Nokea
A 60-year-old patient with a diagnosis of prostate cancer is scheduled to have an interstitial implant for high-dose radiation (HDR). What safety measure should the nurse include in this patient's subsequent plan of care?
- A. Limit the time that visitors spend at the patient's bedside
- B. Teach the patient to perform all aspects of basic care independently
- C. Assign male nurses to the patient's care whenever possible
- D. Situate the patient in a shared room with other patients receiving brachytherapy
Correct Answer: A
Rationale: HDR implants (brachytherapy) emit radiation limiting visitor time (e.g., 30 min) cuts exposure risk. Self-care's nice but not safety-driven. Gender's irrelevant pregnant staff avoid, not males. Shared rooms up exposure, not safety. Nurses in oncology enforce this, shielding others while the source's active, a radiation rule of thumb.
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Mr Xavier, a 60-year-old accountant, was recently started on allopurinol 100 mg two months ago. This was increased to 200 mg three weeks ago in your clinic. He informed you that he was diagnosed with UTI and started on ciprofloxacin. Today, he returns to your clinic with maculopapular rashes on his trunk and abdomen. He has a low-grade fever of 37.5°C. Which is the most appropriate next step?
- A. Stop Ciprofloxacin and continue the chronic medications
- B. Prescribe paracetamol for pain relief and switch to Moxifloxacin 500 mg bd instead
- C. Continue medications and check for Dengue serology
- D. Stop Allopurinol
Correct Answer: D
Rationale: Rashes and fever post-allopurinol hike scream drug reaction stopping it nips hypersensitivity, like SJS risk, tied to uric acid meds over cipro's rarer skin hit. Quitting cipro alone misses the likely culprit; swapping antibiotics or dengue checks dodge the drug link; full stop's overkill. Clinicians halt allopurinol, watching this chronic fix's nasty turn, a swift call.
The New York Heart Association functional class has four grades and is used to assess severity of CHF and impact on QOL. Class III is described as:
- A. Slight impairment of physical activity: comfortable at rest but ordinary activity results in fatigue and palpitations
- B. Unable to carry out any physical activity without discomfort: symptoms of CHF are present even at rest with increased discomfort with any physical activity
- C. No limitation: ordinary physical activity does not cause undue fatigue, dyspnoea or palpitations
- D. Marked limitation of physical activity: comfortable at rest but less than ordinary activity results in symptoms
Correct Answer: D
Rationale: NYHA Class III big limits; rest's fine, but small moves spark symptoms, a QOL hit. Slight's I; none's 0; all-out's IV. Nurses gauge this, a chronic heart's midway bind.
The nurse teaching a young women's community service group about breast self-examination (BSE) will include that:
- A. BSE will reduce the risk of dying from breast cancer
- B. BSE should be done daily while taking a bath or shower
- C. Annual mammograms should be scheduled in addition to BSE
- D. Performing BSE after the menstrual period is more comfortable
Correct Answer: D
Rationale: BSE timing matters post-menstrual breasts are less tender, swollen, or lumpy, making self-checks comfy and accurate, a key teaching point for young women. BSE doesn't cut mortality evidence lags; daily checks overdo it, monthly's enough. Mammograms start later (e.g., 40), not yet for this group. Nurses stress this timing, boosting compliance and awareness, a practical nudge in breast health education, sidestepping unproven claims for a doable habit.
Which of the following clients would not be a candidate for thrombolytic therapy?
- A. Client with a pulse of 102 beats/minute
- B. Client with a blood pressure of 100/60 mm Hg
- C. Client with a history of hemorrhagic stroke one month ago
- D. Client age 65 years
Correct Answer: C
Rationale: Thrombolytics bust clots but bleed big hemorrhagic stroke history, even a month back, bans them, as re-bleed risk soars, a firm no-go. Tachycardia, low BP, or age 65 don't nix it BP's workable, age isn't a cutoff. Nurses screen this, dodging brain bleeds, a safety lock in this clot-dissolving call.
The nurse is preparing an adolescent diagnosed with leukemia for a lumbar puncture. The nurse determines that the child understands the reason for the procedure when the child states that the procedure is done to:
- A. Make sure I don't have meningitis along with my cancer.
- B. Relieve some of the pressure on my brain.
- C. Remove the blood cancer cells so I don't have to have surgery.
- D. Check to see if the cancer has spread through my spinal cord and brain.
Correct Answer: D
Rationale: A lumbar puncture (LP) in leukemia is performed to collect cerebrospinal fluid (CSF) to check for central nervous system (CNS) involvement cancer cells spreading to the spinal cord and brain a critical staging step that influences treatment, like intrathecal chemotherapy. The adolescent's statement about checking for spread reflects accurate understanding, essential for informed consent and reducing anxiety through clarity. Ruling out meningitis is a possible LP use, but in leukemia, CNS metastasis is the primary concern unless symptoms suggest infection. Relieving brain pressure applies to conditions like hydrocephalus, not leukemia's typical presentation. Removing cancer cells via LP isn't a treatment; it's diagnostic. The nurse's confirmation of this understanding ensures the child is prepared, aligning with pediatric oncology's emphasis on patient education and procedural readiness.