ATI Custom: AH2- FA25- Exam 3
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Free ATI Custom: AH2- FA25- Exam 3 Questions
A nurse is caring for a client with breast cancer experiencing hypercalcemia. Which of the following medications is commonly used for the treatment of hypercalcemia?
- Zoledronic acid
- Omeprazole
- Furosemide
- Metformin
Explanation
Zoledronic acid is a bisphosphonate medication commonly used to treat hypercalcemia of malignancy. It works by inhibiting osteoclast-mediated bone resorption, thereby reducing calcium release from bones into the bloodstream. This medication is especially beneficial for clients with cancers that metastasize to bone, such as breast cancer. It is administered intravenously and helps lower serum calcium levels while providing bone protection against further metastasis.
A nurse is educating a client about preventative health. Which of the following are considered risk factors for cancer? (Select All that Apply.)
- Smoking
- Vaccinations
- Fruit and vegetable consumption
- Sun exposure
- Exercise
- Alcohol consumption
- Age
- Obesity
- I. Environmental factors
- J. Genetics
Explanation
Explanation of Correct Answers
A. Smoking:
Smoking is one of the leading preventable causes of cancer worldwide. Tobacco contains numerous carcinogenic substances that damage cell DNA and promote mutations. Prolonged smoking increases the risk of cancers of the lungs, throat, mouth, esophagus, bladder, kidney, pancreas, and cervix. Even secondhand smoke exposure carries significant risk for non-smokers. Quitting smoking significantly reduces cancer risk over time.
D. Sun exposure:
Excessive sun exposure, particularly without protection, exposes the skin to ultraviolet (UV) radiation that damages cellular DNA. Over time, this damage can cause mutations leading to skin cancers such as basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. Preventive measures include wearing sunscreen, protective clothing, and avoiding tanning beds or peak sun hours.
F. Alcohol consumption:
Chronic or excessive alcohol intake increases cancer risk because alcohol and its metabolite, acetaldehyde, are toxic to cells. Alcohol also impairs nutrient absorption and alters hormone levels, contributing to cancers of the mouth, throat, liver, breast, and colon. Reducing or eliminating alcohol consumption lowers this risk.
G. Age:
The risk of developing cancer increases with age due to cumulative exposure to carcinogens, a lifetime of cellular replication errors, and a decline in immune surveillance. Older adults are more susceptible because their cells have had more opportunities to acquire mutations that lead to malignancy.
H. Obesity:
Obesity contributes to chronic inflammation and hormonal imbalances, such as elevated estrogen and insulin levels, which promote tumor growth. Obesity is linked to breast, colon, uterine, pancreatic, and kidney cancers. Weight management through a healthy diet and regular physical activity is crucial in reducing cancer risk.
I. Environmental factors:
Exposure to harmful environmental agents like asbestos, benzene, pesticides, radiation, and industrial chemicals increases cancer risk. Chronic exposure to these carcinogens leads to cellular injury and mutations. Protective measures include workplace safety protocols, using protective equipment, and minimizing contact with known toxins.
J. Genetics:
Inherited mutations in certain genes, such as BRCA1, BRCA2, and TP53, increase susceptibility to cancers including breast, ovarian, and colorectal cancer. While these mutations cannot be prevented, early screening, genetic counseling, and preventive treatments can help reduce mortality through early detection and management.
A nurse is assessing an older adult client who has just been admitted to the medical-surgical unit and presents with a large amount of abdominal ascites. The client is alert and oriented ×3 and states that they walk independently at home and normally use a cane but forgot to bring it to the hospital. Which of the following should be a priority action implemented by the nurse?
- Fall risk protocol
- Sodium restriction diet
- Skin safety protocol
- Bleeding precaution protocol
Explanation
The presence of large abdominal ascites alters the client’s center of gravity, impairs balance, and increases the risk of falls, especially in an older adult who already relies on a cane for mobility. Since the client does not currently have their assistive device, implementing a fall risk protocol is the top priority to ensure immediate safety. This includes providing assistance with ambulation, ensuring the call light is within reach, using nonslip footwear, and possibly arranging a walker or cane while hospitalized. Preventing falls takes precedence before addressing other long-term or secondary issues.
A nurse is caring for a client with a new diagnosis of leukemia. Which of the following lab findings would be expected in a client with leukemia? (Select All that Apply.)
- Low neutrophil count
- Increased platelet count
- Decreased platelet count
- Elevated liver function tests
- Decreased red blood cell count
- Elevated immature white blood cell count
Explanation
Explanation of Correct Answers
A. Low neutrophil count:
Leukemia disrupts normal bone marrow function, leading to decreased production of mature white blood cells, including neutrophils. This neutropenia significantly increases the risk of infection, making infection prevention a major nursing priority for these clients.
C. Decreased platelet count:
Bone marrow suppression caused by leukemic cell overgrowth leads to thrombocytopenia. A decreased platelet count increases the risk of bleeding, bruising, and petechiae. Monitoring for bleeding and implementing bleeding precautions are vital aspects of nursing care.
E. Decreased red blood cell count:
The overproduction of immature leukemic cells crowds out normal red blood cell precursors in the bone marrow, leading to anemia. This results in fatigue, pallor, and shortness of breath. Treatment may include blood transfusions or erythropoietin therapy.
F. Elevated immature white blood cell count:
Leukemia is characterized by uncontrolled proliferation of immature white blood cells (blasts) that are nonfunctional. This causes an abnormally high total WBC count, but with poor immune defense. The presence of blasts in the blood or bone marrow confirms the diagnosis.
A nurse is caring for a client who reports increased anxiety and nervousness, heat intolerance, and unintentional weight loss. Blood testing reveals decreased thyroid-stimulating hormone (TSH), elevated thyroxine (T4), and elevated triiodothyronine (T3) levels. Which of the following vital sign abnormalities does the nurse anticipate?
- Decreased body temperature
- Slow respiratory rate
- Hypotension
- Tachycardia
Explanation
The client’s laboratory results and symptoms indicate hyperthyroidism, specifically an overproduction of thyroid hormones (T3 and T4) and suppression of TSH. These hormones accelerate the body’s metabolic rate, leading to symptoms such as heat intolerance, anxiety, tremors, and tachycardia due to increased oxygen demand and heightened sympathetic nervous system activity. Persistent tachycardia is a hallmark finding and, if untreated, can progress to cardiac arrhythmias or heart failure.
A client is scheduled to have an arteriovenous (AV) fistula created for hemodialysis. What should the nurse include when teaching the client about the fistula? (Select All that Apply.)
- A functioning fistula has a palpable thrill and bruit
- The fistula can be used immediately after its creation
- Avoid using the arm with fistula for blood pressure readings
- You will need to wear restricting clothing over the surgical site to protect the fistula
- Venipuncture should be performed on the arm with the fistula
Explanation
Explanation of Correct Answers
A. A functioning fistula has a palpable thrill and bruit:
A palpable thrill (vibration) and an audible bruit (whooshing sound) indicate adequate blood flow through the AV fistula and confirm patency. The nurse should teach the client to check for these daily, as absence may indicate clotting or blockage requiring immediate medical evaluation.
C. Avoid using the arm with fistula for blood pressure readings:
Blood pressure measurements, IV insertions, and blood draws should never be done on the arm with the AV fistula. Compression or trauma can damage the vascular access, cause clot formation, or compromise blood flow, leading to loss of fistula function. The arm should be protected at all times to maintain long-term dialysis access.
A nurse is assessing a client who is experiencing thyroid storm. Which of the following findings should the nurse anticipate?
- Coma
- Fruity smelling breath
- Hypothermia
- Tachycardia
Explanation
Thyroid storm is a life-threatening complication of uncontrolled hyperthyroidism characterized by excessive thyroid hormone release, leading to severe hypermetabolism. The nurse should anticipate tachycardia, often exceeding 130 beats per minute, as the cardiovascular system becomes overstimulated. Additional findings include high fever, hypertension, anxiety, tremors, diaphoresis, and restlessness. Without prompt treatment—such as beta-blockers, antithyroid medications, and cooling measures—the condition can progress to heart failure, shock, or death.
An emergency department nurse is reviewing the electronic whiteboard at the nurse’s station. Which of the following clients should be assessed first?
- A 59-year-old male who has type 2 diabetes mellitus and is taking metformin
- A 22-year-old female that is alert and oriented x4 with a blood glucose level of 58 mg/dL
- A 38-year-old female who has hyperthyroidism with an elevated temperature and new confusion
- A 46-year-old male with a blood glucose level of 200 mg/dL
Explanation
The client with hyperthyroidism, elevated temperature, and new confusion should be assessed first because these findings suggest thyroid storm, a life-threatening emergency characterized by severe hypermetabolism, high fever, tachycardia, hypertension, and altered mental status. Immediate intervention is needed to prevent cardiovascular collapse and multi-organ failure. Priority actions include stabilizing airway, administering antithyroid medications, beta-blockers, and cooling measures.
The nurse teaches a client about portal hypertension. Which client statement indicates teaching was effective?
- "Portal hypertension means fast-spreading high blood pressure. It causes red veins on my arms."
- "Portal hypertension means high blood pressure throughout my abdomen. It causes me to feel confused."
- "In portal hypertension, blood backs up in the liver. It redistributes to lower pressure areas and can cause enlarged blood vessels in my esophagus."
- "In portal hypertension, blood leaks from my liver. It causes me to feel hungry frequently."
Explanation
Portal hypertension occurs when blood flow through the liver is obstructed, often due to cirrhosis, causing increased pressure in the portal venous system. As a result, blood is redirected to collateral veins in lower-pressure areas such as the esophagus, stomach, and rectum. This leads to the development of esophageal or gastric varices, which are prone to rupture and life-threatening bleeding. The client’s statement correctly explains the mechanism and consequence of portal hypertension.
A nurse is caring for a client who has end-stage kidney disease who will soon begin hemodialysis treatments. Which of the following restrictions should the nurse discuss with the client that may impact quality of life? (Select All that Apply.)
- Restricting fluid intake
- Driving restrictions
- Restricting airplane travel
- Restricting foods high in potassium, sodium, and phosphorus
- Limiting social activities to twice a week
- Time constraints associated with hemodialysis treatment
Explanation
Explanation of Correct Answers
A. Restricting fluid intake
Clients on hemodialysis must limit fluid intake because the kidneys can no longer eliminate excess water efficiently. Excessive fluid can cause hypertension, pulmonary edema, and heart failure. This restriction can affect social experiences and comfort, particularly in hot weather or social situations involving beverages.
D. Restricting foods high in potassium, sodium, and phosphorus
Dietary restrictions are crucial in hemodialysis to prevent dangerous electrolyte imbalances. High potassium foods (bananas, oranges, potatoes), high sodium foods (processed meats, canned soups), and high phosphorus foods (dairy, nuts) must be limited, which can make meal planning difficult and impact quality of life.
F. Time constraints associated with hemodialysis treatment
Hemodialysis typically requires 3–4 sessions per week, each lasting 3–5 hours, limiting work, travel, and social opportunities. The need for transportation and scheduling around treatments often disrupts daily routines and independence.
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