Nokea
A nurse is caring for a patient who has been diagnosed with leukemia. The nurse's most recent assessment reveals the presence of ecchymoses on the patient's sacral area and petechiae on her forearms. In addition to informing the patient's primary care provider, what action should the nurse take?
- A. Initiate measures to prevent venous thromboembolism (VTE).
- B. Check the patient's most recent platelet level.
- C. Place the patient on protective isolation.
- D. Ambulate the patient to promote circulatory function.
Correct Answer: B
Rationale: The patient's signs of ecchymoses and petechiae are suggestive of thrombocytopenia, which is a common complication of leukemia. Thrombocytopenia is a condition characterized by a low platelet count, leading to abnormal bleeding. Checking the patient's most recent platelet level is crucial to assess the severity of thrombocytopenia and guide further interventions. Initiating measures to prevent venous thromboembolism (VTE) (Choice A) is not directly related to the patient's current signs. Placing the patient on protective isolation (Choice C) is not necessary for ecchymoses and petechiae. Ambulating the patient (Choice D) is not appropriate without addressing the underlying cause of abnormal bleeding.
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The nurse is assessing a client with leukemia who is receiving chemotherapy. Which of the following findings would be of most concern?
- A. Alopecia
- B. Fatigue
- C. Nausea and vomiting
- D. Mouth sores
Correct Answer: D
Rationale: The correct answer is D, 'Mouth sores.' Mouth sores (stomatitis) are a common and potentially serious side effect of chemotherapy. They can lead to difficulty eating, increased risk of infection, and overall decreased quality of life for the client. While alopecia, fatigue, and nausea/vomiting are also common side effects of chemotherapy, they are generally manageable and do not pose the same level of immediate concern as the development of mouth sores in a client undergoing chemotherapy.
An adult patient has presented to the health clinic with a complaint of a firm, painless cervical lymph node. The patient denies any recent infectious diseases. What is the nurse's most appropriate response to the patient's complaint?
- A. Call 911.
- B. Promptly refer the patient for medical assessment.
- C. Facilitate a radiograph of the patient's neck and have the results forwarded to the patient's primary care provider.
- D. Encourage the patient to track the size of the lymph node and seek care in 1 week.
Correct Answer: B
Rationale: The most appropriate response for a patient presenting with a firm, painless cervical lymph node and denying recent infectious diseases is to promptly refer the patient for medical assessment. This is crucial to rule out serious underlying conditions such as malignancy or other concerning causes. Calling 911 is not necessary in this situation as it is not an emergency. Ordering a radiograph may not be the most immediate or appropriate action, as further evaluation by a healthcare provider is needed first. Encouraging the patient to wait and track the lymph node for a week is not advisable when a potential serious condition needs to be ruled out promptly.
An emergency department nurse is triaging a 77-year-old man who presents with uncharacteristic fatigue as well as back and rib pain. The patient denies any recent injuries. The nurse should recognize the need for this patient to be assessed for what health problem?
- A. Hodgkin disease
- B. Non-Hodgkin lymphoma
- C. Multiple myeloma
- D. Acute thrombocythemia
Correct Answer: C
Rationale: The correct answer is multiple myeloma (choice C). Back pain is a common presenting symptom in multiple myeloma, especially in older patients. This malignancy can lead to bone pain due to bone destruction and fractures. Hodgkin disease (choice A) and Non-Hodgkin lymphoma (choice B) typically present with symptoms like painless lymph node enlargement, fever, and weight loss. Acute thrombocythemia (choice D) is characterized by an increase in platelet count but is not typically associated with the symptoms described by the patient.
What advice should the oncology nurse give to a client planning a beach vacation after completing radiation treatments for cancer?
- A. Avoid getting salt water on the radiation site.
- 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 correct answer is B because the skin at the radiation site is sensitive to sunlight, and exposure can cause further damage. It is crucial to protect the area from direct sunlight to prevent skin irritation or burns. Choice A is incorrect as salt water typically does not pose a significant risk to the radiation site. Choice C is a positive and encouraging response but does not provide necessary advice for post-radiation care. Choice D, while important in some cases, is not directly related to the client's beach vacation after completing radiation treatments.
When planning care for a 77-year-old male admitted with suspected acute myeloid leukemia (AML), what epidemiologic fact should the nurse be aware of?
- A. Early diagnosis is associated with good outcomes.
- B. Five-year survival for older adults is approximately 50%.
- C. Five-year survival for patients over 75 years old is less than 2%.
- D. Survival rates are wholly dependent on the patient's pre-illness level of health.
Correct Answer: C
Rationale: In the context of AML, the 5-year survival rate significantly decreases with age. The 5-year survival rate for patients over 75 years old is less than 2% compared to 43% for those 50 years or younger, and 19% for those between 50 and 64 years. Choice A is incorrect as early diagnosis does not necessarily guarantee good outcomes in AML. Choice B is inaccurate as the 5-year survival rate is not approximately 50% for older adults with AML. Choice D is incorrect as survival rates for AML patients are influenced by various factors beyond just the pre-illness level of health.