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 years afterward.
- C. This is a normal and I'll let the provider know.
- D. Try adding more vitamins B and C to your diet.
Correct Answer: B
Rationale: Regardless of the cause, radiation-induced fatigue can be debilitating and may last for months or years after treatment has ended. Rest and adequate nutrition can affect fatigue, but it is most important that the client understands this is a normal response.
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A nurse working with clients who experience alopecia knows that which is the best method of helping clients manage the psychosocial impacts of this problem?
- A. Assisting the client to plan for this event
- B. Reassuring the client that alopecia is temporary
- C. Referring the client to a support group
- D. Telling the client that there are worse side effects
Correct Answer: A
Rationale: Alopecia does not occur in all clients with cancer, but when it does, it can be devastating. The best action by the nurse is to teach the client about the possibility and to give the client multiple choices for preparing for it.
A client with cancer is admitted to a short-term rehabilitation facility. The nurse prepares to administer the client's chemotherapy medications. What action by the nurse is most appropriate?
- A. Crush the medications if the client reports difficulty swallowing them.
- B. Give one medication at a time with a full glass of water.
- C. No special precautions are needed for these medications.
- D. Wear personal protective equipment when handling the medications.
Correct Answer: D
Rationale: During the administration of oral chemotherapy agents, nurses must take the same precautions that are used when administering IV chemotherapy. This includes using personal protective equipment. These medications cannot be crushed, split, or chewed. Giving one at a time is not needed.
A client is receiving chemotherapy through a peripheral IV line. What action by the nurse is most important?
- A. Assessing the IV site every hour
- B. Educating the client on side effects
- C. Monitoring the client for nausea
- D. Providing warm packs for comfort
Correct Answer: A
Rationale: Intravenous chemotherapy can cause local tissue destruction if it extravasates into the surrounding tissues. Peripheral IV lines are more prone to this than centrally placed lines. The most important intervention is prevention, so the nurse should check hourly to ensure the IV site is patent, or more frequently depending on facility policy. Education and monitoring for side effects such as nausea are important for all clients receiving chemotherapy. Warm packs may be helpful for comfort, but if the client reports the IV site is painful, this is not the most appropriate action.
A client tells the oncology nurse about an upcoming vacation to be back to celebrate completing radiation treatments for cancer. What response by the nurse is most appropriate?
- A. Are you ensuring the radiation site is protected?
- B. Do not expose the radiation area to direct sunlight.
- C. Have a wonderful time and enjoy your vacation!
- D. Remember you should not drink alcohol for a year.
Correct Answer: B
Rationale: The radiation site is extremely sensitive to sunlight after radiation therapy has been completed. The nurse should inform the client to avoid sun exposure to this area. This advice continues for 1 year after treatment has been completed. The other statements are not appropriate.
A client receiving chemotherapy has a white blood cell count of 1000/mm³. What actions by the nurse are most appropriate? (Select all that apply.)
- A. Assess all mucous membranes every 4 to 8 hours.
- B. Do not allow the client to eat meat or poultry.
- C. Listen to lung sounds and monitor for cough.
- D. Monitor the venous access device appearance with vital signs.
- E. Take and record vital signs every 4 to 8 hours.
Correct Answer: A,C,D,E
Rationale: Per facility protocol, the nurse should assess this client for infection every 4 to 8 hours by assessing all mucous membranes, listening to lung sounds, monitoring for cough, monitoring the appearance of the venous access device, and recording vital signs. Eating meat and poultry is allowed.