Nokea
A nurse is caring for a patient who is being treated for leukemia in the hospital. The patient was able to maintain her nutritional status for the first few weeks following her diagnosis but is now exhibiting early signs and symptoms of malnutrition. In collaboration with the dietitian, what intervention should the nurse implement?
- A. Arrange for total parenteral nutrition (TPN).
- B. Facilitate placement of a percutaneous endoscopic gastrostomy (PEG) tube.
- C. Provide the patient with several small, soft-textured meals each day.
- D. Assign responsibility for the patient's nutrition to the patient's friends and family.
Correct Answer: C
Rationale: For patients experiencing difficulties with oral intake, the provision of small, easily chewed meals may be beneficial. Option A (TPN) and B (PEG tube placement) are more invasive interventions and should be considered if non-oral routes are necessary. Option D is not appropriate as the primary responsibility for a patient's nutrition should lie with healthcare professionals to ensure proper management and monitoring.
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A nurse is teaching a patient with chronic lymphocytic leukemia (CLL) about potential complications. Which complication should the nurse emphasize?
- A. Infection
- B. Hemorrhage
- C. Fatigue
- D. Splenomegaly
Correct Answer: A
Rationale: The correct answer is A: Infection. Patients with chronic lymphocytic leukemia (CLL) are at a significant risk of infection due to their compromised immune system. Emphasizing the importance of infection prevention and prompt treatment is crucial in the care of these patients. Choice B, Hemorrhage, is less common in CLL compared to other types of leukemia. Choice C, Fatigue, is a common symptom but not a complication that poses immediate risks. Choice D, Splenomegaly, is a common finding in CLL but not the most critical complication to emphasize regarding patient education.
A client with a history of prostate cancer is in the clinic and reports new onset of severe low back pain. What action by the nurse is most important?
- A. Assess the client's gait and balance.
- B. Ask the client about any changes in urinary symptoms.
- C. Document the report thoroughly.
- D. Inquire about the client's recent activities.
Correct Answer: A
Rationale: The correct action by the nurse is to assess the client's gait and balance. Severe low back pain in a client with a history of prostate cancer may indicate spinal cord compression, a serious complication. Assessing gait and balance can help determine if there is any spinal cord involvement, which requires immediate medical attention. Asking about changes in urinary symptoms (choice B) is important to assess for possible urinary obstruction, but assessing gait and balance takes precedence due to the risk of spinal cord compression. Documenting the report thoroughly (choice C) is essential but not the most immediate action needed. Inquiring about recent activities (choice D) is not as critical as assessing for spinal cord involvement.
A nurse is caring for a patient diagnosed with chronic myeloid leukemia (CML) who is receiving the drug imatinib (Gleevec). What should the nurse monitor in this patient to assess for side effects of this therapy?
- A. Cardiac function
- B. Renal function
- C. Liver function
- D. Pulmonary function
Correct Answer: A
Rationale: The correct answer is A: Cardiac function. Imatinib can cause fluid retention and heart failure, so cardiac function should be closely monitored. Renal function (choice B) is not typically affected by imatinib. Liver function (choice C) is not the primary concern with this medication. Pulmonary function (choice D) is not directly impacted by imatinib therapy.
Nurse Farah is caring for a client following a mastectomy. Which assessment finding indicates that the client is experiencing a complication related to the surgery?
- A. Pain at the incision site
- B. Arm edema on the operative side
- C. Sanguineous drainage in the Jackson-Pratt drain
- D. Complaints of decreased sensation near the operative site
Correct Answer: B
Rationale: Arm edema on the operative side (lymphedema) is a known complication after a mastectomy. This can indicate impaired lymphatic drainage, leading to fluid accumulation in the arm. Pain at the incision site is expected postoperatively and may not necessarily indicate a complication. Sanguineous drainage in the Jackson-Pratt drain is a common finding in the immediate postoperative period. Complaints of decreased sensation near the operative site could be related to nerve damage or surgical manipulation, but it is not a typical complication after a mastectomy.
Which of the following is a correct statement by the nurse to a patient under radiation therapy?
- A. Brachytherapy can be administered by a pregnant nurse
- B. Teletherapy makes the patient radioactive
- C. Brachytherapy is an internal radiation therapy
- D. Teletherapy requires proper disposal of feces since feces is not a source of radiation
Correct Answer: C
Rationale: The correct statement is that Brachytherapy is an internal radiation therapy. Brachytherapy involves placing radioactive sources inside or near the tumor, delivering a high radiation dose to the targeted area while minimizing exposure to surrounding healthy tissues. Choices A and B are incorrect because pregnant nurses should not administer radiation therapy and brachytherapy does not make the patient radioactive. Choice D is incorrect as feces is not a source of radiation in teletherapy, and it does not require special disposal.