a lobectomy is scheduled for a patient with stage i nonsmall cell lung cancer the patient tells the nurse i would rather have chemotherapy than surge

NCLEX-RN

NCLEX RN Prioritization Questions

1. A patient with stage I nonsmall cell lung cancer expresses a preference for chemotherapy over surgery. Which response by the nurse is most appropriate?

A. Are you concerned about the potential pain from surgery?
B. Have you had negative experiences with previous surgeries?
C. Surgery is the recommended treatment for stage I lung cancer.
D. Tell me about your understanding of the different available treatments.

Correct answer: D

Rationale: The most appropriate response by the nurse in this situation is to gather more information about the patient's concerns and preferences. By asking the patient to share their understanding of the available treatments, the nurse encourages open communication and gains insight into the patient's knowledge and preferences. Option A focuses solely on pain, which may not be the patient's primary concern. Option B assumes negative experiences without exploring the patient's current thoughts. Option C, stating that surgery is the recommended treatment, dismisses the patient's preference and does not address their concerns. Chemotherapy is not the primary treatment for nonsmall cell lung cancer; it may be used for nonresectable tumors or as adjuvant therapy to surgery, making it crucial for the nurse to explore the patient's treatment preferences and understanding.

2. Which patient is at risk for developing oral candidiasis, a type of stomatitis?

A. A 77-year-old woman in a long-term care facility taking an antibiotic
B. A 35-year-old man who has had HIV for 6 years
C. A 40-year-old man who is undergoing chemotherapy
D. An 80-year-old woman with dentures

Correct answer: A

Rationale: The correct answer is a 77-year-old woman in a long-term care facility taking an antibiotic. This patient has multiple risk factors for developing oral candidiasis, including older age, being in a long-term care facility, and taking antibiotics. Candidiasis can be caused by long-term antibiotic therapy, immunosuppressive therapy (such as chemotherapy), older age, living in a long-term care facility, diabetes, having dentures, and poor oral hygiene. Choices B, C, and D are less likely to be at high risk for oral candidiasis compared to the correct answer.

3. Rhogam is most often used to treat mothers that have a infant.

A. RH positive, RH positive
B. RH positive, RH negative
C. RH negative, RH positive
D. RH negative, RH negative

Correct answer: C

Rationale: Rhogam is administered to RH-negative mothers who have an RH-positive infant to prevent the development of anti-RH antibodies in the mother's system. Choice A (RH positive, RH positive) is incorrect because Rhogam is not used when both mother and infant are RH positive. Choice B (RH positive, RH negative) is incorrect because Rhogam is used when the mother is RH negative, not RH positive. Choice D (RH negative, RH negative) is incorrect as Rhogam is not typically needed if both mother and infant are RH negative.

4. The parents of an infant who underwent surgical repair of bladder exstrophy ask if the infant will be able to control their bladder as they get older. How should the nurse respond?

A. Your child will need catheterization until bladder control is gained.
B. Your child will be able to control their bladder like other children.
C. You should potty train your child at the same time you normally would.
D. Your child will not have a sphincter mechanism for the first 3 to 5 years, so urine will drain freely.

Correct answer: D

Rationale: Bladder exstrophy is a congenital defect where the infant is born with the bladder located on the outside of the body. Surgical repair typically occurs within the first 1 to 2 days of life. In the following 3 to 5 years post-surgery, urine will drain freely from the urethra due to the absence of a sphincter mechanism. This period allows the bladder to develop capacity as the child grows. Subsequent surgical interventions will be required to establish a functioning sphincter mechanism. Therefore, the correct response is that the child will not have a sphincter mechanism for the first 3 to 5 years, leading to urine draining freely. Options A, B, and C are incorrect as they do not align with the physiological process and management of bladder exstrophy.

5. Which of the following clients is most appropriate for receiving telemetry?

A. A client with syncope potentially related to cardiac dysrhythmia
B. A client with unstable angina
C. A client with sinus rhythm and PVCs
D. A client who had a myocardial infarction 6 hours ago

Correct answer: A

Rationale: Telemetry is used to monitor the cardiac rhythms of clients with potentially unstable conditions or those rhythms that affect activities. Clients with syncope potentially related to cardiac dysrhythmia require continuous monitoring to detect any potential life-threatening dysrhythmias. Unstable angina can be monitored in a telemetry unit, but syncope with potential cardiac causes takes precedence. Clients with sinus rhythm and PVCs may not necessitate telemetry unless there are further indications of instability. A client who had a myocardial infarction 6 hours ago is typically monitored in an intensive care unit rather than a telemetry unit.