Nokea
A home health nurse is caring for a patient with multiple myeloma. Which of the following interventions should the nurse prioritize when addressing the patients severe bone pain?
- A. Implementing distraction techniques
- B. Educating the patient about the effective use of hot and cold packs
- C. Teaching the patient to use NSAIDs effectively
- D. Helping the patient manage the opioid analgesic regimen
Correct Answer: D
Rationale: Multiple myeloma causes severe bone pain due to the proliferation of malignant plasma cells in the bone marrow, leading to osteolytic lesions and bone destruction. Opioid analgesics are often required to manage this level of pain effectively, especially in cases where the pain is severe and chronic. The nurse's priority should be helping the patient manage their opioid regimen, ensuring they understand proper dosing, side effects, and safe use of the medication. Opioids are generally necessary in such cases because they provide stronger pain relief compared to other types of analgesics, such as NSAIDs or non-opioid medications.
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An oncology patient has just returned from the post-anesthesia care unit after an open hemicolectomy. This patient¢â‚¬â„¢s plan of nursing care should prioritize which of the following?
- A. Assess the patient hourly for signs of compartment syndrome.
- B. Assess the patient¢â‚¬â„¢s fine motor skills once per shift.
- C. Assess the patient¢â‚¬â„¢s wound for dehiscence every 4 hours.
- D. Maintain the patient¢â‚¬â„¢s head of bed at 45 degrees or more at all times.
Correct Answer: C
Rationale: After an open hemicolectomy (surgical removal of part of the colon), monitoring the surgical wound for signs of dehiscence (wound reopening) is a critical nursing priority. Dehiscence is a serious postoperative complication that can occur if the surgical site does not heal properly. Regular wound assessments every 4 hours allow the nurse to identify early signs of complications, such as redness, swelling, increased drainage, or separation of the wound edges. Early detection is key to preventing further complications, such as infection or evisceration (protrusion of abdominal organs through the wound).
A client is receiving rituximab 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 start of cell division in the cancer cells.
- D. It sensitizes certain cancer cells to chemotherapy.
Correct Answer: C
Rationale: Rituximab is a monoclonal antibody that targets CD20, a protein found on the surface of certain B-cells, including some cancerous B-cells, such as in non-Hodgkin's lymphoma and chronic lymphocytic leukemia (CLL). Rituximab works by binding to the CD20 protein, which leads to the destruction of the cancerous B-cells through various mechanisms, including preventing the initiation of cell division. By blocking the division process, rituximab helps slow the growth and proliferation of cancer cells, allowing the immune system and additional treatments to clear them more effectively.
Mina, who is suspected of an ovarian tumor is scheduled for a pelvic ultrasound. The nurse provides which preprocedure instruction to the client?
- A. Eat a light breakfast only
- B. Maintain an NPO status before the procedure
- C. Wear comfortable clothing and shoes for the procedure
- D. Drink six to eight glasses of water without voiding before the test
Correct Answer: D
Rationale: A pelvic ultrasound requires the client to have a full bladder because the bladder acts as a window through which pelvic organs, such as the uterus and ovaries, can be visualized more clearly. The full bladder pushes the intestines out of the way and provides a better acoustic pathway for the ultrasound waves. Without this, the pelvic organs might be obscured, and the images would be less accurate.
Which of the following statements by the oncology nurse displays understanding about antineoplastic medications?
- A. Chemotherapy is not going to spread throughout the body
- B. Chemotherapy affects the immune system
- C. Chemotherapy is specific to cancer cells only
- D. Chemotherapy makes the patient radioactive
Correct Answer: B
Rationale: Chemotherapy targets rapidly dividing cells, which include both cancerous and healthy cells, such as those in the bone marrow, hair follicles, and the lining of the digestive tract. Since the bone marrow produces immune cells (white blood cells), chemotherapy can weaken the immune system by reducing the body's ability to produce these cells, making patients more susceptible to infections. This is why close monitoring and supportive measures to protect immune function are important during chemotherapy treatment.
A nurse is planning care for a patient with leukemia who has been experiencing severe fatigue. What is the most appropriate intervention to include in the care plan?
- A. Encouraging the patient to remain in bed
- B. Scheduling frequent rest periods
- C. Providing a high-calorie diet
- D. Administering blood transfusions
Correct Answer: B
Rationale: In patients with leukemia, severe fatigue is a common symptom due to factors such as anemia, the disease process itself, and the effects of treatments like chemotherapy. The most appropriate intervention is to schedule frequent rest periods to help manage fatigue while encouraging a balance between rest and activity. This approach allows the patient to conserve energy for essential tasks and prevent exhaustion, without promoting complete inactivity, which can lead to deconditioning.