NUR 201 Exam 7 - Which statement by the client indicates underst...

NUR 201 Exam 7

• The nurse is teaching a client who has pernicious anemia about necessary dietary changes.

Which statement by the client indicates understanding about those changes?

• "I'll increase animal proteins like fish and meat."
• "I'll work on increasing my fats and carbohydrates."
• "I'll avoid eating green leafy vegetables.
• "I'll limit my intake of citrus fruits."

Answer A Clients who have pernicious anemia have a Vitamin B12 deficiency and need to consume foods high in Vitamin B12, such as animal and plant proteins, citrus fruits, green leafy vegetables, and dairy products. While carbohydrates and fats can provide sources of energy, they do not supply the necessary nutrient to improve anemia

• A nurse is caring for a client who is about to receive a bone marrow transplant. To

best help the client cope with the long recovery period, what action by the nurse is best?

• Arrange a visitation schedule among friends and family.
• Explain that this process is difficult but must be endured.
• Help the client find things to hope for each day of recovery.
• Provide plenty of diversionary activities for this time

Answer C Providing hope is an essential nursing function during treatment for any disease process, but especially during the recovery period after bone marrow transplantation, which can take up to 3 weeks. The nurse can help the client look ahead to the recovery period and identify things to hope for during this time. Visitors are important to clients, but may pose an infection risk.Telling the client that the recovery period must be endured does not acknowledge his or her feelings. Diversionary activities are important, but not as important as instilling hope

• A client has received a bone marrow transplant and is waiting for engraft- ment. What

action(s) by the nurse are most appropriate?(Select all that apply.) 1 / 4

• Not allowing any visitors until engraftment
• Limiting the protein in the client's diet
• Placing the client in protective precautions
• Teaching visitors appropriate hand hygiene
• Telling visitors not to bring live flowers or plants

Answer C, D, E The client waiting for engraftment after bone marrow transplant has no white cells to protect him or her against infection. The client is on protective precautions and visitors are taught hand hygiene. No fresh flowers or plants are allowed due to the standing water in the vase or container that may harbor organisms; clients are also told not to work with houseplants in the home. Limiting protein is not a healthy option and will not promote engraftment.

• . The nurse learning about cellular regulation understands that which process occurs

during the S phase of the cell cycle?

• Actual division (mitosis)
• Doubling of DNA
• Growing extra membrane
• No reproductive activity

Answer B During the S phase, the cell must double its DNA content through DNA synthesis. Actual division, or mitosis, occurs during the M phase. Growing extra membrane occurs in the G1 phase. During the G0 phase, the cell is working but is not involved in any reproductive activity

• A nurse is learning the difference between normal cells and benign tumor cells. What

information does this include?

• Benign tumors grow through invasion of other tissue.
• Benign tumors have lost their cellular regulation from contact inhibition.
• Growing in the wrong place or time is typical of benign tumors.
• The loss of characteristics of the parent cells is called anaplasia. 2 / 4

Answer C Benign tumors are basically normal cells growing in the wrong place or at the wrong time.Benign cells grow through hyperplasia, not invasion. Benign tumor cells retain contact inhibition. Anaplasia is a characteristic of cancer cells.

• A nurse learns that which of the following is the single biggest risk factor for developing

cancer?

• Exposure to tobacco
• Advancing age
• Occupational chemicals
• Oncovirus infection

Answer B The single biggest risk factor for developing cancer is advancing age. As one ages, immunity decreases and exposures increase. Tobacco use is the single most preventable cause of cancer.Exposure to chemicals and oncoviruses cause fewer cancers

• Which statement about carcinogenesis is accurate?
• An initiated cell will always become clinical cancer.
• Cancer becomes a health problem once it is 1 cm in size.
• Normal hormones and proteins do not promote cancer growth.
• Tumor cells need to develop their own blood supply

Answer D Tumors need to develop their own blood supply through a process called angiogenesis. An initiated cell needs a promoter to continue its malignant path. Normal hormones and proteins in the body can act as promoters. A 1-cm tumor is a detectable size, but other events have to occur for it to become a health problem

• The nurse caring for oncology clients knows that which form of metastasis is the most

common?

• Bloodborne 3 / 4

• Direct invasion
• Lymphatic spread
• Via bone marrow

Answer A Bloodborne metastasis is the most common way for cancer to metastasize. Direct invasion and lymphatic spread are other methods. Bone marrow is not a medium in which cancer spreads, although cancer can occur in the bone marrow.

• A nurse has taught a client about dietary changes that can reduce the chances of

developing cancer. What statement by the client indicates the nurse needs to provide additional teaching?

• "Foods high in vitamin A and vitamin C are important."
• "I'll have to cut down on the amount of bacon I eat."
• "I'm so glad I don't have to give up my juicy steaks."
• "Vegetables, fruit, and high-fiber grains are important."

Answer C To decrease the risk of developing cancer, one should cut down on the consumption of red meats and animal fat. The other statements are correct.

• A client is in the oncology clinic for a first visit since being diagnosed with cancer. The

nurse reads in the client's chart that the cancer classification is TISN0M0. What does the nurse conclude about this client's cancer?

• The primary site of the cancer cannot be determined.
• Regional lymph nodes could not be assessed.
• There are multiple lymph nodes involved already.
• There are no distant metastases noted in the report

Answer

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