

( ) disseminated intravascular coagulation ( ) disseminated intravascular coagulation

( ) deep vein thrombosis ( ) deep vein thrombosis
( ) hypercoagulation ( ) hypercoagulation
(X) bleeding (X) bleeding
44. The mother of a newborn infant questions why her baby needs a vitamin K injection immediately after birth. The nurse explains that
vitamin K is needed because;

( ) the infant was exposed to high levels of heparin upon birth ( ) the infant was exposed to high levels of heparin upon birth
(X) infants are not born with the normal intestinal bacteria that (X) infants are not born with the normal intestinal bacteria that
synthesize vitamin K for clotting synthesize vitamin K for clotting
( ) infants have a higher body fat content , which prohibits the ( ) infants have a higher body fat content , which prohibits the
absorption of Vitamin K absorption of Vitamin K
( ) it is hospital policy to administer the injection to newborns ( ) it is hospital policy to administer the injection to newborns
45. The father of a 2 - year old boy recently diagnosed with hemophilia A asks about preventing complications for the boy. What
education should the nurse provide/

( ) " hemophilia A will no longer be a concern once treated with ( ) " hemophilia A will no longer be a concern once treated with
a blood transfusion" a blood transfusion"
( ) " do not allow the child to play outside or with other children ' ( ) " do not allow the child to play outside or with other children '
( ) " small bleeding in the joints is to be expected and can be ( ) " small bleeding in the joints is to be expected and can be
treated at home" treated at home"
(X) " avoid administering aspirin and NSAIDs" (X) " avoid administering aspirin and NSAIDs"
46. A 42- year old male patient recently diagnosed with liver cancer requires close monitoring for bleeding abnormalities due to:

( ) a vitamin C deficiency in the diet ( ) a vitamin C deficiency in the diet

( ) increased amounts of vitamin K being produced in the liver ( ) increased amounts of vitamin K being produced in the liver
( ) weakening of the organ walls as a result of inflammation ( ) weakening of the organ walls as a result of inflammation
(X) the reduction of clotting factors synthesized in the liver (X) the reduction of clotting factors synthesized in the liver
47. The first stage of hemostasis is:

( ) formation of the platelet plug ( ) formation of the platelet plug

( ) clot retraction ( ) clot retraction
(X) vessel spasm (X) vessel spasm
( ) clot dissolution ( ) clot dissolution
48. Disseminated intravascular coagulation (DIC) is characterized by:

( ) thrombocytosis as a result of widespread infection ( ) thrombocytosis as a result of widespread infection

( ) impaired platelet function due to vitamin K deficiency
(X) widespread coagulation and bleeding in the vascular
compartment
( ) bleeding due to structurally weak vessels resulting from
vitamin C deficiency
49. What medication is used to prevent platelet aggregation?
( ) impaired platelet function due to vitamin K deficiency
(X) widespread coagulation and bleeding in the vascular
compartment
( ) bleeding due to structurally weak vessels resulting from
vitamin C deficiency

( ) tirofiban ( ) tirofiban
( ) vitamin K ( ) vitamin K
(X) ticlopidine (X) ticlopidine
( ) warfarin ( ) warfarin
50. Which of the following is true when describing a patient with AIDS?

(X) the individual will have decreased numbers of CD4 cells or
helper T cells
( ) the individual will unlikely to develop cancer
( ) streptococcal pneumonia is the leading cause of death for
people with HIV infection worldwide
( ) the individual will likely be seronegative
(X) the individual will have decreased numbers of CD4 cells or
helper T cells
( ) the individual will unlikely to develop cancer
( ) streptococcal pneumonia is the leading cause of death for
people with HIV infection worldwide
( ) the individual will likely be seronegative

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 51. The ELISA is a more sensitive assay than the western blot when assessing for the presence of antibodies to specific viral antigens,
such as HIV.

( ) True ( ) True
(X) False (X) False
52. When the body produces antibodies against its own tissue , it is:

(X) hypersensitivity/ autoimmunity (X) hypersensitivity/ autoimmunity

( ) an immunologic reaction / cell mediated immunity ( ) an immunologic reaction / cell mediated immunity
( ) hypersensitivity / cell - mediated immunity ( ) hypersensitivity / cell - mediated immunity
( ) allloimmunity/ hypersensitivity ( ) allloimmunity/ hypersensitivity
53. SITUATION: Mr. Smith, a 25 year-old male is admitted to the hospital after sustaining burns to the chest and abdomen. The
accident occurred when gasoline ignited while he was cleaning the engine of his motorcycle.

The client tells the emergency room nurse that when he realized his clothes were on fire, he ran into his house to telephone for
help. Of the following courses of action that had been available to the client , it would have been best for him to:

(X) fall to the ground and roll (X) fall to the ground and roll
( ) take off his clothing immediately ( ) take off his clothing immediately
( ) stand still and call for help ( ) stand still and call for help
( ) spray his clothing with fire extinguisher liquid ( ) spray his clothing with fire extinguisher liquid
54. Using the "rule of nines" the nurse would determine that approximately what percentage of the client's body surface has been
burned?

(X) 0.18 (X) 0.18

( ) 0.27 ( ) 0.27
( ) 0.36 ( ) 0.36
( ) 0.45 ( ) 0.45
55. The nurse assess the client for fluid shifting . The best definition of fluid shifts that are expected to occur during the emergent phase
of burn injury is that they are due to fluid moving from the:

(X) vascular to interstitial space (X) vascular to interstitial space

( ) extracellular to intracellular space ( ) extracellular to intracellular space
( ) intracellular to extracellular space ( ) intracellular to extracellular space
( ) interstitial to vascular space ( ) interstitial to vascular space
56. The nurse should recognize that the fluid derangement is due to a fluid shift that results from an increase in the :

(X) permeability of capillary walls (X) permeability of capillary walls

( ) total volume of intravascular plasma ( ) total volume of intravascular plasma
( ) total volume of circulating whole blood ( ) total volume of circulating whole blood
( ) permeability of the kidney tubules ( ) permeability of the kidney tubules
57. The client with a major burn injury receives total parenteral nutrition(TPN). The primary reason for this therapy for this client is to
help:

( ) correct water and electrolyte imbalances ( ) correct water and electrolyte imbalances
( ) allow the gastrointestinal tract to rest ( ) allow the gastrointestinal tract to rest
( ) provide supplemental vitamins and minerals ( ) provide supplemental vitamins and minerals
(X) ensure adequate caloric and protein intake (X) ensure adequate caloric and protein intake
58. The client hears the physician using the term "Eschar" when speaking about the burn wounds; he asks the nurse what the word
means. Which of the following descriptions by the nurse best defines eschar?

( ) scar tissue in developmental stage ( ) scar tissue in developmental stage

(X) crust covering of the wound without blood supply (X) crust covering of the wound without blood supply
( ) burned tissue that has become infected ( ) burned tissue that has become infected
( ) visible living tissue with a rich blood supply ( ) visible living tissue with a rich blood supply

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 59. While caring for the client with a burn injury , the nurse should observe for signs and symptoms of which complication believed to be
due primarily to stress?

( ) infection ( ) infection
( ) gastric dilatation ( ) gastric dilatation
( ) nitrogen imbalance ( ) nitrogen imbalance
(X) gastrointestinal ulceration (X) gastrointestinal ulceration
60. An adult client was burned in an explosion. The burn initially affected the client's entire face (anterior half of the head) and the upper
half of the anterior torso, and there were circumferential burns to the lower half of both arms. The client's clothes caught on fire, and
the client ran, causing subsequent burn injuries to the posterior surface of the head and the upper half of the posterior torso. Using
the rule of nines, what would be the extent of the burn injury?

( ) 0.18 ( ) 0.18
( ) 0.24 ( ) 0.24
(X) 0.36 (X) 0.36
( ) 0.48 ( ) 0.48
61. The nurse is preparing to care for a burn client scheduled for an escharotomy procedure being performed for a third-degree
circumferential arm burn. The nurse understands that which finding is the anticipated therapeutic outcome of the escharotomy?

(X) Return of distal pulses (X) Return of distal pulses

( ) Brisk bleeding from the site ( ) Brisk bleeding from the site
( ) Decreasing edema formation ( ) Decreasing edema formation
( ) Formation of granulation tissue ( ) Formation of granulation tissue
62. A client is undergoing fluid replacement after being burned on 20% of her body 12 hours ago. The nursing assessment reveals a
blood pressure of 90/50 mm Hg, a pulse rate of 110 beats/minute, and a urine output of 20 mL over the past hour. The nurse
reports the findings to the health care provider (HCP) and anticipates which prescription?

( ) Transfusing 1 unit of packed red blood cells ( ) Transfusing 1 unit of packed red blood cells
( ) Administering a diuretic to increase urine output ( ) Administering a diuretic to increase urine output
(X) Increasing the amount of intravenous (IV) lactated Ringer's (X) Increasing the amount of intravenous (IV) lactated Ringer's
solution administered per hour solution administered per hour
( ) Changing the IV lactated Ringer's solution to one that ( ) Changing the IV lactated Ringer's solution to one that
contains dextrose in water contains dextrose in water
63. A client is brought to the emergency department with partial thickness burns to his face, neck, arms, and chest after trying to put out
a car fire. The nurse should implement which nursing actions for this client? Select all that apply.

[ ] Restrict fluids. [ ] Restrict fluids.

[X] Assess for airway patency. [X] Assess for airway patency.
[X] Administer oxygen as prescribed. [X] Administer oxygen as prescribed.
[ ] Place a cooling blanket on the client. [ ] Place a cooling blanket on the client.
[X] Elevate extremities if no fractures are present. [X] Elevate extremities if no fractures are present.
[ ] Prepare to give oral pain medication as prescribed. [ ] Prepare to give oral pain medication as prescribed.
64. The nurse is caring for a client who sustained superficial partial-thickness burns on the anterior lower legs and anterior thorax.
Which finding does the nurse expect to note during the resuscitation/emergent phase of the burn injury?

( ) Decreased heart rate ( ) Decreased heart rate

( ) Increased urinary output ( ) Increased urinary output
( ) Increased blood pressure ( ) Increased blood pressure
(X) Elevated hematocrit levels (X) Elevated hematocrit levels
65. The nurse is administering fluids intravenously as prescribed to a client who sustained superficial partial-thickness burn injuries of
the back and legs. In evaluating the adequacy of fluid resuscitation, the nurse understands that which assessment would provide
the most reliable indicator for determining the adequacy?

( ) Vital signs ( ) Vital signs

(X) Urine output (X) Urine output
( ) Mental status ( ) Mental status
( ) Peripheral pulses ( ) Peripheral pulses

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 66. The nurse manager is observing a new nursing graduate caring for a burn client in protective isolation. The nurse manager
intervenes if the new nursing graduate planned to implement which unsafe component of protective isolation technique?

( ) Using sterile sheets and linens ( ) Using sterile sheets and linens
( ) Performing strict hand washing technique ( ) Performing strict hand washing technique
(X) Wearing gloves and a gown only when giving direct care to (X) Wearing gloves and a gown only when giving direct care to
the client the client
( ) Wearing protective garb, including a mask, gloves, cap, shoe ( ) Wearing protective garb, including a mask, gloves, cap, shoe
covers, gowns, and plastic apron covers, gowns, and plastic apron
67. The nurse is caring for a client following an autograft and grafting to a burn wound on the right knee. What would the nurse
anticipate to be prescribed for the client?

( ) Out-of-bed activities ( ) Out-of-bed activities

( ) Bathroom privileges ( ) Bathroom privileges
(X) Immobilization of the affected leg (X) Immobilization of the affected leg
( ) Placing the affected leg in a dependent position ( ) Placing the affected leg in a dependent position
68. Mafenide acetate (Sulfamylon) is prescribed for a client with a burn injury. When applying the medication, the client complains of
local discomfort and burning. The nurse should take which most appropriate action?

( ) Discontinue the medication. ( ) Discontinue the medication.

( ) Notify the health care provider. ( ) Notify the health care provider.
(X) Inform the client that this is expected. (X) Inform the client that this is expected.
( ) Apply a thinner film than prescribed to the burn site. ( ) Apply a thinner film than prescribed to the burn site.
69. A burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury. The nurse monitors the client,
knowing that which finding indicates that a systemic effect has occurred?

(X) Hyperventilation (X) Hyperventilation

( ) Local rash at the burn site ( ) Local rash at the burn site
( ) Elevated blood pressure ( ) Elevated blood pressure
( ) Local pain at the burn site ( ) Local pain at the burn site
70. Isotretinoin (Amnesteem or Claravis) is prescribed for a client with severe acne. Before the administration of this medication, the
nurse anticipates that which laboratory test will be prescribed?

( ) Platelet count ( ) Platelet count

(X) Triglyceride level (X) Triglyceride level
( ) Complete blood count ( ) Complete blood count
( ) White blood cell count ( ) White blood cell count
71. A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin (Amnesteem or Claravis).
The nurse reviews the client's medication record and would contact the HCP if the client is taking which medication?

(X) Vitamin A (X) Vitamin A

( ) Digoxin (Lanoxin) ( ) Digoxin (Lanoxin)
( ) Furosemide (Lasix) ( ) Furosemide (Lasix)
( ) Phenytoin (Dilantin) ( ) Phenytoin (Dilantin)
72. The nurse is applying a topical corticosteroid to a client with eczema. The nurse should monitor for the potential for increased
systemic absorption of the medication if the medication were being applied to which body area?

( ) Back ( ) Back
(X) Axilla (X) Axilla
( ) Soles of the feet ( ) Soles of the feet
( ) Palms of the hands ( ) Palms of the hands
73. The clinic nurse is performing an admission assessment on a client and notes that the client is taking azelaic acid (Azelex).
Because of the medication prescription, the nurse would suspect that the client is being treated for which condition?

(X) Acne (X) Acne

( ) Eczema ( ) Eczema
( ) Hair loss ( ) Hair loss
( ) Herpes simplex ( ) Herpes simplex

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 74. Silver sulfadiazine (Silvadene, Thermazene, SSD cream) is prescribed for a client with a partial-thickness burn and the nurse
provides teaching about the medication. Which statement made by the client indicates a need for further teaching about the
treatments?

( ) "The medication is an antibacterial." ( ) "The medication is an antibacterial."

( ) "The medication will help heal the burn." ( ) "The medication will help heal the burn."
(X) "The medication will permanently stain my skin." (X) "The medication will permanently stain my skin."
( ) "The medication should be applied directly to the wound." ( ) "The medication should be applied directly to the wound."
75. The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that
chemical sunscreens are most effective when applied at which times?

( ) Immediately before swimming ( ) Immediately before swimming

( ) 5 minutes before exposure to the sun ( ) 5 minutes before exposure to the sun
( ) Immediately before exposure to the sun ( ) Immediately before exposure to the sun
(X) At least 30 minutes before exposure to the sun (X) At least 30 minutes before exposure to the sun
76. The nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which would the nurse expect to note
specifically in this disorder?

(X) Increased calcium level (X) Increased calcium level

( ) Increased white blood cells ( ) Increased white blood cells
( ) Decreased blood urea nitrogen level ( ) Decreased blood urea nitrogen level
( ) Decreased number of plasma cells in the bone marrow ( ) Decreased number of plasma cells in the bone marrow
77. The nurse is developing a plan of care for the client with multiple myeloma and includes which priority intervention in the plan?

(X) Encouraging fluids (X) Encouraging fluids

( ) Providing frequent oral care ( ) Providing frequent oral care
( ) Coughing and deep breathing ( ) Coughing and deep breathing
( ) Monitoring the red blood cell count ( ) Monitoring the red blood cell count
78. When caring for a client with an internal radiation implant, the nurse should observe which principles? Select all that apply.

[ ] Limiting the time with the client to 1 hour per shift.
[X] Keeping pregnant women out of the client's room.
[X] Placing the client in a private room with a private bath.
[X] Wearing a lead shield when providing direct client care.
[ ] Removing the dosimeter film badge when entering the client's
room.
[ ] Allowing individuals younger than 16 years old in the room as
long as they are 6 feet away from the client.
79. While giving care to a client with an internal cervical radiation implant, the nurse finds the implant in the bed. The nurse should take
which initial action?
[ ] Limiting the time with the client to 1 hour per shift.
[X] Keeping pregnant women out of the client's room.
[X] Placing the client in a private room with a private bath.
[X] Wearing a lead shield when providing direct client care.
[ ] Removing the dosimeter film badge when entering the client's
room.
[ ] Allowing individuals younger than 16 years old in the room as
long as they are 6 feet away from the client.

( ) Call the health care provider (HCP). ( ) Call the health care provider (HCP).
( ) Reinsert the implant into the vagina. ( ) Reinsert the implant into the vagina.
( ) Pick up the implant with gloved hands and flush it down the ( ) Pick up the implant with gloved hands and flush it down the
toilet. toilet.
(X) Pick up the implant with long-handled forceps and place it in (X) Pick up the implant with long-handled forceps and place it in
a lead container. a lead container.
80. The nurse should plan to implement which intervention in the care of a client experiencing neutropenia as a result of chemotherapy?

( ) Restrict all visitors. ( ) Restrict all visitors.

( ) Restrict fluid intake. ( ) Restrict fluid intake.
(X) Teach the client and family about the need for hand hygiene. (X) Teach the client and family about the need for hand hygiene.
( ) Insert an indwelling urinary catheter to prevent skin ( ) Insert an indwelling urinary catheter to prevent skin
breakdown. breakdown.

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 81. The home health care nurse is caring for a client with cancer who is complaining of acute pain. The most appropriate determination
of the client's pain should include which assessment?

(X) The client's pain rating (X) The client's pain rating
( ) Nonverbal cues from the client ( ) Nonverbal cues from the client
( ) The nurse's impression of the client's pain ( ) The nurse's impression of the client's pain
( ) Pain relief after appropriate nursing intervention ( ) Pain relief after appropriate nursing intervention
82. A client with carcinoma of the lung develops syndrome of inappropriate antidiuretic hormone (SIADH) as a complication of the
cancer. The nurse anticipates that the health care provider will request which prescriptions? Select all that apply.

[X] Radiation [X] Radiation

[X] Chemotherapy [X] Chemotherapy
[ ] Increased fluid intake [ ] Increased fluid intake
[ ] Decreased oral sodium intake [ ] Decreased oral sodium intake
[X] Serum sodium level determination [X] Serum sodium level determination
[X] Medication that is antagonistic to antidiuretic hormone [X] Medication that is antagonistic to antidiuretic hormone
83. The nurse is monitoring a client for signs and symptoms related to superior vena cava syndrome. Which is an early sign of this
oncological emergency?

( ) Cyanosis ( ) Cyanosis
( ) Arm edema ( ) Arm edema
(X) Periorbital edema (X) Periorbital edema
( ) Mental status changes ( ) Mental status changes
84. The nurse manager is teaching the nursing staff about signs and symptoms related to hypercalcemia in a client with metastatic
prostate cancer and tells the staff that which is a late sign of this oncological emergency?

( ) Headache ( ) Headache
( ) Dysphagia ( ) Dysphagia
( ) Constipation ( ) Constipation
(X) Electrocardiographic changes (X) Electrocardiographic changes
85. As part of chemotherapy education, the nurse teaches a female client about the risk for bleeding and self-care during the period of
greatest bone marrow suppression (the nadir). The nurse understands that further teaching is needed if the client makes which
statement?

( ) "I should avoid blowing my nose." ( ) "I should avoid blowing my nose."
( ) "I may need a platelet transfusion if my platelet count is too ( ) "I may need a platelet transfusion if my platelet count is too
low." low."
(X) "I'm going to take aspirin for my headache as soon as I get (X) "I'm going to take aspirin for my headache as soon as I get
home." home."
( ) "I will count the number of pads and tampons I use when ( ) "I will count the number of pads and tampons I use when
menstruating." menstruating."
86. A client with acute myelocytic leukemia is being treated with busulfan (Myleran, Busulfex). Which laboratory value would the nurse
specifically monitor during treatment with this medication?

( ) Clotting time ( ) Clotting time

(X) Uric acid level (X) Uric acid level
( ) Potassium level ( ) Potassium level
( ) Blood glucose level ( ) Blood glucose level
87. A client with small cell lung cancer is being treated with etoposide (Toposar). The nurse monitors the client during administration,
knowing that which adverse effect is specifically associated with this medication?

( ) Alopecia ( ) Alopecia
( ) Chest pain ( ) Chest pain
( ) Pulmonary fibrosis ( ) Pulmonary fibrosis
(X) Orthostatic hypotension (X) Orthostatic hypotension

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 88. A clinic nurse prepares a teaching plan for a client receiving an antineoplastic medication. When implementing the plan, the nurse
should make which statement to the client?

( ) "You can take aspirin (acetylsalicylic acid) as needed for
headache."
( ) "You can drink beverages containing alcohol in moderate
amounts each evening."
(X) "You need to consult with the health care provider (HCP)
before receiving immunizations."
( ) "It is fine to receive a flu vaccine at the local health fair
without HCP approval because the flu is so contagious."
89. Tamoxifen citrate is prescribed for a client with metastatic breast carcinoma. The nurse administering the medication understands
that which is the primary action of this medication?
( ) "You can take aspirin (acetylsalicylic acid) as needed for
headache."
( ) "You can drink beverages containing alcohol in moderate
amounts each evening."
(X) "You need to consult with the health care provider (HCP)
before receiving immunizations."
( ) "It is fine to receive a flu vaccine at the local health fair
without HCP approval because the flu is so contagious."

( ) It increases DNA and RNA synthesis. ( ) It increases DNA and RNA synthesis.
( ) It promotes the biosynthesis of nucleic acids. ( ) It promotes the biosynthesis of nucleic acids.
( ) It increases estrogen concentration and estrogen response. ( ) It increases estrogen concentration and estrogen response.
(X) It competitively binds to estrogen receptors on tumors and (X) It competitively binds to estrogen receptors on tumors and
other tissue targets. other tissue targets.
90. A client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client
is taking this medication?

( ) Glucose level ( ) Glucose level

(X) Calcium level (X) Calcium level
( ) Potassium level ( ) Potassium level
( ) Prothrombin time ( ) Prothrombin time
91. The clinic nurse assesses the skin of a client with a diagnosis of psoriasis. The nurse understands that which characteristic is
associated with this skin disorder?

( ) Oily skin ( ) Oily skin

( ) Clear, thin nail beds ( ) Clear, thin nail beds
( ) Red-purplish scaly lesions ( ) Red-purplish scaly lesions
(X) Silvery-white scaly patches (X) Silvery-white scaly patches
92. The clinic nurse notes that the health care provider has documented a diagnosis of herpes zoster (shingles) in the client's chart.
Based on an understanding of the cause of this disorder, the nurse determines that this definitive diagnosis was made by which
diagnostic test?

( ) Patch test ( ) Patch test

( ) Skin biopsy ( ) Skin biopsy
(X) Culture of the lesion (X) Culture of the lesion
( ) Wood's light examination ( ) Wood's light examination
93. The community health nurse is conducting a research study and is identifying clients in the community at risk for latex allergy.
Which client population is at most risk for developing this type of allergy?

(X) Hairdressers (X) Hairdressers

( ) The homeless ( ) The homeless
( ) Children in day care centers ( ) Children in day care centers
( ) Individuals living in a group home ( ) Individuals living in a group home
94. Which interventions apply in the care of a client at high risk for an allergic response to a latex allergy? Select all that apply.

[X] Use nonlatex gloves. [X] Use nonlatex gloves.

[X] Use medications from glass ampules.
[ ] Place the client in a private room only.
[X] Keep a latex-safe supply cart available in the client's area.
[X] Avoid the use of medication vials that have rubber stoppers.
[X] Use a blood pressure cuff from an electronic device only to
measure the blood pressure.
[X] Use medications from glass ampules.
[ ] Place the client in a private room only.
[X] Keep a latex-safe supply cart available in the client's area.
[X] Avoid the use of medication vials that have rubber stoppers.
[X] Use a blood pressure cuff from an electronic device only to
measure the blood pressure.

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 95. The camp nurse prepares to instruct a group of children about Lyme disease. Which information should the nurse include in the
instructions

(X) Lyme disease is caused by a tick carried by deer. (X) Lyme disease is caused by a tick carried by deer.
( ) Lyme disease is caused by contamination from cat feces. ( ) Lyme disease is caused by contamination from cat feces.
( ) Lyme disease can be caused by the inhalation of spores ( ) Lyme disease can be caused by the inhalation of spores
from bird droppings. from bird droppings.
( ) Lyme disease can be contagious through skin contact with ( ) Lyme disease can be contagious through skin contact with
an infected individual. an infected individual.
96. A client is diagnosed with scleroderma. Which intervention should the nurse anticipate to be prescribed?

( ) Maintain bed rest as much as possible. ( ) Maintain bed rest as much as possible.
(X) Administer corticosteroids as prescribed for inflammation. (X) Administer corticosteroids as prescribed for inflammation.
( ) Advise the client to remain supine for 1 to 2 hours after ( ) Advise the client to remain supine for 1 to 2 hours after
meals. meals.
( ) Keep the room temperature warm during the day and cool at ( ) Keep the room temperature warm during the day and cool at
night. night.
97. A female client arrives at the health care clinic and tells the nurse that she was just bitten by a tick and would like to be tested for
Lyme disease. The client tells the nurse that she removed the tick and flushed it down the toilet. Which nursing actions are most
appropriate? Select all that apply.

[ ] Tell the client that testing is not necessary unless arthralgia [ ] Tell the client that testing is not necessary unless arthralgia
develops. develops.
[X] Tell the client to avoid any woody, grassy areas that may [X] Tell the client to avoid any woody, grassy areas that may
contain ticks. contain ticks.
[X] Instruct the client to immediately start to take the antibodies [X] Instruct the client to immediately start to take the antibodies
that are prescribed. that are prescribed.
[X] Inform the client to plan to have a blood test 4 to 6 weeks [X] Inform the client to plan to have a blood test 4 to 6 weeks
after a bite to detect the presence of the disease. after a bite to detect the presence of the disease.
[ ] Tell the client if this happens again to never remove the tick [ ] Tell the client if this happens again to never remove the tick
but vigorously scrub the area with an antiseptic. but vigorously scrub the area with an antiseptic.
98. The nurse is preparing a group of Cub Scouts for an overnight camping trip and instructs the scouts about the methods to prevent
Lyme disease. Which statement by one of the Cub Scouts indicates a need for further instructions?

( ) "I need to bring a hat to wear during the trip." ( ) "I need to bring a hat to wear during the trip."
( ) "I should wear long-sleeved tops and long pants." ( ) "I should wear long-sleeved tops and long pants."
(X) "I should not use insect repellents because it will attract the (X) "I should not use insect repellents because it will attract the
ticks." ticks."
( ) "I need to wear closed shoes and socks that can be pulled up ( ) "I need to wear closed shoes and socks that can be pulled up
over my pants." over my pants."
99. The client with acquired immunodeficiency syndrome is diagnosed with cutaneous Kaposi's sarcoma. Based on this diagnosis, the
nurse understands that this has been confirmed by which finding?

( ) Swelling in the genital area ( ) Swelling in the genital area

( ) Swelling in the lower extremities ( ) Swelling in the lower extremities
(X) Positive punch biopsy of the cutaneous lesions (X) Positive punch biopsy of the cutaneous lesions
( ) Appearance of reddish-blue lesions noted on the skin ( ) Appearance of reddish-blue lesions noted on the skin
100. The home care nurse is performing an assessment on a client who has been diagnosed with an allergy to latex. In determining the
client's risk factors, the nurse should question the client about an allergy to which food item?

( ) Eggs ( ) Eggs
( ) Milk ( ) Milk
( ) Yogurt ( ) Yogurt
(X) Bananas (X) Bananas

Time Used: 00:41:53 Final Score: 92%

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