Nclex Questions Med/surg Chapters 12-17

Front 1

A patient one day postoperative after abdominal surgery has incisional pain, 99.5 temp, slight erythema at the incision margins, and 30 ml serosanguineous drainage in the Jackson-Pratt drain. Based on this assessment, what conclusion would the nurse make?
incision shows signs of an infection
normal inflammatory response
shows signs of impending dehiscence
physician needs to be notified about her condition

Back 1

normal inflammatory response

Front 2

A patient in the unit has a 103.7 temp. Which intervention would be most effective in restoring normal body temp?

cooling blanket
antipyretics on an around the clock schedule
increased fluids and have the UAP give sponge bath
prescribed antibiotics and warm blankets

Back 2

antipyretics on an around the clock schedule

Front 3

A nurse is caring for a patient who has a pressure ulcer that is treated with debridement, irrigations, and moist gauze dressings. How should the nurse anticipate healing to occur?

tertiary intention
secondary intention
regeneration of cells
remodeling of tissues

Back 3

secondary intention

Front 4

A nurse is caring for a patient with diabetes who is scheduled for amputation of his necrotic left greater toe. The patient's WBC count is 15.0 X 10/6/UL and he has coolness of the lower extremities, weighs 75 pounds more than his ideal weight, and smokes two packs of cigarettes per day. Which priority nursing diagnosis addresses the primary factor affecting the patient's ability to heal?

Imbalanced nutrition due to high fat foods
impaired tissue integrity related to decreased blood flow from diabetes and smoking
ineffective peripheral tissue perfusion related to narrowed blood vessels secondary to diabetes and smoking
ineffective coping dealing with indifference and denial of long term effects of diabetes and smoking

Back 4

impaired tissue integrity related to decreased blood flow from diabetes and smoking

Front 5

Which one of the orders should a nurse question in the plan of care for a patient with a stage III pressure ulcer?

pack the ulcer with foam dressing
turn and position every 2 hours
clean the ulcer every shift with Dakins solution
assess for pain and medicate before dressing change

Back 5

clean the ulcer every shift with Dakin's solution

Front 6

The nurse assessing a patient with a chronic leg wound finds local signs of erythema and pain at the wound site. What would the nurse anticipate being ordered to assess the patient's systemic response?

serum protein analysis
WBC count and differential
punch biopsy of center of wound
culture and sensitivity of the wound

Back 6

WBC count an differential

Front 7

An 85 year old patient is assessed to have a score of 16 on the Braden scale. based on this info, how should the nurse plan for this patient's care?

implement a q2hr turning schedule with skin assess
place Duoderm on the patient's sacrum
elevate the head of the bed 90 degrees
continue with weekly skin assessments with no special precautions

Back 7

implement a q2hr turning schedule with skin assess

Front 8

A 65 year old stroke patient with limited mobility has a purple area of suspected deep tissue injury on the left greater trochanter. Which nursing diagnosis is/are most appropriate (select all that apply)?

acute pain related to tissue damage and inflammation
impaired skin integrity related to immobility and decreased sensitivity
impaired tissue integrity related to inadequate circulation secondary to pressure
risk for infection related to loss of tissue integrity and undernutrition secondary to stroke

Back 8

impaired skin integrity related to immobility and decreased sensitivity
impaired tissue integrity related to inadequate circulation secondary to pressure

Front 9

An 82 year old man is being cared for at home by his family. A pressure ulcer on his right buttock measures 1 x 2 x 0.8 cm in depth and pink subcutaneous tissue is completely visible on the wound bed. Which stage would the nurse document on the wound assessment form?

I
II
III
IV

Back 9

III

Front 10

When assessing a patient who is receiving cefazolin (Ancef) for the treatment of a bacterial infection, which data suggest that treatment has been effective?
White blood cell (WBC) count 8000/μL, temperature 101○ F
White blood cell (WBC) count 4000/μL, temperature 100○ F
White blood cell (WBC) count 8500/μL, temperature 98.4○ F
White blood cell (WBC) count 16,500/μL, temperature 98.8○ F

Back 10

White blood cell (WBC) count 8500/μL, temperature 98.4○ F

Front 11

A patient is ordered to receive acetaminophen 650 mg per rectum every 6 hours as needed for fever greater than 102° F. Which parameter would the nurse monitor, other than temperature, if the patient requires this medication?

Pain level
Intake and output
Oxygen saturation
Level of consciousness

Back 11

Intake and output

Front 12

The nurse determines that the patient may be suffering from an acute bacterial infection based upon which laboratory test result?
Increased platelet count
Increased blood urea nitrogen
Increased number of band neutrophils
Increased number of segmented myelocytes

Back 12

Increased number of band neutrophils

Front 13

Which strategy by the nurse would be most helpful in treating a patient who is experiencing chills because of an infection

Provide a light blanket.
Encourage a hot shower.
Monitor temperature every hour.
Turn up the thermostat in the patient's room.

Back 13

Provide a light blanket.

Front 14

A patient with pneumonia has a fever of over 103o F. What should the nurse do to manage the patient's fever?
Administer aspirin on a scheduled basis around the clock.
Provide acetaminophen every 4 hours to maintain consistent blood levels.
Administer acetaminophen when the patient's oral temperature exceeds 103.5° F.
Provide drug interventions if complementary and alternative therapies have failed.

Back 14

Provide acetaminophen every 4 hours to maintain consistent blood levels.

Front 15

A patient has been provided with a compression dressing in an attempt to facilitate rapid healing of an ankle sprain. What is a priority nursing assessment?
Frequent examination of the character and quantity of exudate
Monitoring for signs and symptoms of local or systemic infections
Assessment of the patient's circulation distal to the location of the dressing
Assessment of the range of motion of the ankle and the patient's activity tolerance

Back 15

Assessment of the patient's circulation distal to the location of the dressing

Front 16

A patient had abdominal surgery last week. The patient calls the office and says the wound is now draining thick white material and it smells funny. How should the nurse document this drainage?
Serous
Purulent
Fibrinous
Catarrhal

Back 16

purulent

Front 17

The patient has inflammation and is complaining of malaise, nausea, and anorexia. The nurse explains to the patient that these manifestations are related to inflammation in what way?
Local response
Systemic response
Infectious response
Acute inflammatory response

Back 17

Systemic response

Front 18

An older patient is transferred from the nursing home with a black wound on her heel. What should the nurse expect to be the first treatment of this wound?
Dress it with an absorbent dressing for exudate.
Handle the wound gently and let it dry out to heal.
Debride the nonviable, eschar tissue to allow healing
Use negative-pressure wound (vacuum) therapy to facilitate

Back 18

Debride the nonviable, eschar tissue to allow healing

Front 19

A postoperative patient is now able to eat and is requesting a snack. What snack should the nurse recommend for the patient that will facilitate wound healing?
Apple Incorrect
Custard
Popsicle
Potato chips

Back 19

Custard

Front 20

A nurse is teaching a patient how to promote healing following abdominal surgery. What should be included in the teaching (select all that apply)?
Take the antibiotic until the wound feels better.
Take the analgesic every day to promote adequate rest for healing.
Be sure to wash hands after changing the dressing to avoid infection.
Take in more fluid, protein, and vitamins C, B, and A to facilitate healing.
Notify the health care provider of redness, swelling, and increased drainage.

Back 20

Take in more fluid, protein, and vitamins C, B, and A to facilitate healing.
Notify the health care provider of redness, swelling, and increased drainage.

Front 21

After the unlicensed assistive personnel (UAP) bathed the patient, she then told the nurse about a reddened area on the patient's coccyx. After assessing the area, what should the nurse have the UAP do for the patient?

Reposition every 2 hours.
Measure the size of the reddened area.
Massage the area to increase blood flow.
Evaluate the area later to see if it is better.

Back 21

Reposition every 2 hours.

Front 22

The unlicensed assistive personnel (UAP) is assisting the patient with Crohn's disease with perineal care. The UAP tells the nurse that the patient had feces coming from the vagina. What should the nurse do about this situation?
Notify the health care provider
Document the fistula formation.
Assess the patient and vaginal drainage
Have the UAP apply a dressing to the vagina.

Back 22

Assess the patient and vaginal drainage

Front 23

The patient previously had a breast reduction. She has come to the surgeon's office complaining about excess soft pink tissue where a scar should be forming. What complication of wound healing does the nurse recognize this to be?
Adhesion
Contractions
Keloid formation
Excess granulation tissue

Back 23

Excess granulation tissue

Front 24

After the surgeon tells the patient that his wound will be allowed to heal by secondary intention, the patient asks the nurse what that is. How should the nurse explain this to the patient?
The wound will be stapled together until it heals.
The healing will contract the area to close the wound.
The wound will be left open and heal from the edges inward.
The wound will be sutured after the current infection is controlled.

Back 24

The wound will be left open and heal from the edges inward.

Front 25

If a person is a heterozygous for a given gene, it means that the person ?

is a carrier for a genetic disorder
is affected by the genetic disorder
has two identical alleles for the gene
has two different alleles for the gene

Back 25

has two different alleles for the gene

Front 26

Common causes of genetic mutations include (select all that apply )

dna damage from toxins
dna damage from UV radiation
inheritance of altered genes from the father
inheritance of altered genes from the mother
inheritance of somatic mutations from either parent

Back 26

dna damage from toxins
dna damage from UV radiation
inheritance of altered genes from the father
inheritance of altered genes from the mother

Front 27

A father who has an X-linked recessive disorder and a wife with a normal genotype will?

pass the carrier state to his male children
pass the carrier state to all of his children
pass the carrier state to all his female children
not pass on the genetic mutation to any of his kids

Back 27

pass the carrier state to all his female children

Front 28

What characterizes multifocal genetic disorders?

Genetic testing available for most disorders
commonly caused by single gene alterations
many family members report having the disorder
caused by complex interactions of genetic and environmental factors

Back 28

caused by complex interactions of genetic and environmental factors

Front 29

If a person tests positive for a genetic mutation, it means (select all that apply)

lab found an alteration in a gene
person is predisposed to develop a genetic disease
that the person
person will develop that disease at some point
there is no possibility that other family members may also be at risk
that the person should not have any children or any additional children

Back 29

there is no possibility that other family members may also be at risk
lab found an alteration in a gene

Front 30

What role does pharmacogentics have in health care?

it can assess individual variability to many drugs
it can be used to determine the effectiveness of a drug
it provides important assessment data for gene therapy
it can assess the variability of drug responses due to single genes

Back 30

it can assess the variability of drug responses due to single genes

Front 31

A couple who recently had a son with hemophilia A is consulting with a nurse. They want to know if their next child will have hemophilia A. The nurse can tell the parents that if their child is a

boy, he will have it
boy, he will be a carrier
girl, she will be a carrier
girl, 50% chance she will be a carrier

Back 31

girl, 50% chance she will be a carrier

Front 32

r which individual is genetic carrier screening indicated?
A patient with a history of type 1 diabetes
A patient with a family history of sickle cell disease
A patient whose mother and sister died of breast cancer
A patient who has a long-standing history of iron-deficiency anemia

Back 32

A patient with a family history of sickle cell disease

Front 33

A young mother is worried that her female baby will have hemophilia because the baby's father has it. How should the nurse explain this genetic disorder to the young mother?
Nearly all affected people are male.
Daughters of affected males will be carriers.
The daughter has a 50% chance of being affected.
If the mother is a carrier, the patient could have hemophilia.

Back 33

If the mother is a carrier, the patient could have hemophilia.

Front 34

Two sons of a father who has Huntington's disease cannot agree on whether or not to be tested for Huntington's disease because of the cost. What assistance should the nurse give when discussing presymptomatic genetic testing with these men?
"If one brother has the disease, the other brother will as well."
"A positive genetic mutation increases your risk of the disease."
"If there is a positive result, the patient will be diagnosed with the disease."
"You could use a direct-to-consumer genetic test for making future life decisions."

Back 34

"If there is a positive result, the patient will be diagnosed with the disease."

Front 35

The couple is adopting a baby girl. What health information related to the baby's biologic parents will be most useful to the parents and the baby as she grows up?
The grandmother had breast cancer.
The family has a history of Alzheimer's disease.
The family has an individual with Down syndrome.
The family has familial adenomatous polyposis (FAP).

Back 35

The family has familial adenomatous polyposis (FAP).

Front 36

The parents of a child diagnosed with cystic fibrosis ask the nurse what happened to cause this disease. What is the best response by the nurse?
It is X-linked so it was passed to the child from the mother.
It is a chromosome disorder that usually skips a generation.
It is autosomal recessive so both copies of the gene are abnormal.
It is autosomal dominant so the abnormal gene allele is expressed instead of the normal allele.

Back 36

It is autosomal recessive so both copies of the gene are abnormal.

Front 37

The patient has late stage non-small cell lung cancer. The physician is considering using crizotinib (Xalkori) for this patient. What should be done before it is prescribed for the patient?
Give chemotherapy first.
Test for hypersensitivity to this drug.
Test for the abnormal anaplastic lymphoma kinase (ALK) gene.
Test for gene abnormalities that will affect the appropriate dose.

Back 37

Test for the abnormal anaplastic lymphoma kinase (ALK) gene.

Front 38

A 5-year-old girl was diagnosed with type 1 diabetes mellitus. The mother says that no one else in her family has had diabetes and asks why her daughter would get it. How should the nurse explain this complex disease?
It is a congenital disorder that she was born with.
It is a single gene disorder, meaning only one gene mutation caused the disease.
It is a multifactorial genetic disorder caused by one or more genes and environmental factors.
It was an acquired genetic mutation, meaning she developed it, but her children will not have it.

Back 38

It is a multifactorial genetic disorder caused by one or more genes and environmental factors.

Front 39

The woman with ovarian cancer would like to know which kind of genetic testing could help prevent her daughters from getting ovarian cancer. What should the nurse tell this patient?
Forensic testing
Carrier screening
Predictive testing
Prenatal diagnostic testing

Back 39

Predictive testing

Front 40

The couple is delivering their first child. What newborn genetic screening should the nurse teach them about (select all that apply)?
Pheylketonuria
Dienoyl-CoA reductase
Polycystic kidney disease
Congenital hypothyroidism
Hereditary nonpolyposis colorectal cancer syndrome

Back 40

Pheylketonuria
Congenital hypothyroidism

Front 41

A patient with a father with polycystic kidney disease does not want to have genetic testing done for polycystic kidney disease because she is worried that she might lose her health insurance if genetic abnormalities are found. Based on the nurse's knowledge of the Genetic Information Nondiscrimination Act (GINA), what should the nurse teach this patient?
GINA should protect her from this happening.
GINA does not extend to cover preexisting conditions.
GINA will only protect her after she is diagnosed with polycystic kidney disease.
GINA health coverage nondiscrimination protection also extends to life insurance.

Back 41

GINA should protect her from this happening.

Front 42

!e function of monocytes in immunity is related to their ability to
a. stimulate the production of T and B lymphocytes.
b. produce antibodies on exposure to foreign substances.
c. bind antigens and stimulate natural killer cell activation.
d. capture antigens by phagocytosis and present them to lymphocytes.

Back 42

capture antigens by phagocytosis and present them to lymphocytes.

Front 43

One function of cell-mediated immunity is
a. formation of antibodies.
b. activation of the complement system.
c. surveillance for malignant cell changes.
d. opsonization of antigens to allow phagocytosis by neutrophils.

Back 43

surveillance for malignant cell changes.

Front 44

!e reason newborns are protected for the "rst 6 months of life
from bacterial infections is because of the maternal transmission of
a. IgG.
b. IgA.
c. IgM.
d. IgE

Back 44

IgG

Front 45

In a type I hypersensitivity reaction the primary immunologic
disorder appears to be
a. binding of IgG to an antigen on a cell surface.
b. deposit of antigen-antibody complexes in small vessels.
c. release of cytokines used to interact with speci"c antigens.
d. release of chemical mediators from IgE-bound mast cells and
basophils.

Back 45

release of chemical mediators from IgE-bound mast cells and
basophils.

Front 46

!e nurse is alerted to possible anaphylactic shock immediately
a%er a patient has received intramuscular penicillin by the development
of
a. edema and itching at the injection site.
b. sneezing and itching of the nose and eyes.
c. a wheal-and-$are reaction at the injection site.
d. chest tightness and production of thick sputum.

Back 46

a. edema and itching at the injection site.

Front 47

!e nurse advises a friend who asks him to administer his allergy
shots that
a. it is illegal for nurses to administer injections outside of a
medical setting.
b. he is quali"ed to do it if the friend has epinephrine in an injectable
syringe provided with his extract.
c. avoiding the allergens is a more e#ective way of controlling
allergies, and allergy shots are not usually e#ective.
d. immunotherapy should only be administered in a setting
where emergency equipment and drugs are available.

Back 47

immunotherapy should only be administered in a setting
where emergency equipment and drugs are available.

Front 48

Association between HLA antigens and diseases is most commonly
found in what disease conditions?
a. Malignancies
b. Infectious diseases
c. Neurologic diseases
d. Autoimmune disorders

Back 48

Autoimmune disorders

Front 49

A patient is undergoing plasmapheresis for treatment of systemic
lupus erythematosus. !e nurse explains that plasmapheresis is
used in her treatment to
a. remove T lymphocytes in her blood that are producing antinuclear
antibodies.
b. remove normal particles in her blood that are being damaged
by autoantibodies.
c. exchange her plasma that contains antinuclear antibodies with
a substitute $uid.
d. replace viral-damaged cellular components of her blood with
replacement whole blood.

Back 49

exchange her plasma that contains antinuclear antibodies with
a substitute $uid.

Front 50

!e most common cause of secondary immunode"ciencies is
a. drugs.
b. stress.
c. malnutrition.
d. human immunode"ciency virus.

Back 50

drugs

Front 51

What accurately describes rejection following transplantation?
a. Hyperacute rejection can be treated with OKT3.
b. Acute rejection can be treated with sirolimus or tacrolimus.
c. Chronic rejection can be treated with tacrolimus or cyclosporine.
d. Hyperacute reaction can usually be avoided if crossmatching is
done before the transplantation.

Back 51

Hyperacute reaction can usually be avoided if crossmatching is
done before the transplantation.

Front 52

In a person having an acute rejection of a transplanted kidney,
what would help the nurse understand the course of events (select
all that apply)?
a. A new transplant should be considered.
b. Acute rejection can be treated with OKT3.
c. Acute rejection usually leads to chronic rejection.
d. Corticosteroids are the most successful drugs used to treat
acute rejection.
e. Acute rejection is common a%er a transplant and can be treated
with drug therapy.

Back 52

Acute rejection is common a%er a transplant and can be treated
with drug therapy.

Acute rejection can be treated with OKT3.

Front 53

Which statement made by the nurse is most appropriate in teaching patient interventions to minimize the effects of seasonal allergic rhinitis?
"You will need to get rid of your pets."
"You should sleep in an air-conditioned room."
"You would do best to stay indoors during the winter months."
"You will need to dust your house with a dry feather duster twice a week."

Back 53

"You should sleep in an air-conditioned room."

Front 54

When caring for a patient with a known latex allergy, the nurse would monitor the patient closely for a cross-sensitivity to which foods (select all that apply)?
Grapes
Oranges
Bananas
Potatoes
Tomatoes

Back 54

Bananas
Potatoes
Tomatoes
grapes

Front 55

Ten days after receiving a bone marrow transplant, a patient develops a skin rash on his palms and soles, jaundice, and diarrhea. What is the most likely etiology of these clinical manifestations?
The patient is experiencing a type I allergic reaction.
An atopic reaction is causing the patient's symptoms.
The patient is experiencing rejection of the bone marrow.
Cells in the transplanted bone marrow are attacking the host tissue.

Back 55

Cells in the transplanted bone marrow are attacking the host tissue.

Front 56

A patient's low hemoglobin and hematocrit have necessitated a transfusion of packed red blood cells (RBCs). Shortly after the first unit of RBCs starts to infuse, the patient develops signs and symptoms of a transfusion reaction. Which type of hypersensitivity reaction has the patient experienced?
Type I
Type II
Type III
Type IV

Back 56

Type II

Front 57

A patient has begun immunotherapy for the treatment of intractable environmental allergies. When administering the patient's immunotherapy, what is the nurse's priority action?
Monitor the patient's fluid balance.
Assess the patient's need for analgesia.
Monitor for signs and symptoms of an adverse reaction.
Assess the patient for changes in level of consciousness.

Back 57

Monitor for signs and symptoms of an adverse reaction.

Front 58

A healthy 65-year-old man who lives at home is at the clinic requesting a "flu shot." When assessing the patient, what other vaccinations should the nurse ask the patient about receiving (select all that apply)?
Shingles
Pneumonia
Meningococcal
Haemophilus influenzae type b (Hib)
Measles, mumps, and rubella (MMR)

Back 58

Shingles
Pneumonia

Front 59

On initial assessment of an older patient, the nurse knows to look for certain types of diseases because which immunologic response increases with age?
Autoimmune response
Cell-mediated immunity
Hypersensitivity response
Humoral immune response

Back 59

Autoimmune response

Front 60

A 21-year-old student had taken amoxicillin once as a child for an ear infection. She is given an injection of Penicillin V and develops a systemic anaphylactic reaction. What manifestations would be seen first?
Dyspnea
Dilated pupils
Itching and edema
Wheal-and-flare reaction

Back 60

Itching and edema

Front 61

The patient with an allergy to bee stings was just stung by a bee. After administering oxygen, removing the stinger, and administering epinephrine, the nurse notices the patient is hypotensive. What should be the nurse's first action?
Administer IV diphenhydramine (Benadryl).
Administer nitroprusside as soon as possible.
Anticipate tracheostomy with laryngeal edema.
Place the patient recumbent and elevate the legs.

Back 61

Place the patient recumbent and elevate the legs.

Front 62

The patient with an autoimmune disease will be treated with plasmapheresis. What should the nurse teach the patient about this treatment?
It will gather platelets for use later when needed.
It will cause anemia because it removes whole blood and RBCs are damaged.
It will remove the IgG autoantibodies and antigen complexes from the plasma.
It will remove the peripheral stem cells in order to cure the autoimmune disease.

Back 62

It will remove the IgG autoantibodies and antigen complexes from the plasma.

Front 63

The patient with diabetes mellitus has been ill for some time with a severe lung infection needing corticosteroids and antibiotics. The patient does not feel like eating. The nurse understands that this patient is likely to develop
major histoincompatibility.
primary immunodeficiency.
secondary immunodeficiency.
acute hypersensitivity reaction.

Back 63

secondary immunodeficiency.

Front 64

Which statement by the patient who has had an organ transplant would indicate that the patient understands the teaching about the immunosuppressive medications?
"My drug dosages will be lower because the medications enhance each other."
"Taking more than one medication will put me at risk for developing allergies."
"I will be more prone to malignancies because I will be taking more than one drug."
"The lower doses of my medications can prevent rejection and minimize the side effects."

Back 64

"The lower doses of my medications can prevent rejection and minimize the side effects."

Front 65

Trends in the incidence and death rates of cancer include the fact
that
a. lung cancer is the most common type of cancer in men.
b. a higher percentage of women than men have lung cancer.
c. breast cancer is the leading cause of cancer deaths in women.
d. African Americans have a higher death rate from cancer than
whites.

Back 65

d

Front 66

What features of cancer cells distinguish them from normal cells
(select all that apply)?
a. Cells lack contact inhibition.
b. Cells return to a previous undi"erentiated state.
c. Oncogenes maintain normal cell expression.
d. Proliferation occurs when there is a need for more cells.
e. New proteins characteristic of embryonic stage emerge on cell
membrane.

Back 66

a e b

Front 67

A characteristic of the stage of progression in the development of
cancer is
a. oncogenic viral transformation of target cells.
b. a reversible steady growth facilitated by carcinogens.
c. a period of latency before clinical detection of cancer.
d. proliferation of cancer cells in spite of host control mechanisms.

Back 67

d

Front 68

!e primary protective role of the immune system related to
malignant cells is
a. surveillance for cells with tumor-associated antigens.
b. binding with free antigen released by malignant cells.
c. production of blocking factors that immobilize cancer cells.
d. responding to a new set of antigenic determinants on cancer
cells.

Back 68

a

Front 69

!e primary di"erence between benign and malignant neoplasms
is the
a. rate of cell proliferation.
b. site of malignant tumor.
c. requirements for cell nutrients.
d. characteristic of tissue invasiveness.

Back 69

d

Front 70

!e nurse is caring for a 59-year-old woman who had surgery 1
day ago for removal of a suspected malignant abdominal mass.
!e patient is awaiting the pathology report. She is tearful and says
that she is scared to die. !e most e"ective nursing intervention
at this point is to use this opportunity to
a. motivate change in an unhealthy lifestyle.
b. teach her about the seven warning signs of cancer.
c. instruct her about healthy stress relief and coping practices.
d. allow her to communicate about the meaning of this experience.

Back 70

d

Front 71

!e goals of cancer treatment are based on the principle that
a. surgery is the single most e"ective treatment for cancer.
b. initial treatment is always directed toward cure of the cancer.
c. a combination of treatment modalities is e"ective for controlling
many cancers.
d. although cancer cure is rare, quality of life can be increased
with treatment modalities.

Back 71

c

Front 72

The most e"ective method of administering a chemotherapy agent
that is a vesicant is to
a. give it orally.
b. give it intraarterially.
c. use an Ommaya reservoir.
d. use a central venous access device.

Back 72

d

Front 73

!e nurse explains to a patient undergoing brachytherapy of the
cervix that she
a. must undergo simulation to locate the treatment area.
b. requires the use of radioactive precautions during nursing care.
c. may experience desquamation of the skin on the abdomen and
upper legs.
d. requires shielding of the ovaries during treatment to prevent
ovarian damage.

Back 73

b

Front 74

A patient on chemotherapy and radiation for head and neck
cancer has a WBC count of 1.9 × 103/μL, hemoglobin of 10.8 g/
dL, and a platelet count of 99 × 103/μL. Based on the CBC results,
what is the most serious clinical %nding?
a. Cough, rhinitis, and sore throat
b. Fatigue, nausea, and skin redness at site of radiation
c. Temperature of 101.9° F, fatigue, and shortness of breath
d. Skin redness at site of radiation, headache, and constipation

Back 74

c

Front 75

To prevent fever and shivering during an infusion of rituximab
(Rituxan), the nurse should premedicate the patient with
a. aspirin.
b. acetaminophen.
c. sodium bicarbonate.
d. meperidine (Demerol).

Back 75

b

Front 76

!e nurse counsels the patient receiving radiation therapy or chemotherapy
that
a. e"ective birth control methods should be used for the rest of
the patient’s life.
b. if nausea and vomiting occur during treatment, the treatment
plan will be modi%ed.
c. a$er successful treatment, a return to the person’s previous
functional level can be expected.
d. the cycle of fatigue-depression-fatigue that may occur during
treatment can be reduced by restricting activity.

Back 76

c

Front 77

A patient on chemotherapy for 10 weeks started at a weight of
121 lb. She now weighs 118 lb and has no sense of taste. Which
nursing intervention would be a priority?
a. Advise the patient to eat foods that are fatty, fried, or high in
calories.
b. Discuss with the physician the need for parenteral or enteral
feedings.
c. Advise the patient to drink a nutritional supplement beverage
at least three times a day.
d. Advise the patient to experiment with spices and seasonings to
enhance the &avor of food.

Back 77

d

Front 78

A 70-year-old male patient has multiple myeloma. His wife calls
to report that he sleeps most of the day, is confused when awake,
and complains of nausea and constipation. Which complication
of cancer is this most likely caused by?
a. Hypercalcemia
b. Tumor lysis syndrome
c. Spinal cord compression
d. Superior vena cava syndrome

Back 78

a

Front 79

A patient has recently been diagnosed with early stages of breast
cancer. What is most appropriate for the nurse to focus on?
a. Maintaining the patient’s hope
b. Preparing a will and advance directives
c. Discussing replacement child care for the patient’s children
d. Discussing the patient’s past experiences with her grandmother’s
cancer

Back 79

a

Front 80

The nurse is caring for a patient receiving an initial dose of chemotherapy to treat a rapidly growing metastatic colon cancer. The nurse is aware that this patient is at risk for tumor lysis syndrome (TLS) and will monitor the patient closely for which abnormality associated with this oncologic emergency?
Hypokalemia
Hypouricemia
Hypocalcemia
Hypophosphatemia

Back 80

Hypocalcemia

Front 81

The nurse is caring for a patient suffering from anorexia secondary to chemotherapy. Which strategy would be most appropriate for the nurse to use to increase the patient's nutritional intake?
Increase intake of liquids at mealtime to stimulate the appetite.
Serve three large meals per day plus snacks between each meal.
Avoid the use of liquid protein supplements to encourage eating at mealtime.
Add items such as skim milk powder, cheese, honey, or peanut butter to selected foods.

Back 81

Add items such as skim milk powder, cheese, honey, or peanut butter to selected foods.

Front 82

Which item would be most beneficial when providing oral care to a patient with metastatic cancer who is at risk for oral tissue injury secondary to chemotherapy?
Firm-bristle toothbrush
Hydrogen peroxide rinse
Alcohol-based mouthwash
1 tsp salt in 1 L water mouth rinse

Back 82

1 tsp salt in 1 L water mouth rinse

Front 83

Which nursing diagnosis is most appropriate for a patient experiencing myelosuppression secondary to chemotherapy for cancer treatment?
Acute pain
Hypothermia
Powerlessness
Risk for infection

Back 83

Risk for infection

Front 84

Previous administrations of chemotherapy agents to a cancer patient have resulted in diarrhea. Which dietary modification should the nurse recommend?
A bland, low-fiber diet
A high-protein, high-calorie diet
A diet high in fresh fruits and vegetables
A diet emphasizing whole and organic foods

Back 84

A bland, low-fiber diet

Front 85

A 33-year-old patient has recently been diagnosed with stage II cervical cancer. What should the nurse understand about the patient's cancer?
It is in situ.
It has metastasized.
It has spread locally.
It has spread extensively.

Back 85

It has spread locally.

Front 86

Which cellular dysfunction in the process of cancer development allows defective cell proliferation?
Proto-oncogenes
Cell differentiation
Dynamic equilibrium
Activation of oncogenes

Back 86

Dynamic equilibrium

Front 87

A patient has been diagnosed with Burkitt's lymphoma. In the initiation stage of cancer, the cells genetic structure is mutated. Exposure to what may have functioned as a carcinogen for this patient?
Bacteria
Sun exposure
Most chemicals
Epstein-Barr virus

Back 87

Epstein-Barr virus

Front 88

What can the nurse do to facilitate cancer prevention for the patient in the promotion stage of cancer development?
Teach the patient to exercise daily.
Teach the patient promoting factors to avoid.
Tell the patient to have the cancer surgically removed now.
Teach the patient which vitamins will improve the immune system.

Back 88

Teach the patient promoting factors to avoid.

Front 89

When caring for the patient with cancer, what does the nurse understand as the response of the immune system to antigens of the malignant cells?
Metastasis
Tumor angiogenesis
Immunologic escape
Immunologic surveillance

Back 89

Immunologic surveillance

Front 90

The patient is told that the adenoma tumor is not encapsulated but has normally differentiated cells and that surgery will be needed. The patient asks the nurse what this means. What should the nurse tell the patient?
It will recur.
It has metastasized.
It is probably benign.
It is probably malignant.

Back 90

It is probably benign.

Front 91

The laboratory reports that the cells from the patient's tumor biopsy are Grade II. What should the nurse know about this histologic grading?
Cells are abnormal and moderately differentiated.
Cells are very abnormal and poorly differentiated.
Cells are immature, primitive, and undifferentiated.
Cells differ slightly from normal cells and are well-differentiated.

Back 91

Cells are abnormal and moderately differentiated.

Front 92

The patient and his family are upset that the patient is going through procedures to diagnose cancer. What nursing actions should the nurse use first to facilitate their coping with this situation (select all that apply)?
Maintain hope.
Exhibit a caring attitude.
Plan realistic long-term goals.
Give them antianxiety medications.
Be available to listen to fears and concerns.
Teach them about all the types of cancer that could be diagnosed.

Back 92

Maintain hope.
Exhibit a caring attitude.
Be available to listen to fears and concerns.

Front 93

The patient with breast cancer is having teletherapy radiation treatments after her surgery. What should the nurse teach the patient about the care of her skin?
Use Dial soap to feel clean and fresh.
Scented lotion can be used on the area.
Avoid heat and cold to the treatment area.
Wear the new bra to comfort and support the area.

Back 93

Avoid heat and cold to the treatment area.

Front 94

5.
The female patient is having whole brain radiation for brain metastasis. She is concerned about how she will look when she loses her hair. What is the best response by the nurse to this patient?
"When your hair grows back it will be patchy."
"Don't use your curling iron and that will slow down the loss."
"You can get a wig now to match your hair so you will not look different."
"You should contact "Look Good, Feel Better" to figure out what to do about this."

Back 94

"You can get a wig now to match your hair so you will not look different."

Front 95

The patient is receiving biologic and targeted therapy for ovarian cancer. What medication should the nurse expect to administer before therapy to combat the most common side effects of these medications?
Morphine sulfate
Ibuprofen (Advil)
Ondansetron (Zofran)
Acetaminophen (Tylenol)

Back 95

Acetaminophen (Tylenol)

Front 96

The patient is receiving an IV vesicant chemotherapy drug. The nurse notices swelling and redness at the site. What should the nurse do first?
Ask the patient if the site hurts.
Turn off the chemotherapy infusion.
Call the ordering health care provider.
Administer sterile saline to the reddened area.

Back 96

Turn off the chemotherapy infusion.

Front 97

The patient was told that he would have intraperitoneal chemotherapy. He asks the nurse when the IV will be started for the chemotherapy. What should the nurse teach the patient about this type of chemotherapy delivery?
It is delivered via an Ommaya reservoir and extension catheter.
It is instilled in the bladder via a urinary catheter and retained for 1 to 3 hours.
A Silastic catheter will be percutaneously placed into the peritoneal cavity for chemotherapy administration.
The arteries supplying the tumor are accessed with surgical placement of a catheter connected to an infusion pump.

Back 97

A Silastic catheter will be percutaneously placed into the peritoneal cavity for chemotherapy administration.

Front 98

The patient is being treated with brachytherapy for cervical cancer. What factors must the nurse be aware of to protect herself when caring for this patient?
The medications the patient is taking
The nutritional supplements that will help the patient
How much time is needed to provide the patient's care
The time the nurse spends at what distance from the patient

Back 98

The time the nurse spends at what distance from the patient

Front 99

The patient has osteosarcoma of the right leg. The unlicensed assistive personnel (UAP) reports that the patient's vital signs are normal, but the patient says he still has pain in his leg and it is getting worse. What assessment question should the nurse ask the patient to determine treatment measures for this patient's pain?
"Where is the pain?"
"Is the pain getting worse?"
"What does the pain feel like?"
"Do you use medications to relieve the pain?"

Back 99

"What does the pain feel like?"

Front 100

The patient has been diagnosed with non-small cell lung cancer. Which type of targeted therapy will most likely be used for this patient to suppress cell proliferation and promote programmed tumor cell death?
Proteasome inhibitors
BCR-ABL tyrosine kinase inhibitors
CD20 monoclonal antibodies (MoAb)
Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TK)

Back 100

BCR-ABL tyrosine kinase inhibitors

Front 101

During the postoperative care of a 76-year-old patient, the nurse monitors the patient’s intake and output carefully, knowing that the patient is at risk for fluid and electrolyte imbalances primarily because
a. older adults have an impaired thirst mechanism and need reminding to drink fluids.
b. water accounts for a greater percentage of body weight in the older adult than in younger adults.
c. older adults are more likely than younger adults to lose extra- cellular fluid during surgical procedures.
d. small losses of fluid are more significant because body fluids account for only about 50% of body weight in older adults.

Back 101

d. small losses of fluid are more significant because body fluids account for only about 50% of body weight in older adults.

Front 102

During administration of a hypertonic IV solution, the mecha- nism involved in equalizing the fluid concentration between ECF and the cells is
a. osmosis.
b. diffusion.
c. active transport.
d. facilitated diffusion.

Back 102

a. osmosis.

Front 103

An older woman was admitted to the medical unit with dehydra- tion. Clinical indications of this problem are (select all that apply) a. weight loss.
b. dry oral mucosa.
c. full bounding pulse.
d. engorged neck veins.
e. decreased central venous pressure.

Back 103

a. weight loss.
b. dry oral mucosa.
e. decreased Central venous pressure

Front 104

The nursing care for a patient with hyponatremia includes a. fluid restriction.
b. administration of hypotonic IV fluids.
c. administration of a cation-exchange resin.
d. increased water intake for patients on nasogastric suctioning

Back 104

a. fluid restriction.

Front 105

The nurse should be alert for which manifestations in a patient receiving a loop diuretic?
a. Restlessness and agitation
b. Paresthesias and irritability
c. Weak, irregular pulse and poor muscle tone
d. Increased blood pressure and muscle spasms

Back 105

c. Weak, irregular pulse and poor muscle tone

Front 106

Which patient would be at greatest risk for the potential develop-
ment of hypermagnesemia?
a. 83-year-old man with lung cancer and hypertension
b. 65-year-old woman with hypertension taking β-adrenergic
blockers
c. 42-year-old woman with systemic lupus erythematosus and
renal failure
d. 50-year-old man with benign prostatic hyperplasia and a
urinary tract infection

Back 106

c. 42-year-old woman with systemic lupus erythematosus and
renal failure

Front 107

It is especially important for the nurse to assess for which clinical
manifestation(s) in a patient who has just undergone a total thy- roidectomy (select all that apply)?
a. Confusion
b. Weight gain
c. Depressed reflexes
d. Circumoral numbness e. Positive Chvostek’s sign

Back 107

a. Confusion
d. Circumoral numbness e. Positive Chvostek’s sign

Front 108

The nurse anticipates that treatment of the patient with hyper- phosphatemia secondary to renal failure will include
a. fluid restriction.
b. calcium supplements.
c. loop diuretic therapy.
d. magnesium supplements.

Back 108

b. calcium supplements.

Front 109

The lungs act as an acid-base buffer by
a. increasing respiratory rate and depth when CO2 levels in the
blood are high, reducing acid load.
b. increasing respiratory rate and depth when CO2 levels in the
blood are low, reducing base load.
c. decreasing respiratory rate and depth when CO2 levels in the
blood are high, reducing acid load.
d. decreasing respiratory rate and depth when CO2 levels in the
blood are low, increasing acid load.

Back 109

a. increasing respiratory rate and depth when CO2 levels in the
blood are high, reducing acid load.

Front 110

A patient has the following arterial blood gas results: pH 7.52;
PaCO2 30 mm Hg; HCO3− 24 mEq/L. The nurse determines that these results indicate
a. metabolic acidosis.
b. metabolic alkalosis.
c. respiratory acidosis.
d. respiratory alkalosis.

Back 110

d. respiratory alkalosis.

Front 111

The typical fluid replacement for the patient with a fluid volume
deficit is
a. dextran.
b. 0.45% saline.
c. lactated Ringer’s.
d. 5% dextrose in 0.45% saline.

Back 111

c. lactated Ringer’s.

Front 112

The nurse is unable to flush a central venous access device and suspects occlusion. The best nursing intervention would be to
a. apply warm moist compresses to the insertion site.
b. attempt to force 10 mL of normal saline into the device.
c. place the patient on the left side with head-down position.
d. instruct the patient to change positions, raise arm, and cough.

Back 112

d. instruct the patient to change positions, raise arm, and cough.

Front 113

You are admitting a patient with complaints of abdominal pain, nausea, and vomiting. A bowel obstruction is suspected. You assess this patient for which anticipated primary acid-base imbalance if the obstruction is high in the intestine?
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis

Back 113

Metabolic alkalosis

Because gastric secretions are rich in hydrochloric acid, the patient who is vomiting will lose a significant amount of gastric acid and be at an increased risk for metabolic alkalosis.

Front 114

Which serum potassium result best supports the rationale for administering a stat dose of potassium chloride 20 mEq in 250 mL of normal saline over 2 hours?
3.1 mEq/L
3.9 mEq/L
4.6 mEq/L
5.3 mEq/L

Back 114

3.1 mEq/L

The normal range for serum potassium is 3.5 to 5.0 mEq/L

Front 115

You receive a physician's order to change a patient's IV from D5½ NS with 40 mEq KCl/L to D5NS with 20 mEq KCl/L. Which serum laboratory values on this same patient best support the rationale for this IV order change?
Sodium 136 mEq/L, potassium 4.5 mEq/L
Sodium 145 mEq/L, potassium 4.8 mEq/L
Sodium 135 mEq/L, potassium 3.6 mEq/L
Sodium 144 mEq/L, potassium 3.7 mEq/L

Back 115

Sodium 136 mEq/L, potassium 4.5 mEq/L

The normal range for serum sodium is 135 to 145 mEq/L, and the normal range for potassium is 3.5 to 5.0 mEq/L. The change in the IV order decreases the amount of potassium and increases the amount of sodium. Therefore for this order to be appropriate, the potassium level must be near the high end and the sodium level near the low end of their respective ranges.

Front 116

You are caring for a patient admitted with an exacerbation of asthma. After several treatments, the ABG results are pH 7.40, PaCO2 40 mm Hg, HCO3 24 mEq/L, PaO2 92 mm Hg, and O2 saturation of 99%. You interpret these results as
within normal limits.
slight metabolic acidosis.
slight respiratory acidosis.
slight respiratory alkalosis.

Back 116

within normal limits.

The normal pH is 7.35 to 7.45. Normal PaCO2 levels are 35 to 45 mm Hg, and HCO3 is 22 to 26 mEq/L. Normal PaO2 is >80 mm Hg.

Front 117

You are caring for a patient admitted with a diagnosis of chronic obstructive pulmonary disease (COPD) who has the following arterial blood gas results: pH 7.33, PaO2 47 mm Hg, PaCO2 60 mm Hg, HCO3 32 mEq/L, and O2 saturation of 92%. What is the correct interpretation of these results?
Fully compensated respiratory alkalosis
Partially compensated respiratory acidosis
Normal acid-base balance with hypoxemia
Normal acid-base balance with hypercapnia

Back 117

Partially compensated respiratory acidosis

A low pH (normal 7.35-7.45) indicates acidosis. In the patient with respiratory disease such as COPD, the patient retains carbon dioxide (normal 35-45 mm Hg), which acts as an acid in the body. For this reason, the patient has respiratory acidosis. The elevated HCO3 indicates a partial compensation for the elevated CO2.

Front 118

You are caring for a patient receiving calcium carbonate for the treatment of osteopenia. Which serum laboratory result would you identify as an adverse effect related to this therapy?
Sodium falling to 138 mEq/L
Potassium rising to 4.1 mEq/L
Magnesium rising to 2.9 mg/dL
Phosphorus falling to 2.1 mg/dL

Back 118

Phosphorus falling to 2.1 mg/dL

Calcium has an inverse relationship with phosphorus in the body. When phosphorus levels fall, calcium rises, and vice versa

Front 119

You are caring for a patient admitted with heart failure. The morning laboratory results reveal a serum potassium level of 2.9 mEq/L. Which classification of medications should you withhold until consulting with the physician?
Antibiotics
Loop diuretics
Bronchodilators
Antihypertensives

Back 119

Loop diuretics

Loop diuretics are contraindicated during episodes of hypokalemia because these medications cause the kidneys to excrete sodium and potassium.

Front 120

You are caring for a patient admitted with diabetes mellitus, malnutrition, and massive GI bleed. In analyzing the morning lab results, the nurse understands that a potassium level of 5.5 mEq/L could be caused by which factors in this patient (select all that apply)?
The potassium level may be increased if the patient has renal nephropathy.
The patient may be excreting extra sodium and retaining potassium because of malnutrition.
The potassium level may be increased as a result of dehydration that accompanies high blood glucose levels.
There may be excess potassium being released into the blood as a result of massive transfusion of stored hemolyzed blood.
The patient has been overeating raisins, baked beans, and salt substitute that increase the potassium level.

Back 120

The potassium level may be increased if the patient has renal nephropathy.
The potassium level may be increased as a result of dehydration that accompanies high blood glucose levels.
There may be excess potassium being released into the blood as a result of massive transfusion of stored hemolyzed blood.

Front 121

You are caring for an older patient who is receiving IV fluids postoperatively. During the 8:00 AM assessment of this patient, you note that the IV solution, which was ordered to infuse at 125 mL/hr, has infused 950 mL since it was hung at 4:00 AM. What is the priority nursing intervention?
Notify the physician and complete an incident report.
Slow the rate to keep vein open until next bag is due at noon.
Obtain a new bag of IV solution to maintain patency of the site.
Listen to the patient's lung sounds and assess respiratory status.

Back 121

Listen to the patient's lung sounds and assess respiratory status.

Front 122

When assessing a patient admitted with nausea and vomiting, which finding supports the nursing diagnosis of deficient fluid volume?
Polyuria
Decreased pulse
Difficulty breathing
General restlessness

Back 122

General restlessness

Restlessness is an early cerebral sign that dehydration has progressed to the point where an intracellular fluid shift is occurring. If the dehydration is left untreated, cerebral signs could progress to confusion and later coma.

Front 123

Which nursing intervention is most appropriate when caring for a patient with dehydration?
Auscultate lung sounds every 2 hours.
Monitor daily weight and intake and output.
Monitor diastolic blood pressure for increases.
Encourage the patient to reduce sodium intake.

Back 123

Monitor daily weight and intake and output.

Front 124

When planning the care of a patient with dehydration, what would the nurse instruct the unlicensed assistive personnel (UAP) to report?
60 mL urine output in 90 minutes
1200 mL urine output in 24 hours
300 mL urine output per 8-hour shift
20 mL urine output for 2 consecutive hours

Back 124

20 mL urine output for 2 consecutive hours

The minimal urine output necessary to maintain kidney function is 30 mL/hr. If the output is less than this for 2 consecutive hours, the nurse should be notified so that additional fluid volume replacement therapy can be instituted.

Front 125

When planning care for a patient with dehydration related to nausea and vomiting, the nurse would anticipate which fluid shift to occur because of the fluid volume deficit?
Fluid movement from the blood vessels into the cells
Fluid movement from the interstitial spaces into the cells
Fluid movement from the blood vessels into interstitial spaces
Fluid movement from the interstitial space into the blood vessels

Back 125

Fluid movement from the interstitial space into the blood vessels

In dehydration, fluid is lost first from the blood vessels. To compensate, fluid moves out of the interstitial spaces into the blood vessels to restore circulating volume in that compartment. As the interstitial spaces then become volume depleted, fluid moves out of the cells into the interstitial spaces.

Front 126

When planning care for adult patients, which oral intake is adequate to meet daily fluid needs of a stable patient?
500 to 1500 mL
1200 to 2200 mL
2000 to 3000 mL
3000 to 4000 mL

Back 126

2000 to 3000 mL

Front 127

While caring for a patient with metastatic bone cancer, which clinical manifestations would alert the nurse to the possibility of hypercalcemia in this patient?
Weakness
Paresthesia
Facial spasms
Muscle tremors

Back 127

Weakness

Signs of hypercalcemia are lethargy, headache, weakness, muscle flaccidity, heart block, anorexia, nausea, and vomiting. Paresthesia, facial spasms, and muscle tremors are symptoms of hypocalcemia.

Front 128

While performing patient teaching regarding hypercalcemia, which statements are appropriate (select all that apply)?
Have patient restrict fluid intake to less than 2000 mL/day.
Renal calculi may occur as a complication of hypercalcemia.
Weight-bearing exercises can help keep calcium in the bones.
The patient should increase daily fluid intake to 3000 to 4000 mL.
Treatment of heartburn can best be managed with Tums as needed.

Back 128

Renal calculi may occur as a complication of hypercalcemia.
Weight-bearing exercises can help keep calcium in the bones.
The patient should increase daily fluid intake to 3000 to 4000 mL.

Front 129

The patient has chronic kidney disease and ate a lot of nuts, bananas, peanut butter, and chocolate. The patient is admitted with loss of deep tendon reflexes, somnolence, and altered respiratory status. What treatment should the nurse expect for this patient?
Renal dialysis
IV potassium chloride
IV furosemide (Lasix)
IV normal saline at 250 mL per hour

Back 129

Renal dialysis

Renal dialysis will need to be administered to remove the excess magnesium that is in the blood from the increased intake of foods high in magnesium

Front 130

The patient is admitted with metabolic acidosis. Which system is not functioning normally?
Buffer system
Kidney system
Hormone system
Respiratory system

Back 130

Kidney system

When the patient has metabolic acidosis, the kidneys are not combining H+ with ammonia to form ammonium or eliminating acid with secretion of free hydrogen into the renal tubule.

Front 131

The dehydrated patient is receiving a hypertonic solution. What assessments must be done to avoid risk factors of these solutions (select all that apply)?
Lung sounds
Bowel sounds
Blood pressure
Serum sodium level
Serum potassium level

Back 131

Lung sounds
Blood pressure
Serum sodium level

Front 132

When assessing the patient with a multi-lumen central line, the nurse notices that the cap is off one of the lines. On assessment, the patient is in respiratory distress, and the vital signs show hypotension and tachycardia. What is the nurse's priority action?
Administer oxygen.
Notify the physician.
Rapidly administer more IV fluid.
Reposition the patient to the right side.

Back 132

Administer oxygen.

Front 133

The patient was admitted for a paracentesis to remove ascites fluid. Five liters of fluid was removed. What IV solution may be used to pull fluid into the intravascular space after the paracentesis?
0.9% sodium chloride
25% albumin solution
Lactated Ringer's solution
5% dextrose in 0.45% saline

Back 133

25% albumin solution

After a paracentesis of 5 L or greater of ascites fluid, 25% albumin solution may be used as a volume expander. Normal saline, lactated Ringer's, and 5% dextrose in 0.45% saline will not be effective for this action.