Med-surge

7. The goals of cancer treatment are based on

Cellular Aberrations the principle that
a. surgery is the single most effective
The number of the question corresponds to the treatment for cancer.
same-numbered outcome at the beginning of b. initial treatment is always directed
the chapter. toward cure of the cancer.
1. Trends in the incidence and death rates of c. a combination of treatment
cancer include the fact that modalities is effective for controlling
a. lung cancer is the most common many cancers.
type of cancer in men. d. although cancer cure is rare, quality
b. a higher percentage of women than of life can be increased with treatment
men have lung cancer. modalities.
c. breast cancer is the leading cause of
cancer deaths in women. 8. The most effective method of administering
d. African Americans have a higher a chemotherapy agent that is a vesicant is to
death rate from cancer than whites. a. give it orally.
b. give it intraarterially.
2. What features of cancer cells distinguish c. use an Ommaya reservoir.
them from normal cells (select all that apply)? d. use a central venous access device.
a. Cells lack contact inhibition.
b. Cells return to a previous 9. The nurse explains to a patient undergoing
undifferentiated state. brachytherapy of the cervix that she
c. Oncogenes maintain normal cell a. must undergo simulation to locate
expression. the treatment area.
d. Proliferation occurs when there is a b. requires the use of radioactive
need for more cells. precautions during nursing care.
e. New proteins characteristic of c. may experience desquamation of
embryonic stage emerge on cell the skin on the abdomen and upper
membrane. legs.
d. requires shielding of the ovaries
3. A characteristic of the stage of progression during treatment to prevent ovarian
in the development of cancer is damage.
a. oncogenic viral transformation of
target cells. 10. A patient on chemotherapy and radiation
b. a reversible steady growth for head and neck cancer has a WBC count of
facilitated by carcinogens. 1.9 × 103/μL, hemoglobin of 10.8 g/ dL, and a
c. a period of latency before clinical platelet count of 99 × 103/μL. Based on the
detection of cancer. CBC results, what is the most serious clinical
d. proliferation of cancer cells in spite finding?
of host control mechanisms. a. Cough, rhinitis, and sore throat
b. Fatigue, nausea, and skin redness at
4. The primary protective role of the immune site of radiation
system related to malignant cells is c. Temperature of 101.9° F, fatigue,
a. surveillance for cells with tumor- and shortness of breath
associated antigens. d. Skin redness at site of radiation,
b. binding with free antigen released headache, and constipation
by malignant cells.
c. production of blocking factors that 11. To prevent fever and shivering during an
immobilize cancer cells. infusion of rituximab (Rituxan), the nurse
d. responding to a new set of antigenic should premedicate the patient with
determinants on cancer cells. a. aspirin.
b. acetaminophen.
5. The primary difference between benign and c. sodium bicarbonate.
malignant neoplasms is the d. meperidine (Demerol).
a. rate of cell proliferation.
b. site of malignant tumor. 12. The nurse counsels the patient receiving
c. requirements for cell nutrients. radiation therapy or chemotherapy that
d. characteristic of tissue invasiveness. a. effective birth control methods
should be used for the rest ofthe
6. The nurse is caring for a 59-year-old woman patient’s life.
who had surgery 1 day ago for removal of a b. if nausea and vomiting occur during
suspected malignant abdominal mass. The treatment, the treatment plan will be
patient is awaiting the pathology report. She is modified.
tearful and says that she is scared to die. The c. after successful treatment, a return
most effective nursing intervention at this point to the person’s previous functional
is to use this opportunity to level can be expected.
a. motivate change in an unhealthy d. the cycle of fatigue-depression-
lifestyle. fatigue that may occur during
b. teach her about the seven warning treatment can be reduced by
signs of cancer. restricting activity.
c. instruct her about healthy stress
relief and coping practices. 13. A patient on chemotherapy for 10 weeks
d. allow her to communicate about the started at a weight of 121 lb. She now weighs
meaning of this experience.
118 lb and has no sense of taste. Which c. implement measures to decrease
nursing intervention would be a priority? the risk of the patient acquiring an
a. Advise the patient to eat foods that infection.
are fatty, fried, or high in calories. d. assess the patient’s ability to pay for
b. Discuss with the physician the need health care services at the time of
for parenteral or enteral feedings. admission.
c. Advise the patient to drink a
nutritional supplement beverage at 4. The nurse is assigned to care for a newly
least three times a day. admitted patient. Number in order the steps for
d. Advise the patient to experiment using the nursing process to prioritize care.
with spices and seasonings to enhance (Number 1 is the first step, and number 5 is the
the flavor of food. last step.)
_5__ Evaluate whether the plan was effective.
14. A 70-year-old male patient has multiple _2__ Identify any health problems.
myeloma. His wife calls to report that he sleeps _1__ Collect patient information.
most of the day, is confused when awake, and _4_ Carry out the plan.
complains of nausea and constipation. Which _3_ Determine a plan of action.
complication of cancer is this most likely
caused by? 5. The linkages among NANDA-I nursing
a. Hypercalcemia diagnoses, NOC patient outcomes, and NIC
b. Tumor lysis syndrome nursing interventions can be used to
c. Spinal cord compression a. evaluate patient outcomes.
d. Superior vena cava syndrome b. provide guides for planning care.
c. predict the results of nursing care.
15. A patient has recently been diagnosed with d. shorten written care plans for
early stages of breast cancer. What is most individual patients.
appropriate for the nurse to focus on? 6. Advantages of the use of informatics in
a. Maintaining the patient’s hope health care delivery are
b. Preparing a will and advance (select all that apply)
directives a. reduced need for home care nurses
c. Discussing replacement child care in rural areas.
for the patient’s children b. increased patient anonymity and
d. Discussing the patient’s past confidentiality.
experiences with her grandmother’s c. the ability to achieve and maintain
cancer high standards of care.
d. improved communication of the
patient’s health status to the health
care team.
IMPORTANCE OF EVIDENCE BASED PRACTICE e. access to standardized plans of care
1. An example of a nursing activity that that are available for most types of
reflects the American Nurses Association’s health problems.
definition of nursing is
a. diagnosing a patient with a feeding 7. When using evidence-based practice, the
tube as being at risk for aspiration. nurse
b. establishing protocols for treating a. must use clinical practice guidelines
patients in the emergency department. developed by national health agencies.
c. providing antianxiety drugs for a b. should use findings from
patient who has disturbed sleep randomized controlled trials to plan
patterns. care for all patient problems.
d. identifying and treating c. uses clinical decision making and
dysrhythmias that occur in a patient in judgment to determine what evidence
the coronary care unit. is appropriate for a specific clinical
situation.
2. A nurse working on the medical-surgical unit d. statistically analyzes the relationship
at an urban hospital would like to become of nursing interventions to patient
certified in a medical-surgical specialty. The outcomes to establish evidence for the
nurse knows that this process would most likely most appropriate
require. patient interventions.
a. a bachelor’s degree in nursing. 8. The nurse’s role in addressing the National
b. formal education in advanced Patient Safety Goals established by The Joint
nursing practice. Commission includes (select all that apply)
c. experience for a specific period in a. using side rails and alarm systems
medical-surgical nursing. as necessary to prevent patient falls.
d. membership in a medical-surgical b. memorizing and implementing all
nursing specialty organization. the rules published by The Joint
Commission.
3. A nurse is providing care to a patient after c. verifying telephone and verbal
right hip surgery. Within a pay-for-performance orders using the “write down and read
system, a critical role of the nurse is to back” procedure.
a. ensure that care is provided using a d. encouraging patients to be actively
minimal amount of supplies. involved in and question their own
b. discharge the patient at completion health care.
of the number of approved days of e. obtaining a complete list of the
care. patient’s medications and monitoring
 their use throughout the continuum of student do before incorporating the evidence into
care. practice?
a. Obtain informed consent.
9. The nurse is caring for a diabetic patient in b. Collect the most relevant and best evidence.
the ambulatory surgical unit who has just c. Critically appraise the evidence gathered.
undergone debridement of an infected toe. d. Share the outcome with others.
Which task is most appropriate for the nurse to e. Get approval from the institutional review board.
delegate to unlicensed assistive personnel
(UAP)? 7. The nurse administrator wants to implement
a. Check the patient’s vital signs.
evidence-based practices in a hospital and is
b. Evaluate the patient’s awareness.
searching for evidence on nursing practices that
c. Monitor the site of the patient’s IV
improve health care quality. The nurse has been
catheter.
d. Evaluate the patient’s tibial and referring to both research-based and non-research-
pedal pulses. based evidence. Which should the nurse
administrator study in order to get non-research-
Clinical questioning using PICOT based evidence?
format a. Meta-analysis
b. Systematic reviews
1. The nurse understands that using a PICOT format for c. Randomized controlled trials studies
clinical questions helps in refining the search for d. Quality improvement and risk management data
evidence. Which are the best reasons to follow the
PICOT format? 8. The nurse researcher interviews parents of children
a. It helps to ask a more focused question. who have diabetes and asks them to describe how
b. It is necessary to follow the sequence of PICOT. they deal with their child's illness. The analysis of the
c. It prevents wandering when searching for evidence. interviews yields common themes and stories
d. It allows the researcher to ask questions that are describing the parents' coping strategies. This is an
focused on theory. example of which type of study?
e. It helps to identify knowledge gaps within a clinical a. Historical
situation. b. Qualitative
c. Correlational
2. A 55-year-old patient is diagnosed with lung cancer d. Experimental
and has a history of smoking. Which type of study
would be initiated to find the association between 9. The nurse researcher decides to complete a study to
smoking and lung cancer,? evaluate how Florence Nightingale improved patient
a. Case-control study outcomes in the Crimean War. This is an example of
b. Randomized controlled trial which type of research?
c. Historical research a. Historical
d. Retrospective study b. Evaluation
e. Descriptive research c. Exploratory
d. Experimental
3. The nurse designs and conducts an informational
health campaign and then measures the outcomes of 10. The nurse working in an orthopedic center finds that
the campaign. Which type of research practice did the most of the patients coming to the clinic have
nurse perform? mechanical low-back aches. Which is the best
a. Evaluation reference in order to develop a good plan of care for
b. Descriptive these patients?
c. Exploratory a. Psychology and related health care disciplines
d. Experimental (PsycINFO)
b. Cochrane Database
4. The nurse is developing the protocol for a research c. National Guidelines Clearinghouse (NGC)
study. The nurse is referencing various research d. Cumulative Index of Nursing and Allied Health Literature
articles to develop the procedures for the study. To (CINAHL)
which section of the research articles should the
nurse refer? 11. To which type of study should the nurse refer in order
a. Abstract to find the strongest evidence of the effectiveness of a
b. Introduction particular treatment?
c. Methods a. Case control studies
d. Results b. Randomized control trials
c. Descriptive studies
5. A group of nurses have implemented an evidence- d. Systematic reviews
based practice (EBP) change and have evaluated the
effectiveness of the change. What is their next step? 12. A group of nurses are studying the research on
nursing-sensitive outcomes. Which outcomes are
a. Conduct a literature review. nursing sensitive?
b. Share the findings with others. a. Prevalence of restraint use
c. Conduct a statistical analysis. b. Prevalence of pressure ulcers
d. Create a well-defined PICOT question. c. Effectiveness of acetaminophen
d. Patient falls with injury
6. The nursing student is preparing an evidence-based e. Prevalence of heart failure
practice project for which the student has posed a
clear and concise clinical question. Which should the 13. Which statement shows the steps of the research
process in the correct order?
a. Review the literature, state the research problem, and Advance Directives
develop a theoretical construct.
b. Review the literature, state the research problem, and
1. Living Will
select the research strategy.
c. Select the research strategy, collect data, and analyze
o Document that has instructions for
data. future medical care
d. State the research problem, review the literature, and o Wishes
clarify operational definitions.  DTP- directive to physician
 DPAAC – durable power of
14. The nurse is conducting research on the effect of attorney for healthcare
imagery on pain perception. Which actions should the  MPOA- medical power of
nurse perform when searching the scientific
attorney. Can appoint legal
databases for evidence?
guardians
a. Seek the assistance of a medical librarian.
b. Enter and manipulate different key words. 2. DNR
c. Be prepared for some confusion with the evidence o Do not resuscitate.
obtained. 3. WWT
d. Refer to agency policies and procedures manuals. o Withholding
e. Refer to existing clinical practice guidelines. o Withdrawing
o Treatment
15. The nurse is referring to various research articles in
- List of procedures or treatments that you
order to acquire information about a PICOT question
for which no pilot study has been done. After studying want to do with me.
the references, the nurse finds that the evidence is
not strong enough to apply in practice. What should = As a nurse you should have this qualities
the nurse do to investigate the PICOT question? Respect
Choose the best answer. Dignity
a. Conduct a pilot study. Comfort
b. Conduct a systematic review.
c. Conduct a randomized controlled trial.
d. Implement the change that the nurse predicts in clinical
settings.

Patients’ Bill of Rights

1. Right to appropriate medical and Humanae

treatment
2. Right to informed consent.
3. Right to privacy and confidentiality
4. Right to information
5. Right to health care provider and facility
6. Right to self determination
7. Right to religious belief
8. Right to medical records
9. Right to leave
10. Right to refuse participation in medical
research
11. Right correspondence and receive visitors.
12. Right express grievances
13. Right to be informed of his rights and
obligations as a patient

Non-disclosure and HIV law

 RA 11166
 Ph. HIV & AIDS policy Act of 2018
Sec 30: compulsory HIV testing
Sec 47: disclosure to person with potential of HIV

Legal & Ethical issues Affecting End of Life care