Nokea
A nurse in the oncology clinic is providing preoperative education to a client just diagnosed with cancer. The client has been scheduled for many days. What action by the nurse is best?
- A. Call the client at home the next day to review teaching.
- B. Give the client information about a cancer support group.
- C. Provide all the preoperative instructions in writing.
- D. Reassure the client that surgery will be over soon.
Correct Answer: A
Rationale: Clients are often overwhelmed at a sudden diagnosis of cancer and may be more overwhelmed at the idea of a major operation so soon. This stress significantly impacts the client's ability to understand, retain, and recall information. The nurse should call the client at home the next day to review the teaching and to answer questions. The client may or may not be ready to investigate a support group, but this does not help with teaching. Giving information in writing is important (if the client can read it), but in itself will not be enough. Telling the client about surgery will be over soon is giving false reassurance and does nothing for teaching.
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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 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.
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 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.
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.