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A client with colon cancer is scheduled for chemotherapy post-resection. Which of the following should the nurse monitor for as a common side effect of chemotherapy?
- A. Hypertension.
- B. Nausea and vomiting.
- C. Hyperglycemia.
- D. Joint pain.
Correct Answer: B
Rationale: Nausea and vomiting are common side effects of chemotherapy due to its impact on rapidly dividing cells, including those in the gastrointestinal tract. Hypertension, hyperglycemia, and joint pain are less commonly associated with chemotherapy. CN: Pharmacological and parenteral therapies; CL: Analyze
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The nurse is assessing a client with chronic myeloid leukemia (CML). The nurse should assess the client for:
- A. Lymphadenopathy.
- B. Hyperplasia of the gums.
- C. Bone marrow expansion.
- D. Shortness of breath.
Correct Answer: D
Rationale: CML causes an overproduction of white blood cells, leading to symptoms like fatigue, splen enlarge, and shortness of breath due to anemia or hyperviscosity. Shortness of breath is a common finding to assess. Lymphadenopathy, gum hyperplasia, and marrow expansion are less typical.
A client expresses concern about how a hypophysectomy will affect his sexual function. Which of the following statements provides the most accurate information about the physiologic effects of hypophysectomy?
- A. Removing the source of excess hormone should restore the client's libido, erectile function, and fertility.'
- B. Potency will be restored, but the client will remain infertile.'
- C. Fertility will be restored, but impotence and decreased libido will persist.'
- D. Exogenous hormones will be needed to restore erectile function after the adenoma is removed.'
Correct Answer: D
Rationale: Hypophysectomy may disrupt pituitary hormone production, including those affecting sexual function. Exogenous hormones (e.g., testosterone) are often needed to restore erectile function.
A nurse is assessing a female who is receiving the second administration of chemotherapy for breast cancer. When obtaining this client's health history, what is the most important information the nurse should obtain?
- A. Has your hair been falling out in clumps?
- B. Have you had nausea or vomiting?
- C. Have you been sleeping at night?
- D. Do you have your usual energy level?
Correct Answer: B
Rationale: Nausea and vomiting are critical to assess during chemotherapy, as they can lead to dehydration, malnutrition, and treatment delays if not managed promptly.
The nurse is caring for a client who is receiving prescribed ketorolac. Which of the following client findings would indicate a therapeutic response? Select all that apply.
- A. Decreased pain
- B. Increased urinary output
- C. Decreased blood pressure
- D. Decreased temperature
- E. Increased muscle coordination
Correct Answer: A,D
Rationale: Ketorolac, an NSAID, reduces pain and inflammation, which can lower temperature in febrile clients. It does not directly affect urinary output, blood pressure, or muscle coordination.
The nurse is providing discharge teaching for a client post-inguinal herniorrhaphy. Which statement by the client indicates a need for further teaching?
- A. I'll avoid heavy lifting for about 6 weeks.
- B. I can take a shower tomorrow.
- C. I'll call the doctor if I have a fever.
- D. I can resume sexual activity next week.
Correct Answer: D
Rationale: Resuming sexual activity within a week post-inguinal herniorrhaphy may strain the surgical site, indicating a need for further teaching to delay such activities for 4–6 weeks. The other statements align with appropriate postoperative care. CN: Health promotion and maintenance; CL: Evaluate