Nokea
A client has scheduled brachytherapy sessions and states that she feels as though she is not safe around her family. What is the best response by the nurse?
- A. You are only radioactive when the radioactive implant is in place.
- B. To be totally safe, it is a good idea to sleep in a separate room.
- C. It is best to stay a safe distance from friends or family between treatments.
- D. You should use a separate bathroom from the rest of the family.
Correct Answer: A
Rationale: In brachytherapy, the surgeon inserts an applicator into the uterus. After placement is verified, the radioactive isotope is placed in the applicator for several minutes for a single treatment. There are no restrictions for the woman to stay away from her family or the public between treatments.
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A client who had a hysterectomy has a 200-mg dose of ciprofloxacin (Cipro) ordered to infuse in 30 minutes. At what rate should the nurse infuse the medication if the pharmacy provides 200 mg in a 100-mL bag of normal saline? (Record your answer using a whole number) mL/hr
- A. 200 mL/hr
- B. 100 mL/hr
- C. 150 mL/hr
- D. 250 mL/hr
Correct Answer: A
Rationale: To calculate the infusion rate: The pharmacy provides 200 mg in a 100-mL bag, to be infused over 30 minutes. Infusion rate (mL/hr) = Total volume (mL) ÷ Time (hr). Here, 100 mL ÷ 0.5 hr = 200 mL/hr.
A postmenopausal client is experiencing low back and pelvic pain, fatigue, and bloody vaginal discharge. What laboratory tests would the nurse expect to see ordered for this client if endometrial cancer is suspected? (Select all that apply.)
- A. Cancer antigens (CA-125)
- B. White blood cell (WBC) count
- C. Hemoglobin and hematocrit (H&H)
- D. Prothrombin time (PT)
Correct Answer: A,C
Rationale: Serum tumor markers such as CA-125 assess for metastasis, especially if elevated. H&H would evaluate the possibility of anemia, a common finding with postmenopausal bleeding with endometrial cancer. WBC count is not indicated since there are no signs of infection. The INR and PT are coagulation tests to measure the time it takes for a fibrin clot to form, used to evaluate coagulation in clients receiving oral warfarin.
The nurse is caring for a postoperative client following an anterior colporrhaphy. What action can be delegated to the unlicensed assistive personnel (UAP)?
- A. Reviewing the hematocrit and hemoglobin results
- B. Reading the hematocrit and hemoglobin results to an old grandson
- C. Assessing the level of pain and any drainage
- D. Drawing a shallow hot bath for comfort measures
Correct Answer: D
Rationale: The UAP is able to provide comfort through a bath. The registered nurse should review any laboratory results, complete any teaching, and assess pain and discharge.
A client is admitted to the emergency department with toxic shock syndrome. Which action by the nurse is the most important?
- A. Administer IV fluids to maintain fluid and electrolyte balance.
- B. Remove the tampon as the source of infection.
- C. Collect a blood specimen for culture and sensitivity.
- D. Transfuse the client to manage low blood count.
Correct Answer: B
Rationale: The source of infection should be removed first. All of the other answers are possible interventions depending on the client's symptoms and vital signs, but removing the tampon is the priority.
A client is scheduled to start external beam radiation therapy (EBRT) for her endometrial cancer. Which teaching by the nurse is accurate? (Select all that apply.)
- A. You will need to be hospitalized during this therapy.
- B. Your skin needs to be inspected daily for any breakdown.
- C. It is not wise to stay out in the sun for long periods of time.
- D. The technician applies new site markings before each treatment.
Correct Answer: B,C,D
Rationale: EBRT is usually performed in ambulatory care and does not require hospitalization. The client needs to know to evaluate the skin, especially in the perineal area, for any breakdown, and avoid sunbathing. The client needs to avoid washing off the markings that indicate the treatment site.