The nurse is preparing to care for a patient who has multiple sclerosis (MS). The nurse learns that the patient receives cyclophosphamide (Cytoxan). The nurse knows that this patient is in which stage of MS?
a. Acute attack phase
b. Chronic, progressive phase
c. End-stage phase
d. Remission-exacerbation phase
ANS: B
Cyclophosphamide is used to treat MS patients who are in the chronic, progressive phase.
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A student nurse is administering an enema with an instructor in the room. The patient states that he or she can no longer hold the enema solution
The student nurse acknowledges the patient's request and begins to tell the patient to go to the bathroom but asks the instructor if this is OK. The instructor suggests that the patient wait a few minutes to give the enema solution time to be absorbed into the bowel. In this situation the student nurse demonstrates what level of critical thinking according to Kataoka-Yahiro and Saylor's model? a. Level 1: Basic b. Level 2: Complex c. Level 3: Commitment d. Level 4: Expert
An older adult client is being seen in the dermatology clinic for lesions on the hands and forearm. The client is concerned that he has melanoma and wants to be evaluated
The nurse documents the lesions as small, brown lesions of the hands and forearms. What type of benign lesions are these characteristic of? A) Senile keratoses B) Senile lentigines C) Melanoma D) Freckles
The nurse has gathered her assessment data and notes several significant changes in the client's health status. The client's weight has increased by 5 lb over the past 24 hours, he is short of breath, and crackles are auscultated at both lung bases
To which step of the Nursing Process should the nurse proceed after organizing these data? a. Diagnosis b. Planning c. Implementation d. Evaluation
The nurse on a psychiatric unit is caring for a client with severe depression. The client states, "I just cannot go on. It is hopeless for me and there is no end in sight. My family would be better off without me burdening them."
The nurse recognizes that this client is most at risk for: a. Ineffective coping b. Denial c. Impaired recovery d. Suicide