MSN 277 MCQ Questions and Answers for Exam 2 Study and Revision A patient with stage II breast cancer tells the nurse, I need to decide about what type of surgery to have, but I feel so overwhelmed that I cannot make any decisions yet! What do you think I should do? Which response by the nurse is best? a. I would have a lumpectomy, but you need to decide what is best for you. b. Tell me what you understand about the surgical options that are available. c. It would not be appropriate for me to make the decision about your health. d. There is no need to make a decision rapidly; you have time to think about this. CORRECT ANS: B This response indicates the nurses willingness to assist the patient with the decision -making process without imposing the nurses values or opinions. Response B indicates that the nurse is not willing to help the patient with the decision about treatment. Because treatment decisions for breast cancer do need to be made relatively quickly, response C is not accurate. Since the nurses values and situation are not the same as the patients, imposing the nurses opinions during this emotionally vulnerable time is not appropriate. A patient at the clinic who has metastatic breast cancer has a new prescription for trastuzumab (Herceptin). The nurse will plan to a. have the patient schedule frequent eye examinations. b. instruct the patient to call if she notices ankle swelling. c. remind the patient that hot flashes may occur with the medication. d. teach the patient about the need to monitor serum electrolyte levels. CORRECT ANS: B Herceptin can lead to ventricular dysfunction, so the patient is taught to self-monitor for symptoms of heart failure. There is no need to monitor serum electrolyte levels. Hot flashes or changes in visual acuity may occur with tamoxifen, but not with tras tuzumab. Any patient guilt about having a therapeutic abortion may be identified when the nurse assesses the functional health pattern of a. value -belief. b. cognitive -perceptual. c. sexuality -reproductive. d. coping -stress tolerance. CORRECT ANS: A The value -belief pattern includes information about conflicts between a patients values and proposed medical care. In the cognitive -perceptual pattern, the nurse will ask questions about pain and sensory intactness. The sexuality -reproductive pattern inclu des data about the impact of the surgery on the patients sexuality. The coping -stress tolerance pattern assessment will elicit information about how the patient feels about the surgery. During the preoperative assessment of a patient scheduled for a colon resection, the patient tells the nurse about using St. Johns wort to prevent depression. The nurse should alert the staff in the postanesthesia recovery area that the patient may a. experience increased pain. b. have hypertensive episodes. c. take longer to recover from the anesthesia. d. have more postoperative bleeding than expected. CORRECT ANS: C St. Johns wort may prolong the effects of anesthetic agents and increase the time to waken completely after surgery. It is not associated with increased bleeding risk, hypertension, or increased pain. On the day of surgery, the nurse is admitting a patient with a history of cigarette smoking. Which action is most important at this time? a. Auscultate for adventitious breath sounds. b. Ask whether the patient has smoked recently. c. Remind the patient about harmful effects of smoking. d. Calculate the cigarette smoking history in pack -years. CORRECT ANS: A Abnormal breath sounds may indicate the presence of an acute respiratory infection or chronic lung disease that will affect the choice of anesthesia and/or proceeding with the scheduled surgery. The other nursing actions also are appropriate but will not a ffect the immediate surgical procedure as much as the presence of abnormal breath sounds. A patient is seen at the health care providers office several weeks before hip surgery for preoperative assessment. The patient reports use of echinacea, saw palmetto, and glucosamine/chondroitin. The nurse should a.
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