During a routine checkup, Nurse Marianne assesses a male client with acquired immunodeficiency syndrome (AIDS) for signs and symptoms of cancer. What is the most common AIDS-related cancer?
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Solution
Kaposi’s sarcoma
Option D: Kaposi’s sarcoma is the most common cancer associated with AIDS.
Options A, B, and C: Squamous cell carcinoma, multiple myeloma, and leukemia may occur in anyone and aren’t associated specifically with AIDS.
Katrina has an abnormal result on a Papanicolaou test. After admitting that she read her chart while the nurse was out of the room, Katrina asks what dysplasia means. Which definition should the nurse provide?
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Solution
Alteration in the size, shape, and organization of differentiated cells
Option D: Dysplasia refers to an alteration in the size, shape, and organization of differentiated cells.
Option A: The presence of completely undifferentiated tumor cells that don’t resemble cells of the tissues of their origin is called anaplasia.
Option B: An increase in the number of normal cells in a normal arrangement in a tissue or an organ is called hyperplasia.
Option C: Replacement of one type of fully differentiated cell by another in tissues where the second type normally isn’t found is called metaplasia.
Jestoni with chronic renal failure (CRF) is admitted to the urology unit. The nurse is aware that the diagnostic test is consistent with CRF if the result is:
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Solution
Blood urea nitrogen (BUN) 100 mg/dl and serum creatinine 6.5 mg/dl.
Option C: The normal BUN level ranges 8 to 23 mg/dl; the normal serum creatinine level ranges from 0.7 to 1.5 mg/dl. The test results in option C are abnormally elevated, reflecting CRF and the kidneys’ decreased ability to remove nonprotein nitrogen waste from the blood.
Option A: CRF causes decreased pH and increased hydrogen ions — not vice versa.
Option B: CRF also increases serum levels of potassium, magnesium, and phosphorous, and decreases serum levels of calcium.
Option D: A uric acid analysis of 3.5 mg/dl falls within the normal range of 2.7 to 7.7 mg/dl; PSP excretion of 75% also falls with the normal range of 60% to 75%.
Maritess was recently diagnosed with a genitourinary problem and is being examined in the emergency department. When palpating her kidneys, the nurse should keep which anatomical fact in mind?
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Solution
The left kidney usually is slightly higher than the right one.
Option A: The left kidney usually is slightly higher than the right one. An adrenal gland lies atop each kidney.
Option C: The average kidney measures approximately 11 cm (4-3/8″) long, 5 to 5.8 cm (2″ to 2¼”) wide, and 2.5 cm (1″) thick.
Option B: The kidneys are located retroperitoneally, in the posterior aspect of the abdomen, on either side of the vertebral column.
Option D: They lie between the 12th thoracic and 3rd lumbar vertebrae.
Ms. X has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client?
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Solution
This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually.
Option A: Women with condylomata acuminata are at risk for cancer of the cervix and vulva. Yearly Pap smears are very important for early detection. Because condylomata acuminata is a virus, there is no permanent cure.
Option C: Because condylomata acuminata can occur on the vulva, a condom won’t protect sexual partners.
Option D: HPV can be transmitted to other parts of the body, such as the mouth, oropharynx, and larynx.
Nurse Tristan is caring for a male client in acute renal failure. The nurse should expect hypertonic glucose, insulin infusions, and sodium bicarbonate to be used to treat:
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Solution
hyperkalemia.
Option C: Hyperkalemia is a common complication of acute renal failure. It’s life-threatening if immediate action isn’t taken to reverse it. The administration of glucose and regular insulin, with sodium bicarbonate, if necessary, can temporarily prevent cardiac arrest by moving potassium into the cells and temporarily reducing serum potassium levels.
Options A, B, and D: Hypernatremia, hypokalemia, and hypercalcemia don’t usually occur with acute renal failure and aren’t treated with glucose, insulin, or sodium bicarbonate.
Kristine is scheduled for a bronchoscopy. When teaching Kristine what to expect afterward, the nurse’s highest priority of information would be:
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Solution
Food and fluids will be withheld for at least 2 hours.
Option A: Prior to bronchoscopy, the doctors spray the back of the throat with anesthetic to minimize the gag reflex and thus facilitate the insertion of the bronchoscope. Giving the client food and drink after the procedure without checking on the return of the gag reflex can cause the client to aspirate. The gag reflex usually returns after two hours.
Tonny has undergoes a left thoracotomy and a partial pneumonectomy. Chest tubes are inserted, and one-bottle water-seal drainage is instituted in the operating room. In the postanesthesia care unit, Tonny is placed in Fowler’s position on either his right side or on his back. The nurse is aware that this position:
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Solution
Facilitate ventilation of the left lung.
Option B: Since only a partial pneumonectomy is done, there is a need to promote expansion of this remaining left lung by positioning the client on the opposite unoperated side.
The nurse is aware that the most relevant knowledge about oxygen administration to a male client with COPD is
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Solution
Oxygen at 1-2L/min is given to maintain the hypoxic stimulus for breathing.
Option A: COPD causes a chronic CO2 retention that renders the medulla insensitive to the CO2 stimulation for breathing. The hypoxic state of the client then becomes the stimulus for breathing. Giving the client oxygen in low concentrations will maintain the client’s hypoxic drive.
Nurse Sherry is teaching male client regarding his permanent artificial pacemaker. Which information given by the nurse shows her knowledge deficit about the artificial cardiac pacemaker?
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Solution
may engage in contact sports
Option D: The client should be advised by the nurse to avoid contact sports. This will prevent trauma to the area of the pacemaker generator.