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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.
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A client's family members are concerned that telling the client about a new finding of cancer will cause extreme emotional distress. They approach the nurse and ask if this can be kept from the client. What actions by the nurse are most appropriate? (Select all that apply.)
- A. Ask the family to describe their concerns more fully.
- B. Consult with a social worker, chaplain, or ethics committee.
- C. Explain the client's right to know and ask for their assistance.
- D. Have the unit manager take over the care of this client and family.
- E. Tell the family that this secret will not be kept from the client.
Correct Answer: A,B,C
Rationale: The client's right of autonomy means that the client must be fully informed as to their diagnosis and treatment options. The nurse cannot ethically keep this information from the client. The nurse can ask the family to explain their concerns more fully so everyone understands the concerns. A social worker, chaplain, or ethics committee can become involved to assist the nurse, client, and family. Explaining the client's right to know while seeking family assistance fosters collaboration.
A client is receiving rituximab (Rituxan) and asks how it works. What response by the nurse is best?
- A. It causes rapid lysis of the cancer cell membranes.
- B. It destroys the enzymes needed to create cancer cells.
- C. It prevents the initiation of cancer cell division.
- D. It sensitizes certain cancer cells to chemotherapy.
Correct Answer: C
Rationale: Rituximab prevents the initiation of cancer cell division. The other statements are not accurate.
A client has a low hemoglobin level. Which medication does the nurse prepare to administer?
- A. Epoetin alfa (Epogen)
- B. Filgrastim (Neupogen)
- C. Mesna (Mesnex)
- D. Oprelvekin (Neumega)
Correct Answer: A
Rationale: The client's hemoglobin is low, so the nurse should prepare to administer epoetin alfa, a colony-stimulating factor that increases production of red blood cells. Filgrastim is for neutropenia. Mesna is used to decrease bladder toxicity from some chemotherapeutic agents. Oprelvekin is used to increase platelet count.
A client has received a dose of ondansetron (Zofran) for nausea. What action by the nurse is most important?
- A. Assess the client for a headache.
- B. Assist the client by getting out of bed.
- C. Initiate the client to reduce salt intake.
- D. Weigh the client daily before the client eats.
Correct Answer: B
Rationale: Ondansetron side effects include postural hypotension, vertigo, and bradycardia, all of which increase the client's risk for injury. The nurse should assist the client when getting out of bed. Headache and fluid retention are not side effects of this drug.
A client has mucositis. What actions by the nurse will improve the client's nutrition? (Select all that apply.)
- A. Assist with rinsing the mouth with saline frequently.
- B. Encourage the client to eat room-temperature foods.
- C. Give the client hot liquids to hold in the mouth.
- D. Provide local anesthetic medications to swish and spit.
- E. Remind the client to brush gently after each meal.
Correct Answer: A,B,D,E
Rationale: Mucositis can interfere with nutrition. The nurse can help by assisting with rinsing the mouth frequently with saline, encouraging the client to eat cool or room-temperature foods, providing swish-and-spit anesthetics, and reminding the client to keep the mouth clean by brushing gently after each meal. Hot liquids should be avoided as they can be painful for the client.