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A 50-year-old man diagnosed with leukemia will begin chemotherapy. What would the nurse do to combat the most common adverse effects of chemotherapy?
- A. Administer an antiemetic
- B. Administer an antimetabolite
- C. Administer a tumor antibiotic
- D. Administer an anticoagulant
Correct Answer: A
Rationale: Chemo's nastiest duo nausea and vomiting strike most patients, triggered by gut and brain reactions to drugs like cyclophosphamide. Antiemetics (e.g., ondansetron) preempt this, keeping patients eating and hydrated, a frontline move in oncology. Antimetabolites (like methotrexate) and tumor antibiotics (like doxorubicin) are chemo agents, not side-effect fixes. Anticoagulants dodge clots, not nausea. Nurses prioritize this relief, knowing it's the biggest hurdle to treatment tolerance.
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A hospitalized client has a platelet count of 58,000/mm³. What action by the nurse is best?
- A. Implement fall precautions
- B. Encourage high-protein foods
- C. Limit visitors to healthy adults
- D. Institute neutropenic precautions
Correct Answer: A
Rationale: A platelet count of 58,000/mm³ below 150,000 signals thrombocytopenia, raising bleeding risk, especially from falls. Implementing fall precautions curbs trauma, preventing bleeds like intracranial hemorrhage, a practical priority over dietary tweaks. High-protein foods aid healing but don't address immediate danger. Limiting visitors or neutropenic precautions fits low WBCs, not platelets 58,000 isn't neutropenic (below 1,000 neutrophils). Nurses prioritize safety, making fall precautions the best action, directly mitigating this lab's implications in a hospitalized client prone to injury.
A patient with lung cancer develops syndrome of inappropriate antidiuretic hormone secretion (SIADH). After reporting symptoms of weight gain, weakness, and nausea and vomiting to the physician, you would anticipate which initial order for the treatment of this patient?
- A. A fluid bolus as ordered
- B. Fluid restrictions as ordered
- C. Urinalysis as ordered
- D. Sodium-restricted diet as ordered
Correct Answer: B
Rationale: SIADH, common in lung cancer, overproduces ADH, retaining water and diluting sodium hyponatremia causes weight gain, weakness, nausea. Fluid restriction, the initial fix, curbs water intake, raising sodium levels naturally, tackling the root imbalance. A fluid bolus worsens dilution, risking seizures. Urinalysis checks concentration, not a treatment. Sodium restriction deepens hyponatremia, counterproductive. Anticipating fluid limits aligns with SIADH's pathophysiology nurses expect this order to stabilize the patient, monitoring for symptom relief or escalation, a frontline step in managing this paraneoplastic crisis.
During the teaching session for a patient who has a new diagnosis of acute leukemia, the patient is restless and looks away without making eye contact. The patient asks the nurse to repeat the information about the complications associated with chemotherapy. Based on this assessment, which nursing diagnosis is appropriate for the patient?
- A. Risk for ineffective adherence to treatment related to denial of need for chemotherapy
- B. Acute confusion related to infiltration of leukemia cells into the central nervous system
- C. Deficient knowledge: chemotherapy related to a lack of interest in learning about treatment
- D. Risk for ineffective health maintenance related to possible anxiety about leukemia diagnosis
Correct Answer: D
Rationale: New leukemia diagnosis plus restlessness and repeat requests scream anxiety risk for ineffective health maintenance' fits, as it ties to coping, not denial , brain infiltration , or disinterest . Nurses in oncology spot this fear fogs learning, needing slower, calmer teaching to stick.
People with metabolic syndrome have an increased risk of which of the following disorders, besides type 2 diabetes mellitus?
- A. Hypertension, infections
- B. Myocardial infarction, hypertension
- C. Myocardial infarction, infections
- D. Myocardial infarction, liver cirrhosis
Correct Answer: B
Rationale: Metabolic syndrome hikes heart attacks, hypertension vascular hits, not infections or cirrhosis extras. Nurses track this, a chronic CV duo.
A patient with Hodgkin's lymphoma who is undergoing external radiation therapy tells the nurse, 'I am so tired I can hardly get out of bed in the morning.' Which intervention should the nurse add to the plan of care?
- A. Minimize activity until the treatment is completed.
- B. Establish time to take a short walk almost every day.
- C. Consult with a psychiatrist for treatment of depression.
- D. Arrange for delivery of a hospital bed to the patient's home.
Correct Answer: B
Rationale: Radiation fatigue's brutal Hodgkin's therapy saps energy, but short walks fight deconditioning without overtaxing. Resting fully risks weakness; depression isn't assumed fatigue's treatment-driven. A bed doesn't fix it. Nurses in oncology balance this activity preserves function, key for lymphoma patients slogging through radiation's grind.