Adult Health 3

1.

1 point

The nurse is teaching a patient about primary prevention of cancer related to diet. What are some teaching points which the nurse will emphasize?

Choose foods which have higher amounts of bran.

Eat foods low in Vitamin A but high in Vitamin C.

Avoid alcohol completely.

Avoid excessive intake of animal fat.

2.

1 point

From the following options, select the answer which labels the following cancers correctly: a benign tumor in the epithelial glands, a benign tumor in the adipose tissue, and a malignant tumor in the kidneys. (look for patterns)

Adenoma, Lipoma, and Renal cell carcinoma.

Adenoma, Liposarcoma, and Renal cell carcinoma.

Adenocarcinoma, Liposarcoma, and Renal cell carcinoma.

Adenocarcinoma, Lipoma, and Renal cell carcinoma.

3.

1 point

Insulin does its job in which of the following ways? Select all that apply.

Fuel facilitator - to feed glucose from the blood into the cells.

Breakdown inhibitor - so the liver won't break down glycogen into glucose.

Storage facilitator - for triglyceride storage in fat cells.

Synthesis inhibitor - to prevent protein synthesis in muscle.

4.

1 point

When preparing a diabetic patient on NPO for a surgery, the nurse should question which situation?

A well-regulated diabetic patient with a BG of 85.

A patient who is still taking their basal insulin even though they are NPO.

A patient with a high BG level of 189.

A surgery scheduled for 0800 hours.

5.

1 point

What is alopecia?

An acute immune response to chemotherapy.

Hair loss.

An animal closely related to the alpaca.

A brand of wig most often used after hair loss due to cancer treatment.

6.

1 point

Why is insulin only given via subcutaneous routes rather than IM injection?

Insulin needs to be predictable. All onset/peak/duration times are given for subQ injections.

Insulin needles are sharper than regular needles making them more likely to tear muscle tissue if injected via and IM injection site.

Insulin requires the lipids contained in the subcutaneous tissue to become activated.

Skeletal muscles are very vascular and would cause the insulin to go right into the blood stream, resulting in an overdose.

7.

1 point

Knowing that the word "nadir" means the lowest point in a given situation, the nurse would expect which of the following to be the medical definition of Nadir?

Period of depression during radiation therapy.

Period of time in which chemotherapy drugs cause the WBC count to be at its lowest.

A time, equal in all chemo drugs, in which the immune response is at it's lowest point.

Time in which patient experiences a cessation of effectiveness from chemo drugs.

8.

1 point

What are some examples of primary prevention techniques related to cancer?

Avoidance of known or potential carcinogens.

Screening, such as mammograms.

Removal of at risk tissues.

Chemoprevention and vaccination.

9.

1 point

You are asked to take a set of vital signs on a post operative patient who has just undergone a right total mastectomy with axillary dissection. What is most important to remember?

Taking her radial pulse in the right hand to make sure she has proper blood flow.

You should not take her blood pressure using her right arm.

The patient is at a high risk for lymphedema, so placing an IV in the R lower arm is a high priority.

Monitoring her respirations due to post-operative stress.

10.

1 point

When a diabetic patient takes insulin for prandial hyperglycemia, their best option/s would be to take _______ insulin.

Intermediate acting

Long acting

Rapid acting

Short acting

11.

1 point

Which class of drugs works by delaying absorption of carbs from the small intestine?

Alpha-Glucosidase Inhibitors, which can cause GI symptoms such as diarrhea.

Insulin Sensitizers, which has a risk for lactic acid build up!

Amylin Analogs, which also delays gastric emptying, thus triggering satiety.

Incretin Mimetics, which also decrease glucagon secretion.

12.

1 point

Which of the following methods of glucose monitoring is the most accurate?

OneTouch® Glucose Monitoring.

Accucheck® Glucose Monitoring.

Serum glucose check (lab draw).

Non serum glucose check.

13.

1 point

Fill in the blank regarding the process of DKA.
1. There is a depletion of insulin in the body.
2. Fatty acids pour into the mitochondria to provide fuel for cells.
3. _________________________________
4. Carbons combine into ketone bodies in the cell.
5. Ketone bodies circulate in the body, causing metabolic acidosis.

The Krebs cycle turns fatty acids into carbine units.

Circulating ketone bodies cause a fruity smell in the patient's breath.

Betaoxydation occurs, in which fatty acids get chopped up into carbon units.

The matrix of the mitochondria accepts fatty acids to begin the Krebs cycle.

14.

1 point

Which of the following statements is most correct for a patient with diabetes in regards to diet?

For every 5gm of carb they eat, they must take 1 unit of rapid acting insulin.

For every 15gm of carb they eat, they must take 1 unit of rapid acting insulin.

Carbohydrates are NOT to be a part of the diabetics diet.

For every 10gm of carb they eat, they must take 1 unit of rapid acting insulin.

15.

1 point

A cancer patient with known bone metastasis presents with the following signs and symptoms: Fatigue, loss of appetite, nausea and vomiting, constipation, polyuria, severe muscle weakness, loss of deep tendon reflexes, paralytic ileus, dehydration, and EKG changes. You expect the diagnoses to be which of the following?

Hypocalcemia

Hypercalcemia

Hypokalemia

Hyperkalemia

16.

1 point

A nurse is performing a casual blood glucose check on a patient. Patient indicates a need for further teaching if he states which of the following?

"This test will not necessarily be affected by the corticosteroid I'm currently taking."

"This test can be done at any point during the day."

"I do not need to eat a balanced diet prior to this test being performed."

"As long as my glucose is under 300 mg/dl, I won't have to do a fasting blood glucose check."

17.

1 point

How are cancers graded?

On a grading scale from 1-4.

On a grading scale from grade 1-4; when undetermined, it's a grade "x".

On a grading scale from 1-5.

On a grading scale from 1-10, with grade 10 being most malignant. A grade "x" is assigned for cancers which are difficult to determine spread.

18.

1 point

The nurse is assessing a patient with Kussmaul respirations, a "fruity" breath, nausea, and abdominal pain. The nurse immediately recognizes which problem?

Diabetic Ketosis

Metabolic alkalosis

Respiratory alkalosis

Respiratory acidosis

19.

1 point

A patient has an increased risk for nephropathy if they have which of the following factors? (select all that apply)

3-5 year history of diabetes

No history of retinopathy

Uncontrolled hypertension

Genetic Predisposition

20.

1 point

For a diabetic patient experiencing Somogyi phenomenon, what would be an important teaching point?

Patient must increase insulin in the evening to prevent glucose build up over night, causing hyperglycemia.

Somogyi phenomenon is a result of the body's releasing growth hormone over night which causes a spike in glucose.

Another name for the Somogyi phenomenon is the Dawn Phenomenon.

Patient must reduce insulin in the evening to prevent rebound hyperglycemia.

21.

1 point

What is the definition of neoplasia?

Normal reproduction of cells in the blood plasma.

Immature plasma cells.

Cell reproduction which is slower than normal.

Cells which grow that are not needed for replacement or for growth and development.

22.

1 point

While discussing implications of radiation in regards to ADLs, what is an important teaching point the nurse must provide for their patient who is undergoing radiation therapy?

It's ok to remove markings that have been placed on the patient's skin.

Do not use regular skin cream unless it is approved by an MD.

Being out in the sun is alright as long as the patient limits it to under an hour.

Xerostomia will not be a problem.

23.

1 point

A nurse is ordered to give Orlistat (Xenical) PO 120 mg tid at mealtimes to a patient with a BMI of 39. Which statement by the patient indicates NO need for further teaching?

"Orlistat causes me to lose weight by inhibiting lipase."

"My GI s/e are caused by 20% of my food intake being fat intake."

"This drug will not affect my hypertension."

"A common side effect I must be aware of is insomnia."

24.

1 point

The nurse is teaching a patient who has just undergone a mastectomy what to expect upon discharge. What statement by the patient indicates a need for further teaching?

"I can do simple exercises to promote venous return after I get my drains removed."

"If numbness in the area of surgery persists, I should contact my doctor immediately."

"I may need follow up care."

"Even though I've had this surgery, I should still have cancer screenings performed on my other breast."

25.

1 point

What are some things you as a nurse should be aware of regarding glipizide (Glucotrol)?

If taken with an NSAID, it will potentiate hypoglycemia.

It is a sulfonylurea agent, which is an insulin secratagogue.

If taken with alcohol, it will worsen hyperglycemia.

It stimulates insulin release from beta cells in the pancreas.

26.

1 point

The nurse wants to administer a shot of insulin that will have a duration of 24 hours and a peak of 1-4 hours after administration. Which type of insulin should the nurse administer?

Glulisine (Apidra)

Glargine (Lantus)

NPH (Humulin N)

Aspart (NovoLog)

27.

1 point

The nurse is discussing an exercise plan for a patient with Type 1 diabetes. Which statement by the patient indicates a need for further teaching?

"My glucose will be low after exercising, but I can take a snack and lower my insulin intake to compensate for it."

"I have to wait only 30 minutes after my insulin injection to start exercising."

"If my glucose is above 250 mg/dl and my urine has ketone bodies, I must stop exercising."

"I must always wear my 'medic alert' bracelet while exercising."

28.

1 point

The three P's often associated with diabetes are?

Polydypsia

Polyphagia

Polyuria

Polyglotism

29.

1 point

What should be some priority nursing interventions from a chemo patient suffering from thrombocytopenia?

Avoid IM injections and venipunctures.

Observe IV sites every 12 hours for bleeding.

Apply a warm compress to areas of trauma.

Instruct the patient not to blow or insert objects into their nose.

30.

1 point

What are some examples of noninvasive breast cancers?

Ductal Carcinoma in Situ (DCIS)

Non-infiltrating Ductal Carcinoma

Infiltrating Ductal Carcinoma

Lobular Carcinoma in Situ (LCIS)

31.

1 point

A diabetic comes into the ER with HHS, a BG of 800 and severe dehydration. What are some of the signs and symptoms you would expect to see?

Hemoconcentration

Hypervalemia

Hypoviscosity

Hypoxia

32.

1 point

Normal cells, after having matured beyond embryonic development, have which of the following characteristics?

Contact Inhibition

Apoptosis

Non-migratory

Associative funtion

33.

1 point

True or False? DKA causes metabolic acidosis while HHS doesn't affect ABGs at all.

Partly true; with HHS, the ABGs may or may not be normal.

True

False

Partly false; with DKA, the ABGs may or may not be normal.

34.

1 point

A nurse is preparing to give rosiglitazone (Avandia), which is a Thiazolidinedione, to a 20 y/o female patient. What is the most important thing to teach the patient?

Thiazolidinediones increase fertility in women so the patient should take a contraceptive if she is not wanting to become pregnant.

Patient should not monitor weight while taking a Thiazolidinedione.

Patient should not have to monitor their liver function while on this med.

Patient should have regular tests done to monitor her kidney function.

35.

1 point

What are some common EARLY signs of DKA and HHS?

Increased thirst and urination.

Weakness and fatigue.

Hypoxia.

Ketosis.

36.

1 point

A 5' 4", 43 year old female patient presents with a waist circumference of 40 inches. The nurse realizes:

This is an indicator of central obesity and may be harmful if not corrected.

Patient is in the morbid obesity category.

Patient's BMI is in the overweight category.

Patient has a healthy BMI.