Endocrine and Cancer Conditions

1. The nurse is planning discharge teaching for a client with hypothyroidism. Which of the following diet characteristics should be included in the teaching plan for this client? a) b) c) d) High protein and high calorie High carbs and low fiber High fiber and low calorie Restricted fluids and low protein 2. The nurse is reinforcing teaching with a 72 year old client regarding early stage prostate cancer ask the nurse. What statement by the client would require a follow-up by the nurse? a) b) c) d) “Because the cancer grows slowly my physician will take a conservative approach” “My age is a factor that contributes to my treatment plan” “My physician will recommend surgery to prevent the cancer from spreading” “I will have to have my prostate-specific antigen (PSA) monitored regularly” 3. The nurse is presenting a community program to teach a group of well senior citizens about colon health. Which information would be most appropriate to include? a) b) c) d) A bi-annual colonoscopy is suggested Ensure that a B-complex vitamin is taken daily to decrease risk. A good diet and exercise can prevent colon cancer. Diet should include foods that are high fiber and low fat. 4. The nurse is caring for a client with lung cancer. Which finding indicates the development of the syndrome of inappropriate antidiuretic hormone (SIADH)? a) b) c) d) Diminished LOC Twitching of hands and tingling of the lips Rapid increase in urine output to 400 ml/hr Low urine osmolality 5. The nurse is planning care for a client recovering from a transphenoidal hypophysectomy. What nursing interventions would be included in the plan of care for this client? SATA a) b) c) d) e) Assess neurological status every hour for first 24 hrs Teach client to cough and deep breathe Teach client to use soft bristle toothbrush Teach client to notify nurse of post-nasal drop Maintain hourly intake and output record. 6. The nurse has completed teaching for a client that had a malignant melanoma removed. What statement by the client best indicates teaching has been effective? a) b) c) d) “I will avoid sun exposure between 11 am and 3pm” “I will make an appointment every 3 years for a skin cancer check” “I will wear SPF 15 sunscreen when going out in boat” “Melanoma rarely metastasizes” 7. The nurse of a client receiving propylthiouracil (PTU) for hyperthyroidism. What indicates the medication is effective? a) Bounding pulses and decreasing edema. b) Increased respirations and an increase in thyroxine (T4) c) Decreased basal metabolic rate and thyroid bruit d) Increase in body weight and decrees in pulse rate 8. The nurse is caring for a client with colorectal cancer who will undergo external-beam pelvic radiation. What action is most appropriate to include in the teaching plan? a) b) c) d) Encourage sitz bath and meticulous cleaning Test all stools for the presence of blood Maintain high-carb diet Inspect the mouth and throat for thrush 9. The nurse is caring for a client prescribed hydrocortisone 25 mg by mouth for adrenal insufficiency. Which of the following best indicates the medication is effective? a) b) c) d) Decreased appetite and weight loss Decreased hyperexcitability and restlessness Decreased weakness and fatigue Decreased blood pressure and serum sodium level 10. The nurse is educating a client with stomatitis. What information would be most appropriate to teach the client? a) b) c) d) Rinse mouth with warm water after smoking or eating acidic foods. Rinse their mouth with hot water and viscous lidocaine after meals and as needed. Rinse their mouth with baking soda and warm water after meals. Rinse their mouth with hydrogen peroxide and use a baking soda paste on sores. 11. A 32-year-old client is being seen in the office following 3 weeks after a radical mastectomy. What statement by the client best indicates the client is experiencing appropriate coping? a) b) c) d) “I am doing fantastic since the surgery and I’m back to jogging” “I have been helping my family deal with their feelings about the surgery” “I have been having difficulty coping with the surgery and cry sometimes” “I have been unable to leave the house or talk to my friends about the surgery” 12. A client with hyperaldosteronism is scheduled for an adrenlectomy. Prior to surgery, what nursing intervention would be priority? a) b) c) d) Monitor the blood pressure Elevate the patient’s extremities to relieve edema Encourage fluids Provide a potassium-restricted diet 13. The nurse is caring for a client receiving a continuous ACTH infusion over 24-hours. Which changes are expected if the endocrine negative feedback loops are normal? a) Higher-than-normal cortisol levels; lower-than-normal serum Corticotrophin Releasing Hormone (CRH) levels. b) Lower-than-normal serum cortisol levels; lower-than-normal serum Corticotrophin Releasing Hormone (CRH) levels. c) Higher-than-normal serum cortisol levels; high-than-normal serum Corticotrophin Releasing Hormone (CRH) levels. d) Lower-than-normal serum cortisol levels; higher-than-normal serum Corticotrophin Releasing Hormone (CRH) levels. 14. The nurse is caring for a client who has adrenal insufficiency (Addison’s disease). What statement by the client indicates understanding of the discharge instructions? a) b) c) d) “I wont have to use replacement therapy for the rest of my life” “I should never change my medication dose without notifying my HCP” “I should wear an alert bracelet at all time and carry medical identification” “My condition is not one that is easily worsened by external stress” 15. The nurse caring for a 24-year old client with testicular cancer scheduled to begin treatment. He says: “I don’t know why I should bother with this treatment. This cancer is going to kill me anyways. What do you think? What is the best response? a) b) c) d) “Treatment for testicular cancer works well and the odds of complete remission are good” “Why do you say that?” “You think your cancer is going kill you despite treatment?” “I don’t know, what did your doctor say?” 16. The nurse is caring for a client with diabetes insipidus. What is the priority nursing intervention for this disease process? a) b) c) d) Administer 3% normal saline Adequate fluid replacement Obtaining daily weights Ambulating client TID 17. The nurse is caring for a client diagnosed with Hodgkin’s lymphoma. What will the nurse include in the plan of care? a) b) c) d) Obtaining consent for a bone marrow biopsy to determine response to therapy Teach the client about B symptoms and the need for 2-4 cycles of chemotherapy Monitor for presence of M protein in urine Increase fluids to manage hypercalcemia 18. The nurse is caring for a client undergoing external radiation. What statement best indicates teaching has been effective regarding dry desquamation? a) b) c) d) “I can apply aloe gel to the area to help with discomfort as needed” “I can use ice packs on the area to relieve swelling” “I can scrub the area with warm soap and water to relieve itching” “I can apply a heating pad to the area to relieve discomfort” 19. A client undergoing chemotherapy reports, “I am so tired I can hardly get out of bed in the morning.” What is the most appropriate intervention of the nurse to suggest to the client? a) b) c) d) Strict bed rest until the treatment is completed. Group activates together and plan for rest periods in between. Follow a daily jogging program to improve stamina Take your furosemide (Lasix) in the morning to sleep better at night 20. The nurse is teaching a client that had an outpatient transrectal ultrasound with prostate biopsy. What information should be included in the teaching plan? a) Avoid sexual intercourse for six weeks b) Report fever, chills, and difficulty voiding c) Remove perineal dressing in 24 hours d) Expect gross hematuria for three to four days 21. A client receiving chemotherapy is also receiving allopurinol and busulfan. The nurse teaches the allopurinol is to prevent emergent complication of chemotherapy, including what sign and symptoms? a) b) c) d) Hypercalcemia and hyperkalemia Low platelets and low white blood cells (WBC) Hypokalemia and low platelets Hypocalcemia and hyperphosphatemia 22. The nurse is developing a plan of care for a client with multiple myeloma. What is the priority intervention to include in the plan of care? a) b) c) d) Providing oral care Monitoring red blood cell counts Encouraging fluids Coughing and deep breathing 23. A client has been admitted with diarrhea, fatigue and nausea die to chemotherapy. What assessment findings would the nurse expect? a) b) c) d) Urinary output 360 ml in 8 hours and respiration 22 per minute Urinary output 210 ml in 8 hours and heart rate 58 bpm Urinary output 210 ml in 8 hours and pulse 125 bpm Urinary output 360 ml in 8 hours and respirations 8 per minute 24. The nurse is preparing to teach a community class about colon cancer. Which risk factors are most appropriate to include in the teaching plan? a) b) c) d) Age over 65 and high-fiber diet History of pancreatitis and polyps Sedentary lifestyles and vegetarian diet High fat diet and alcohol consumption 25. The community health nurse is preparing to teach a group of adults about smoking and lung cancer. What statement should be included in the teaching? a) b) c) d) The risk of smoking is measured by how many cigarettes are smoked per day. If you smoke, you should start getting regular screening done at age 50 Men are more likely to get lung cancer, but women are more likely to die A lingering cough is often the first sign of lung cancer 26. The nurse is caring for client who has multiple myeloma. What is the most important aspect of care? a) b) c) d) The client may develop a decreased in sensation in the extremities The final stage of the disease is extended giving the patient time to adapt Pain control will require large doses of opioid narcotic medications Assessment will include review of electrolytes and renal function 27. The nurse is caring for a client with enlarged cervical lymph nodes. What additional symptoms would indicate a possible diagnosis of Hodgkin’s lymphoma? SATA a) Weight loss b) Bradycardia