ATI RN
Burns Pediatric Primary Care 7th Edition Test Bank Questions
Question 1 of 5
A client is receiving the cell cycle-nonspecific alkylating agent thiotepa (thioplex), 60 mg weekly for 4 weeks by bladder instillation as part of a chemotherapeutic regimen to treat bladder cancer. The client asks the nurse how the drug works. How does thiotepa exert its therapeutic effects?
Correct Answer: C
Rationale: Thiotepa is a cell cycle-nonspecific alkylating agent that exerts its therapeutic effects by interfering with both DNA replication and RNA transcription. The alkylating properties of thiotepa lead to the cross-linking of DNA strands, ultimately inhibiting DNA replication. Additionally, thiotepa can also disrupt RNA synthesis, further affecting protein production and cell function. This combined action on DNA replication and RNA transcription contributes to the cytotoxic effects of thiotepa on rapidly dividing cancer cells.
Question 2 of 5
A client has a routine Papanicolaou (Pap) test during a yearly gynecologic examination. The result reveals a class V finding. What should the nurse tell the client about this finding?
Correct Answer: D
Rationale: Class V findings on a Pap test indicate the presence of severely abnormal cells, suggesting a high likelihood of precancerous or cancerous changes. Therefore, it calls for a biopsy as soon as possible to further investigate and determine the appropriate course of action. Immediate follow-up and intervention are crucial in cases of Class V Pap test results to address any potential serious health concerns.
Question 3 of 5
A client receives a sealed radiation implant to treat cervical cancer. When caring for this client, the nurse should:
Correct Answer: B
Rationale: When caring for a client who has received a sealed radiation implant to treat cancer, it is important to consider the client to be radioactive for a certain period of time. Typically, the client is considered radioactive for about 10 days after the implant is removed. During this time, precautions should be taken to limit exposure to radiation, including following the principles of time, distance, and shielding. It is important for healthcare providers to wear appropriate protective gear when caring for the client and to limit the time spent in close proximity to the client. After the radioactive period has passed, the client will no longer be considered radioactive, and standard precautions can be followed.
Question 4 of 5
The nurse is reviewing the medication history of a new preoperative patient who is nil by mouth (NPO). The nurse notes that the patient has been on long-term oral steroid therapy. The nurse understands that which of the following is the reason that steroids cannot be abruptly stopped?
Correct Answer: A
Rationale: Steroids should not be abruptly stopped, especially in patients on long-term therapy, because higher steroid levels are needed during stress. Abruptly stopping steroids can lead to adrenal insufficiency and a life-threatening condition called adrenal crisis. Patients undergoing surgery or experiencing significant stress require higher doses of steroids to prevent adrenal crisis. It is important for healthcare providers to monitor and adjust steroid doses accordingly during stressful situations such as surgery.
Question 5 of 5
Pulmonary edema is characterized by:
Correct Answer: C
Rationale: Pulmonary edema is characterized by increased hydrostatic pressure in the pulmonary capillaries and a rise in pulmonary venous pressure, which leads to fluid leaking out of the pulmonary capillaries and into the alveoli. This results in elevated left ventricular end-diastolic pressure, which is a key characteristic of pulmonary edema. Therefore, all of the above alterations (increased hydrostatic pressure, a rise in pulmonary venous pressure, and elevated left ventricular end-diastolic pressure) are seen in pulmonary edema.