Conditions and Treatments - NCLEX-PN
Card 0 of 5640
What type of thyroid cancer has the worst prognosis?
What type of thyroid cancer has the worst prognosis?
The 5 year survival rate for aplastic carcinoma of the thyroid is 7-14%. The 5 year survival rates of papillary, medullary, and follicular thyroid carcinomas are close to 100% for stage I cancers. Survival rates decrease to approximately 50% for stage IV papillary and follicular carcinomas and 28% for stage IV medullary carcinoma.
The 5 year survival rate for aplastic carcinoma of the thyroid is 7-14%. The 5 year survival rates of papillary, medullary, and follicular thyroid carcinomas are close to 100% for stage I cancers. Survival rates decrease to approximately 50% for stage IV papillary and follicular carcinomas and 28% for stage IV medullary carcinoma.
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The home health nurse assesses the home of a elderly diabetic patient with peripheral neuropathy who lives alone. Which of the following observations most concerns the nurse?
The home health nurse assesses the home of a elderly diabetic patient with peripheral neuropathy who lives alone. Which of the following observations most concerns the nurse?
Peripheral neuropathy is a common condition among elderly diabetic patients. Due to the loss of sensation in fingers, arms, legs, and toes, these patients must be aware of their surroundings, use proper foot care, inspect feet daily (with a mirror if the patient is elderly or has decreased joint mobility), wear well-fitting shoes, avoid heating pads on feet, avoid walking barefoot, and cut toenails straight across without rounding corners. It is also important for the patient to avoid exercise when their condition is poorly controlled due to the increased demand for glucose. This patient must be sure to check the temperature of baths before using them, as the potential for burns is high in those with decreased sensation and neuropathy.
Peripheral neuropathy is a common condition among elderly diabetic patients. Due to the loss of sensation in fingers, arms, legs, and toes, these patients must be aware of their surroundings, use proper foot care, inspect feet daily (with a mirror if the patient is elderly or has decreased joint mobility), wear well-fitting shoes, avoid heating pads on feet, avoid walking barefoot, and cut toenails straight across without rounding corners. It is also important for the patient to avoid exercise when their condition is poorly controlled due to the increased demand for glucose. This patient must be sure to check the temperature of baths before using them, as the potential for burns is high in those with decreased sensation and neuropathy.
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The bedside nurse cares for a patient newly diagnosed with cystic fibrosis and educates the patient on new diet modifications. The nurse is concerned when the patient makes which of the following statements?
The bedside nurse cares for a patient newly diagnosed with cystic fibrosis and educates the patient on new diet modifications. The nurse is concerned when the patient makes which of the following statements?
Cystic fibrosis is a disorder that mainly affects the lungs, but also alters fat metabolism from a lack of pancreatic enzymes. The disorder is treated with pancreatic enzyme replacement, which is best absorbed when taken before meals or with food. The best diet for cystic fibrosis is low-fat and cholesterol-restricted with good sources of protein, such as fruit, vegetables, lean meats, and cereals. These patients must avoid fatty, marbled meats such as bacon, fatty foods such as avocado, egg yolks, and butter. During illness, patients with cystic fibrosis have higher calorie and protein demands.
Cystic fibrosis is a disorder that mainly affects the lungs, but also alters fat metabolism from a lack of pancreatic enzymes. The disorder is treated with pancreatic enzyme replacement, which is best absorbed when taken before meals or with food. The best diet for cystic fibrosis is low-fat and cholesterol-restricted with good sources of protein, such as fruit, vegetables, lean meats, and cereals. These patients must avoid fatty, marbled meats such as bacon, fatty foods such as avocado, egg yolks, and butter. During illness, patients with cystic fibrosis have higher calorie and protein demands.
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The nurse provides education to a patient newly diagnosed with Addison’s disease. The patient wants to learn about lifestyle modifications such as nutrition and diet changes. Which of the following statements by the nurse would be inappropriate?
The nurse provides education to a patient newly diagnosed with Addison’s disease. The patient wants to learn about lifestyle modifications such as nutrition and diet changes. Which of the following statements by the nurse would be inappropriate?
Patients with Addison’s disease are more susceptible to becoming dehydrated and may lose salts more quickly than others. Because of this, it is important to make sure these patients have a well-rounded diet with an emphasis on fluids. Protein, whole grains, and fibers are routinely recommended in a healthy, balanced diet, but it is not recommended to have a sodium-restricted diet.
Patients with Addison’s disease are more susceptible to becoming dehydrated and may lose salts more quickly than others. Because of this, it is important to make sure these patients have a well-rounded diet with an emphasis on fluids. Protein, whole grains, and fibers are routinely recommended in a healthy, balanced diet, but it is not recommended to have a sodium-restricted diet.
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A client had just undergone a total right knee replacement and has just returned from the operating room. Later that evening, the client suddenly begins to complain of shortness or breath and chest pain on inspiration. The nurse caring for this client further notes the coughing up of blood and that he is sweating profusely.
Which of the following nursing interventions should the nurse perform first?
A client had just undergone a total right knee replacement and has just returned from the operating room. Later that evening, the client suddenly begins to complain of shortness or breath and chest pain on inspiration. The nurse caring for this client further notes the coughing up of blood and that he is sweating profusely.
Which of the following nursing interventions should the nurse perform first?
The priority for this client is to ensure a patent airway by placing him the Fowler's or semi upright seated position. Giving oxygen is warranted but will be given after the client is positioned correctly. ABG's would be helpful in this situation but it not the priority. Auscultation of breath sounds and assessment of mental status are not indicated.
The priority for this client is to ensure a patent airway by placing him the Fowler's or semi upright seated position. Giving oxygen is warranted but will be given after the client is positioned correctly. ABG's would be helpful in this situation but it not the priority. Auscultation of breath sounds and assessment of mental status are not indicated.
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Which of the following organisms causes whooping cough?
Which of the following organisms causes whooping cough?
Whooping cough, a condition that results in severe paroxysmal coughing fits followed by a long wheezing inspiratory gasp (the "whoop") is caused by the bacteria B ordetella pertussis. _Haemophilus influenza_e and Klebsiella pneumoniae both commonly cause pneumonia, and RSV is a virus that is frequently implicated in lower respiratory infections of infants and children.
Whooping cough, a condition that results in severe paroxysmal coughing fits followed by a long wheezing inspiratory gasp (the "whoop") is caused by the bacteria B ordetella pertussis. _Haemophilus influenza_e and Klebsiella pneumoniae both commonly cause pneumonia, and RSV is a virus that is frequently implicated in lower respiratory infections of infants and children.
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How long is the incubation period for pertussis?
How long is the incubation period for pertussis?
The incubation period for pertussis, also known as the catarrhal stage, can last as little as 4 days or as long as 42 days, but a typical period is 1-3 weeks. During this stage the disease looks like a regular upper respiratory infection, with sneezing, mild cough, and runny nose. The infected individual is highly infectious at this time, with bacteria spread by airborne droplets after sneezing or cough.
The incubation period for pertussis, also known as the catarrhal stage, can last as little as 4 days or as long as 42 days, but a typical period is 1-3 weeks. During this stage the disease looks like a regular upper respiratory infection, with sneezing, mild cough, and runny nose. The infected individual is highly infectious at this time, with bacteria spread by airborne droplets after sneezing or cough.
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In pertussis, what stage follows the incubation (also known as the catarrhal) stage?
In pertussis, what stage follows the incubation (also known as the catarrhal) stage?
After the catarrhal stage, an individual with pertussis will progress into the paroxysmal stage. It's during this stage that they will experience uncontrollable fits of 5-15 forceful coughs, followed by a "whoop" or gasp as they struggle to inhale. The force of these coughs can be such that they can result in vomiting, epistaxis, subconjunctival hemorrhage, or even broken ribs.
After the catarrhal stage, an individual with pertussis will progress into the paroxysmal stage. It's during this stage that they will experience uncontrollable fits of 5-15 forceful coughs, followed by a "whoop" or gasp as they struggle to inhale. The force of these coughs can be such that they can result in vomiting, epistaxis, subconjunctival hemorrhage, or even broken ribs.
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What is the final stage of a pertussis infection?
What is the final stage of a pertussis infection?
The final stage of a pertussis infection is known as the convalescent phase. This occurs for 2-6 weeks, after the paroxysmal stage of the disease. During this time coughing decreases, and paroxysms are less severe. The infected individual may experience increased susceptibility to upper and lower respiratory conditions for as much as 6 months after resolution of the infection.
The final stage of a pertussis infection is known as the convalescent phase. This occurs for 2-6 weeks, after the paroxysmal stage of the disease. During this time coughing decreases, and paroxysms are less severe. The infected individual may experience increased susceptibility to upper and lower respiratory conditions for as much as 6 months after resolution of the infection.
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You are the nurse taking care of a 40-year old African-American female who complains of fatigue and shortness of breath. Her physical exam is remarkable for erythema nodosum on the bilateral lower extremities. A chest x-ray is performed that demonstrates bilateral hilar infiltrates. She lives and works in a suburb, has not traveled outside of the United States recently, and does not work in a healthcare setting. Which of the following is the most likely diagnosis?
You are the nurse taking care of a 40-year old African-American female who complains of fatigue and shortness of breath. Her physical exam is remarkable for erythema nodosum on the bilateral lower extremities. A chest x-ray is performed that demonstrates bilateral hilar infiltrates. She lives and works in a suburb, has not traveled outside of the United States recently, and does not work in a healthcare setting. Which of the following is the most likely diagnosis?
The correct answer is "Sarcoidosis." Sarcoidosis is the correct answer as this inflammatory condition is frequently found in African-American women in their 40's who present with fatigue and shortness of breath among other symptoms, who also have erythema nodosum on the lower extremities, and have bilateral hilar infiltrates on chest x-ray. This constellation of findings is highly suggestive of sarcoidosis. Sarcoidosis results in the formation of numerous non-necrotizing granulomas, most commonly found in the lungs, that can play a role in the symptoms experienced by these patients. Other findings suggestive of sarcoidosis include elevated serum calcium levels with normal serum PTH levels.
Tuberculosis can present in a similar manner to sarcoidosis, however given the patient's suburban living environment, lack of a travel history, and lack of healthcare exposure, the likelihood of being exposed to tuberculosis is very low, making sarcoidosis a more likely etiology.
While lung cancer can present as shortness of breath with hilar infiltration in chest x-ray, in a relatively young otherwise healthy patient who also has erythema nodosum and in whom the hilar infiltrates are bilateral, sarcoidosis would be a more likely etiology.
The patient does not have any findings consistent with meningitis (leg rash in meningitis is petechial, not erythema nodosum) or pharyngitis.
The correct answer is "Sarcoidosis." Sarcoidosis is the correct answer as this inflammatory condition is frequently found in African-American women in their 40's who present with fatigue and shortness of breath among other symptoms, who also have erythema nodosum on the lower extremities, and have bilateral hilar infiltrates on chest x-ray. This constellation of findings is highly suggestive of sarcoidosis. Sarcoidosis results in the formation of numerous non-necrotizing granulomas, most commonly found in the lungs, that can play a role in the symptoms experienced by these patients. Other findings suggestive of sarcoidosis include elevated serum calcium levels with normal serum PTH levels.
Tuberculosis can present in a similar manner to sarcoidosis, however given the patient's suburban living environment, lack of a travel history, and lack of healthcare exposure, the likelihood of being exposed to tuberculosis is very low, making sarcoidosis a more likely etiology.
While lung cancer can present as shortness of breath with hilar infiltration in chest x-ray, in a relatively young otherwise healthy patient who also has erythema nodosum and in whom the hilar infiltrates are bilateral, sarcoidosis would be a more likely etiology.
The patient does not have any findings consistent with meningitis (leg rash in meningitis is petechial, not erythema nodosum) or pharyngitis.
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A client presents to the clinic for fecal occult blood testing (FOBT) as part of his colorectal screening appointment. The nurse previously instructed this patient to avoid certain foods for 48-72 hours prior to testing.
All of the following foods were to be avoided except .
A client presents to the clinic for fecal occult blood testing (FOBT) as part of his colorectal screening appointment. The nurse previously instructed this patient to avoid certain foods for 48-72 hours prior to testing.
All of the following foods were to be avoided except .
There are many foods not to be ingested just prior to FOBT, prunes are fine to eat. Red meat, broccoli, cantaloupe, beets, turnips, carrots, horseradish and several others may alter the test results and should be avoided before a FOBT.
There are many foods not to be ingested just prior to FOBT, prunes are fine to eat. Red meat, broccoli, cantaloupe, beets, turnips, carrots, horseradish and several others may alter the test results and should be avoided before a FOBT.
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A 70-year-old female client is being treated as an outpatient for diverticulitis. The nurse explains that there are several complications associated with this disease.
The nurse informs the patient that diverticulitis is the most common cause of what complication?
A 70-year-old female client is being treated as an outpatient for diverticulitis. The nurse explains that there are several complications associated with this disease.
The nurse informs the patient that diverticulitis is the most common cause of what complication?
Diverticulitis is the most common cause of lower GI bleeds. Peritonitis and bowel obstruction are possible complications, but not most commonly associated with diverticulitis. Renal failure and severe diarrhea are not complications of diverticulitis.
Diverticulitis is the most common cause of lower GI bleeds. Peritonitis and bowel obstruction are possible complications, but not most commonly associated with diverticulitis. Renal failure and severe diarrhea are not complications of diverticulitis.
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The pediatric nurse assesses a 11-year-old patient in the emergency department. The child’s parent explains the child’s signs and symptoms from the last few days. Which of the following statements by the parent is most important to the nurse?
The pediatric nurse assesses a 11-year-old patient in the emergency department. The child’s parent explains the child’s signs and symptoms from the last few days. Which of the following statements by the parent is most important to the nurse?
This patient is experiencing signs of appendicitis, which include periumbilical abdominal pain (usually originating in the right lower quadrant), anorexia, nausea, vomiting, localized tenderness, muscle guarding, and a low-grade fever. Appendicitis is frequently diagnosed in young children and young adults with these symptoms and a white blood cell count from 
. The nurse should be most concerned if the pain has suddenly ceased, which may be a sign of perforation, which is an emergency due to hemorrhage and infection risks.
This patient is experiencing signs of appendicitis, which include periumbilical abdominal pain (usually originating in the right lower quadrant), anorexia, nausea, vomiting, localized tenderness, muscle guarding, and a low-grade fever. Appendicitis is frequently diagnosed in young children and young adults with these symptoms and a white blood cell count from
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The pediatric nurse cares for a young child admitted with appendicitis. Which of the following signs and symptoms most concerns the nurse?
The pediatric nurse cares for a young child admitted with appendicitis. Which of the following signs and symptoms most concerns the nurse?
Without treatment, appendicitis can lead to peritonitis or perforation. Typical signs and symptoms of appendicitis include periumbilical abdominal pain, anorexia, nausea, vomiting, localized tenderness, muscle guarding, and low-grade fever. The normal WBC count for a patient with appendicitis ranges from 
. The nurse caring for a patient with appendicitis should always be aware of particularly concerning signs or symptoms of peritonitis, especially those that differ from established baseline signs and symptoms. Many of the symptoms of appendicitis may be apparent with peritonitis, especially tenderness, fever, and white blood cell counts. When assessing for peritonitis, the nurse should specifically look for abdominal rigidity/distention, rebound tenderness, increased/severe abdominal pain, ascites, increased temperature, increased leukocytosis, and paralytic ileus.
Without treatment, appendicitis can lead to peritonitis or perforation. Typical signs and symptoms of appendicitis include periumbilical abdominal pain, anorexia, nausea, vomiting, localized tenderness, muscle guarding, and low-grade fever. The normal WBC count for a patient with appendicitis ranges from
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A patient just returned from a trip outside of the country and is now experiencing fever, nausea, and vomiting. She tests positive for hepatitis A IgM. She would like to know if hepatitis A is a chronic infection, or if it will resolve with treatment. The nurse should advise her which of the following?
A patient just returned from a trip outside of the country and is now experiencing fever, nausea, and vomiting. She tests positive for hepatitis A IgM. She would like to know if hepatitis A is a chronic infection, or if it will resolve with treatment. The nurse should advise her which of the following?
Hepatitis A is a generally benign, self-limiting disease that does not develop into a chronic hepatitis. It also cannot exist in a carrier state. Once the virus is cleared by the immune system, the individual will no longer carry the virus or be infectious to others.
Hepatitis A is a generally benign, self-limiting disease that does not develop into a chronic hepatitis. It also cannot exist in a carrier state. Once the virus is cleared by the immune system, the individual will no longer carry the virus or be infectious to others.
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What is the incubation period of hepatitis B (HBV)?
What is the incubation period of hepatitis B (HBV)?
Hepatitis B has a long incubation period. From the time of initial infection, symptoms might take from 1-6 months to appear.
Hepatitis B has a long incubation period. From the time of initial infection, symptoms might take from 1-6 months to appear.
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Hepatitis B can be transmitted via any of the following routes except .
Hepatitis B can be transmitted via any of the following routes except .
Hepatitis B is primarily transmitted via blood, vaginal secretions, and semen. While the virus is often present in saliva, it is not generally spread by sneezing, kissing, or sharing utensils (unless there are oral abrasions resulting in a mutual exchange of blood). The virus does not have fecal-oral transmission.
Hepatitis B is primarily transmitted via blood, vaginal secretions, and semen. While the virus is often present in saliva, it is not generally spread by sneezing, kissing, or sharing utensils (unless there are oral abrasions resulting in a mutual exchange of blood). The virus does not have fecal-oral transmission.
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A patient with pancreatitis is placed on an NPO order. What does this order mean?
A patient with pancreatitis is placed on an NPO order. What does this order mean?
NPO means is a latin phrase meaning nothing by mouth. This order is used when a patient is not allowed to eat or drink any substances, usually due to a disturbance within the GI tract or if they are scheduled for a surgery. NPO orders are common in the ICU and surgical setting.
NPO means is a latin phrase meaning nothing by mouth. This order is used when a patient is not allowed to eat or drink any substances, usually due to a disturbance within the GI tract or if they are scheduled for a surgery. NPO orders are common in the ICU and surgical setting.
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What is the most common cause of renal failure in the United States?
What is the most common cause of renal failure in the United States?
The most common cause of renal failure in the US is diabetic nephropathy due to diabetes mellitus. Diabetic nephropathy can include multiple complications including arteriosclerosis, glomerulosclerosis, pyelonephritis and renal failure.
The most common cause of renal failure in the US is diabetic nephropathy due to diabetes mellitus. Diabetic nephropathy can include multiple complications including arteriosclerosis, glomerulosclerosis, pyelonephritis and renal failure.
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Which of the following is an insect vector-borne illness?
Which of the following is an insect vector-borne illness?
Insect vector-borne illnesses are given to humans through insects like ticks, mosquitoes, and chiggers. Rocky mountain spotted fever is caused by Rickettsia rickettsii. Ticks are the most common vector for rocky mountain spotted fever. Prevention of tick bites is a crucial teaching point in preventing the spread of the disease. Although misleading, the infection can be obtained throughout the United States of America. Roundworm is caused by a fungus. Rabies is a viral disease that is typically transmitted between mammals through bites. Cat scratch fever is a bacterial infection that can cause severe neurological, musculoskeletal, circulatory, and other system damage in immunocompromised individuals; in healthy people, no treatment is necessary and the infection is fought. Scabies causes extreme itchy red bumps commonly in between the fingers, on the wrist, and around the abdomen. The organism that causes this disease is actually in the arachnid family and is not an insect.
Insect vector-borne illnesses are given to humans through insects like ticks, mosquitoes, and chiggers. Rocky mountain spotted fever is caused by Rickettsia rickettsii. Ticks are the most common vector for rocky mountain spotted fever. Prevention of tick bites is a crucial teaching point in preventing the spread of the disease. Although misleading, the infection can be obtained throughout the United States of America. Roundworm is caused by a fungus. Rabies is a viral disease that is typically transmitted between mammals through bites. Cat scratch fever is a bacterial infection that can cause severe neurological, musculoskeletal, circulatory, and other system damage in immunocompromised individuals; in healthy people, no treatment is necessary and the infection is fought. Scabies causes extreme itchy red bumps commonly in between the fingers, on the wrist, and around the abdomen. The organism that causes this disease is actually in the arachnid family and is not an insect.
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