When assignments are being made for clients with alterations related to gastrointestinal (GI) cancer, which client would be the most appropriate to delegate to an LPN/LVN?
- A. A client with severe anemia secondary to GI bleeding
- B. A client who needs enemas and antibiotics to control GI bacteria
- C. A client who needs preoperative teaching for bowel resection surgery
- D. A client who needs central line insertion for chemotherapy
Correct Answer: B
Rationale: Delegating in GI cancer care hinges on scope LPN/LVNs handle routine tasks like administering enemas and antibiotics, a straightforward intervention to curb bacteria, fitting their training under RN oversight. Severe anemia from bleeding demands RN assessment for stability or transfusion, beyond LPN scope. Preoperative teaching requires detailed education and evaluation, an RN's domain. Central line insertion involves advanced skills and risks, reserved for RNs or specialists. Enemas and antibiotics align with LPN/LVN capabilities, optimizing team roles while keeping complex care with RNs, a practical choice in managing GI cancer's multifaceted needs safely and efficiently.
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A client has a platelet count of 9800/mm^3. What action by the nurse is most appropriate?
- A. Assess the client for calf pain, warmth, and redness.
- B. Instruct the client to call for help to get out of bed.
- C. Obtain cultures as per the facility's standing policy.
- D. Place the client on protective isolation precautions.
Correct Answer: B
Rationale: A platelet count of 9800/mm^3 is severely low (normal is 150,000-450,000/mm^3), indicating thrombocytopenia, a common chemotherapy side effect that heightens bleeding risk. The most appropriate action is instructing the client to call for help before getting out of bed to prevent falls or injuries that could trigger uncontrolled bleeding, such as intracranial hemorrhage. Assessing for calf pain, warmth, and redness checks for thrombosis, which is unrelated to low platelets thrombosis risk rises with high counts. Obtaining cultures relates to infection, tied to low white cells, not platelets. Protective isolation is for neutropenia, not thrombocytopenia. This safety-focused intervention minimizes physical risk, crucial in oncology where low platelets demand proactive prevention to avoid life-threatening bleeds, empowering the client while ensuring nurse oversight.
The home health nurse is caring for a patient who has been receiving interferon therapy for treatment of cancer. Which statement by the patient indicates a need for further assessment?
- A. I have frequent muscle aches and pains.'
- B. I rarely have the energy to get out of bed.'
- C. I experience chills after I inject the interferon.'
- D. I take acetaminophen (Tylenol) every 4 hours.'
Correct Answer: B
Rationale: Interferon's flu-like hell aches , chills , and Tylenol use are par but crushing fatigue flags dose-limiting toxicity, hinting at overdose or depression. Nurses in oncology dig deeper here rarely out of bed' could mean more than side effects, needing med tweaks or psych consult, critical for home care balance.
An oncology nurse is caring for a patient who has developed erythema following radiation therapy. What should the nurse instruct the patient to do?
- A. Periodically apply ice to the area
- B. Keep the area cleanly shaven
- C. Apply petroleum jelly to the affected area
- D. Avoid using soap on the treatment area
Correct Answer: D
Rationale: Radiation erythema red, raw skin needs gentle care to dodge worsening. Soap dries and irritates, stripping fragile skin and upping infection risk, so skipping it's key. Ice or heat can burn or blister radiated tissue, already thin and sensitive. Shaving scrapes it raw; petroleum jelly traps moisture, breeding bacteria. Nurses teach this to protect the site, pushing mild cleansers (if needed) and air exposure, standard in oncology to heal radiation burns without sparking new problems.
Which of the following client statements reflect an outcome expectancy statement?
- A. I am not able to exercise
- B. Exercise helps people lose weight
- C. Exercise is too hard on my arthritis
- D. Dietary restrictions work better than exercise to lose weight
Correct Answer: B
Rationale: Outcome expectancy ties behavior to results exercise shedding pounds nails it, a belief nurses tap for motivation. Can't-do's, pain gripes, or diet bets miss that link, just vent or compare. It's a chronic nudge, faith in action's payoff.
The nurse teaches a patient who is scheduled for a prostate needle biopsy about the procedure. Which statement, if made by the patient, indicates that teaching was effective?
- A. The biopsy will remove the cancer in my prostate gland.
- B. The biopsy will determine how much longer I have to live.
- C. The biopsy will help decide the treatment for my enlarged prostate.
- D. The biopsy will indicate whether the cancer has spread to other organs.
Correct Answer: C
Rationale: Prostate biopsy snags tissue to check if enlargement's benign (BPH) or malignant guiding treatment like surgery or radiation. It's not therapeutic , doesn't predict lifespan , and staging spread needs more (e.g., scans). Nurses in oncology stress this it's a diagnostic linchpin, setting the course for managing prostate issues, critical for patient buy-in and clarity.