A client has squamous cell cancer of the right lung that has metastasized to the brain. In addition to chemotherapy for lung cancer, the physician prescribes lomustine (CeeNU), 100 mg/m2 as a single dose, to treat the brain metastasis. What are the major administration and excretion routes of lomustine?
- A. Oral administration and urinary
- B. I.V. administration and urinary excretion
- C. I.V administration and fecal excretion
- D. Oral administration and fecal excretion
Correct Answer: B
Rationale: The correct answer is B: I.V. administration and urinary excretion. Lomustine is typically administered intravenously, allowing for rapid systemic distribution. The drug is metabolized in the liver and excreted primarily through the kidneys, thus the urinary route. This choice is correct as lomustine's pharmacokinetics align with this pattern.
A: Oral administration and urinary - While some drugs are administered orally, lomustine is not typically given orally due to poor bioavailability.
C: I.V. administration and fecal excretion - Lomustine is not primarily excreted via the feces, making this choice incorrect.
D: Oral administration and fecal excretion - Lomustine is not primarily excreted via the feces, making this choice incorrect.
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What should a male client over age 50 do to help ensure early identification of prostate cancer?
- A. Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly
- B. Have a transrectal ultrasound every 5 years
- C. Perform monthly testicular self-examinations, especially after age 50
- D. Have a complete blood count (CBC) and blood urea nitrogen (BUN) and creatinine levels
Correct Answer: A
Rationale: The correct answer is A: Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly. This is because regular screening with both tests can help detect prostate cancer early. The digital rectal exam allows the doctor to feel for any abnormalities in the prostate gland, while the PSA test measures the levels of a specific protein produced by the prostate gland. If there are any concerning findings, further diagnostic tests can be done to confirm prostate cancer.
Choice B is incorrect because transrectal ultrasound is not a recommended screening test for prostate cancer. Choice C is incorrect as testicular self-examinations are for detecting testicular cancer, not prostate cancer. Choice D is incorrect as CBC, BUN, and creatinine levels are not specific tests for prostate cancer screening.
A client with pernicious anemia is receiving parenteral vitamin B12 therapy. Which client statement indicates effective teaching about this therapy?
- A. “I will receive parenteral vitamin B12 therapy until my signs and symptoms disappear.”
- B. “I will receive parenteral vitamin B12 therapy until my vitamin B12 level returns to normal.”
- C. “I will receive parenteral vitamin B12 therapy monthly for 6 months to a year.”
- D. “I will receive parenteral vitamin B12 therapy for the rest of my life.”
Correct Answer: D
Rationale: The correct answer is D: “I will receive parenteral vitamin B12 therapy for the rest of my life.” This statement is correct because pernicious anemia is a lifelong condition requiring ongoing vitamin B12 supplementation. Patients with pernicious anemia lack intrinsic factor, which is needed to absorb vitamin B12 from food. Therefore, they need lifelong B12 therapy to prevent complications such as anemia and neurological damage.
Choices A, B, and C are incorrect because they suggest a limited duration of therapy. Pernicious anemia is a chronic condition that necessitates continuous treatment. Choice A implies therapy until signs and symptoms disappear, which may not address the underlying cause of the deficiency. Choice B mentions therapy until vitamin B12 levels normalize, which may not prevent recurrence. Choice C suggests monthly therapy for a fixed period, which may not be sufficient for lifelong management.
At a public health fair, a nurse discusses the dangers of sun exposure. Prolonged sun exposure has been blamed for which form of cancer?
- A. Malignant melanoma
- B. Basal cell epithelioma
- C. Squamous cell carcinoma
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D: All of the above. Malignant melanoma, basal cell epithelioma, and squamous cell carcinoma are all forms of skin cancer associated with prolonged sun exposure. Melanoma is the deadliest form, originating in melanocytes; basal cell and squamous cell carcinomas are more common but less aggressive. All three types can develop due to cumulative UV radiation exposure. Therefore, all options are correct in this context.
A nurse adds a nursing diagnosis to a patient’s care plan. Which information did the nurse document?
- A. Decreased cardiac output related to altered myocardial contractility.
- B. Patient needs a low-fat diet related to inadequate heart perfusion. NursingStoreRN
- C. Offer a low-fat diet because of heart problems.
- D. Acute heart pain related to discomfort.
Correct Answer: A
Rationale: The correct answer is A because it follows the correct format of a nursing diagnosis: "Problem related to Etiology." In this case, "Decreased cardiac output" is the problem, and "altered myocardial contractility" is the cause. This format helps identify the specific issue and its underlying cause, allowing for targeted interventions. Choice B is incorrect as it doesn't follow the problem-etiology format and lacks specificity. Choice C is also incorrect as it lacks a clear nursing diagnosis and specific etiology. Choice D is incorrect as it presents a symptom rather than a nursing diagnosis with an associated cause. Overall, choice A is the best option as it provides a clear, specific nursing diagnosis that guides appropriate nursing interventions.
The nurse is preparing to assist the physician with a bone marrow biopsy. Which of the ff. interventions is most important for the nurse to do before the procedure?
- A. Explain the procedure to the patient’s family
- B. Observe the patient for bleeding
- C. Administer an analgesic to the patient
- D. Drape the biopsy site
Correct Answer: B
Rationale: The correct answer is B: Observe the patient for bleeding. Before a bone marrow biopsy, it is crucial to monitor the patient for bleeding tendencies as the procedure can cause bleeding. This step ensures early detection and prompt intervention if bleeding occurs.
Explanation for other choices:
A: Explaining the procedure to the family is important for informed consent but not the most crucial before the procedure.
C: Administering an analgesic may be necessary for pain management but monitoring for bleeding takes precedence.
D: Draping the biopsy site is important for maintaining a sterile field but does not directly impact patient safety like monitoring for bleeding.