R.M. is a 58-year-old woman with stage III ovarian carcinoma. Her initial treatment is an exploratory laparotomy with a total abdominal hysterectomy, an ileocecal resection and anastomosis, omentectomy, and
peritoneal biopsies.
The postoperative CA-125 level is 69 units/mL. Family history analysis reveals a strong
positive occurrence of breast and ovarian cancer in R.M.'s family. Her mother died of breast cancer at the
age of 56, and a maternal aunt died of ovarian cancer at the age of 59 . The oncologist suggests testing for
the presence of the BRCA1 and BRCA2 genes and, if the results are positive, testing of R.M.'s two daughters
and son.
Describe the meaning of this test.
Inherited mutations of the BRCA1 and BRCA2 genes have been found to be associated with an
increased risk of breast and ovarian cancer. Persons with either mutation have an increased
risk of breast cancer. Carriers of BRCA1 mutations have an increased risk of ovarian cancer and
microglandular adenosis; carriers of BRCA2 are at increased risk for Fanconi anemia, pancreatic
cancer, and prostate cancer.
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The nurse prepares to assess for the Trousseau and Chvostek signs in a client. For which health problem is the nurse assessing this client?
a. Anemia b. Hypokalemia c. Hypocalcemia d. Hypophosphatemia
The client, a Jehovah's Witness scheduled for surgery, has expressed concern that she might receive blood products, an act condemned by her religion. What is the nurse's best response?
A. "You should allow the health care professionals to do whatever is needed to save your life." B. "Your chances of needing a transfusion during or after surgery are so small that this is not really a problem." C. "Transfusions are not routine and there are now good alternatives to transfusions if you should lose an excessive amount of blood." D. "If you are worried about contamination, you could have members of your family make blood donations ahead of time specifically for you."
The nurse should advise a mother seeking information about vitamin supplementation that:
a. it is unwise to exceed the recommended daily allowance of some vitamins. b. vitamins derived from natural sources are not as good as those derived synthetically. c. megavitamin doses are likely to be more effective than recommended daily allowances. d. fat-soluble vitamins are safer than water-soluble vitamins to supplement.
You are collecting a stool specimen. Which is correct?
a. Transfer the expelled stool to the specimen container. b. Have the person defecate into the speci-men container. c. Use a tongue blade to transfer 2 table-spoons of feces to the specimen container. d. Ask the person to have a bowel movement at the time specified.