A client has small cell carcinoma of the lung. The nurse should anticipate providing which intervention to the client?
a. Educating the client and family about planned chemotherapy
b. Instructing the client on home care of a chest tube system
c. Preparing the client for lung resection
d. Providing a referral to hospice
D
Small cell carcinoma ("oat cell") does initially respond well to chemo, but the prognosis is very poor because it usually has metastasized when found. Also the high doses of chemotherapy needed for small cell carcinoma often produce toxicity that leads to discontinuation of the treatment. Surgical resection usually does not play a role in treatment because the tumor has usually metastasized by this point. Because of the poor prognosis of this kind of cancer, hospice referral may be the most appropriate option.
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Which term best describes an individual's feelings of anxiety that are broad, long-lasting, and excessive?
a. Generalized anxiety disorder b. Panic attack c. Phobic disorder d. Obsessive-compulsive disorder
A client diagnosed with active tuberculosis is in a negative pressure room for respiratory airborne isolation. How long should the nurse maintain the client in this type of isolation?
1. Until three consecutive sputum specimens for acid fast bacilli are negative 2. Until the Mantoux test (PPD) converts from positive to negative 3. Until the client has orders for discharge 4. Until the chest x-ray is normal
The nurse is preparing to administer methocarbamol (Robaxin) to a patient who is experiencing acute muscle spasms. The nurse notes that the patient's urine has turned black. What will the nurse do?
a. Administer the next dose of methocarbamol since this is a harmless side effect. b. Contact the provider to discuss changing to cyclobenzaprine (Flexeril). c. Obtain an order for a complete blood count to evaluate blood loss. d. Request an order for liver function tests since this indicates hepatotoxicity.
Which example represents a negative patient variance?
1. A patient develops hospital-acquired pneumonia due to noncompliance with respiratory interventions. 2. The nurse administers a mislabeled medication. 3. A CBC was drawn on a patient instead of an ABG. 4. Difficulties were experienced in placing an older adult into long-term care.