Nokea
A client in the oncology clinic reports her family is frustrated at her ongoing fatigue 4 months after radiation therapy for breast cancer. What response by the nurse is most appropriate?
- A. Are you getting adequate rest and sleep each day?
- B. It is normal to be fatigued even for months afterward.
- C. This is not normal and I'll let the primary health care provider know.
- D. Try adding more vitamins B and C to your diet.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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Nurse Mike is providing care to a client with chronic myelogenous leukemia (CML). The nurse knows that the client is at risk for tumor lysis syndrome. Which of the following laboratory values requires immediate intervention?
- A. Increased uric acid level
- B. Increased serum potassium level
- C. Increased serum sodium level
- D. Increased fibrinogen level
Correct Answer: A
Rationale: The correct answer is A: Increased uric acid level. In tumor lysis syndrome, rapid cell destruction releases large amounts of potassium, phosphate, and nucleic acids into the bloodstream. Uric acid can accumulate rapidly, leading to hyperuricemia, which can result in kidney damage due to urate crystal deposition. Immediate intervention is necessary to prevent renal complications. Choices B, C, and D are incorrect because while electrolyte imbalances are common in tumor lysis syndrome, hyperuricemia with potential kidney damage is the priority concern that requires immediate attention.
The client is assessing a client who has a new ureterostomy. Which statement by the client indicates the need for more education about urinary stoma care?
- A. I change my pouch every week.
- B. I change the appliance in the morning.
- C. I empty the urinary collection bag when it is two-thirds full.
- D. When I'm in the shower, I direct the flow of water away from my stoma.
Correct Answer: D
Rationale: The correct answer is D because directing water away from the stoma while showering is incorrect. The stoma can and should be cleaned with water. Choices A, B, and C demonstrate proper stoma care practices, such as changing the pouch regularly, changing the appliance in the morning, and emptying the collection bag when it is two-thirds full, which are all appropriate actions for caring for a urinary stoma.
A nurse is providing education to a patient with polycythemia vera about self-care strategies. What advice should the nurse include?
- A. Avoid hot showers
- B. Drink plenty of fluids
- C. Avoid tight and restrictive clothing
- D. Avoid prolonged sitting
Correct Answer: B
Rationale: The correct advice for a patient with polycythemia vera is to drink plenty of fluids. This helps in reducing the risk of thrombosis by keeping the blood less viscous. Avoiding hot showers (Choice A) is not directly related to managing polycythemia vera. While avoiding tight and restrictive clothing (Choice C) can help improve circulation, it is not the most crucial advice for these patients. Avoiding prolonged sitting (Choice D) is important to prevent blood clots but is not as critical as staying well-hydrated.
A patient diagnosed with acute myelogenous leukemia has just been admitted to the oncology unit. When writing this patient's care plan, what potential complication should the nurse address?
- A. Pancreatitis
- B. Hemorrhage
- C. Arteritis
- D. Liver dysfunction
Correct Answer: B
Rationale: The correct answer is B: Hemorrhage. Patients with acute myelogenous leukemia are at high risk of hemorrhage due to low platelet count and abnormal clotting factors caused by bone marrow suppression. Pancreatitis (choice A) is not a common complication of acute myelogenous leukemia. Arteritis (choice C) refers to inflammation of arteries and is not a typical complication of this type of leukemia. Liver dysfunction (choice D) is not a primary concern in the immediate care plan for a patient with acute myelogenous leukemia.
The nurse is teaching a client about the risk factors associated with colorectal cancer. The nurse determines that further teaching is necessary related to colorectal cancer if the client identifies which item as an associated risk factor?
- A. Age younger than 50 years
- B. History of colorectal polyps
- C. Family history of colorectal cancer
- D. Chronic inflammatory bowel disease
Correct Answer: A
Rationale: The correct answer is A: Age younger than 50 years. Colorectal cancer is more commonly diagnosed in individuals over the age of 50, so being younger than 50 is not typically considered a significant risk factor. Choice B, history of colorectal polyps, is a known risk factor as polyps can develop into cancer over time. Choice C, family history of colorectal cancer, is a well-established risk factor due to genetic predisposition. Choice D, chronic inflammatory bowel disease, such as Crohn's disease or ulcerative colitis, increases the risk of developing colorectal cancer. Therefore, the incorrect choice is A as age younger than 50 years is not a common risk factor for colorectal cancer.