The client receives tamoxifen (Nolvadex) for treatment of breast cancer. She asks the nurse why the medicine works. What is the best response by the nurse?
1. "Tamoxifen (Nolvadex) works by blocking estrogen receptors on breast tissue."
2. "Tamoxifen (Nolvadex) works by inhibiting the cellular mitosis of breast cancer."
3. "Tamoxifen (Nolvadex) works by inhibiting the metabolism of breast cancer cells."
4. "Tamoxifen (Nolvadex) works by binding to the DNA of breast cancer cells."
1
Rationale 1: Breast cancer is dependent on estrogen for growth. Tamoxifen (Nolvadex) acts by blocking estrogen receptors; the tumor is deprived of estrogen.
Rationale 2: Tamoxifen does not inhibit the cellular mitosis of breast cancer.
Rationale 3: Tamoxifen does not inhibit the metabolism of breast cancer cells.
Rationale 4: Tamoxifen does not bind to the DNA of breast cancer cells.
Global Rationale: Breast cancer is dependent on estrogen for growth. Tamoxifen (Nolvadex) acts by blocking estrogen receptors; the tumor is deprived of estrogen. It does not inhibit cellular mitosis or metabolism and does not bind to the DNA of breast cancer cells.
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You are caring for a 65-year-old widower whose wife died 4 months ago. He tells you that he is "not doing well" and that his friends and family seem hesitant to talk with him about his wife. What could the nurse do to help the patient?
A) Refer him to a consciousness-raising group. B) Refer him to a psychiatrist. C) Refer him to a support group. D) Refer him to a church or temple.
Which questions will the nurse plan to ask when assessing a client's ethnicity, which may impact their healthcare needs?
Select all that apply. 1. "What is your religious preference?" 2. "Are there any foods or dietary practices that will impact your care?" 3. "Which ethnic group do you identify yourself as belonging to?" 4. "Does your mother practice the same religion as you?" 5. "What political party do you belong to?"
The nurse is caring for an 82-year-old patient. The nurse knows that changes in cardiac structure and function occur in older adults. What is a normal change expected in the aging heart of an older adult?
A) Decreased left ventricular ejection time B) Decreased connective tissue in the SA and AV nodes and bundle branches C) Thinning and flaccidity of the cardiac values D) Widening of the aorta
A patient is in a hospice receiving palliative care for lung cancer. The cancer has metastasized to the liver and bones. The patient is experiencing dyspnea. What might the nurse do to help to relive the dyspnea the patient is experiencing?
A) A fluid bolus B) High-flow oxygen to treat low oxygen saturation C) High doses of opioids D) Administer corticosteroids as ordered