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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.
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An oncology patient will begin a course of chemotherapy and radiation therapy for the treatment of bone metastases. What is one means by which malignant disease processes transfer cells from one place to another?
- A. Adhering to primary tumor cells
- B. Inducing mutation of cells of another organ
- C. Phagocytizing healthy cells
- D. Invading healthy host tissues
Correct Answer: D
Rationale: The correct answer is D: Invading healthy host tissues. Invasion is the process where malignant cells grow into surrounding healthy tissues, allowing the cancer to spread to other parts of the body. Choices A, B, and C are incorrect. Adhering to primary tumor cells does not involve the transfer of cells to other locations, inducing mutation of cells of another organ is not a mechanism of cell transfer, and phagocytizing healthy cells refers to the process of engulfing and digesting cells, which is not a method of cancer cell transfer.
A client is admitted with superior vena cava syndrome. What action by the nurse is most appropriate?
- A. Administer a dose of allopurinol.
- B. Assess the client's serum potassium level.
- C. Gently inquire about advance directives.
- D. Prepare the client for emergency surgery.
Correct Answer: C
Rationale: The correct answer is to gently inquire about advance directives. Superior vena cava syndrome is often a late-stage manifestation, indicating a serious condition. Discussing advance directives with the client is crucial to ensure their wishes are known in case of deterioration. Administering allopurinol (Choice A) is not indicated for superior vena cava syndrome. Assessing the client's serum potassium level (Choice B) is not the priority when managing this syndrome. Emergency surgery (Choice D) is not typically the initial treatment for superior vena cava syndrome.
The patient is anxious about subjection to radiation therapy. Which of the following statements of the student nurse requires additional teaching?
- A. Teletherapy is radiation from an external source.
- B. Brachytherapy can be administered via oral or IV.
- C. Brachytherapy is a radiation from inside the patient's body.
- D. Chemotherapy is effective in killing all cancer cells.
Correct Answer: D
Rationale: The correct answer is D because the statement 'Chemotherapy is effective in killing all cancer cells' is incorrect. Chemotherapy does not kill all cancer cells and is not the same as radiation therapy. Chemotherapy targets rapidly dividing cells, including cancer cells, but it may not kill every single cancer cell. It is important for the student nurse to understand and communicate this distinction to the patient. Choices A, B, and C provide accurate information about teletherapy, brachytherapy, and chemotherapy, respectively, and do not require additional teaching.
The nurse is caring for a client following radical neck dissection and creation of a tracheostomy. Which assessment finding would indicate an immediate need for intervention?
- A. Frequent swallowing
- B. Presence of mucous membranes
- C. Bubbling in the water-seal chamber
- D. Inspiratory stridor
Correct Answer: D
Rationale: Inspiratory stridor is the correct answer as it suggests airway obstruction, a critical issue requiring immediate intervention. Frequent swallowing (choice A) is a common postoperative finding and does not indicate an immediate need for intervention. The presence of mucous membranes (choice B) is a normal finding and does not require immediate intervention. Bubbling in the water-seal chamber (choice C) of a chest tube drainage system is an expected finding and indicates proper functioning of the system, not an immediate need for intervention.
The nurse is instructing a client to perform a testicular self-examination (TSE). What information should the nurse provide about the procedure?
- A. To examine the testicles while lying down
- B. That the best time for the examination is after a shower
- C. To gently feel the testicle with one finger to feel for a growth
- D. That testicular self-examinations should be done at least every 6 months
Correct Answer: B
Rationale: The correct answer is B. The best time to perform a testicular self-examination is after a warm shower when the scrotal skin is relaxed. This makes it easier to detect any abnormalities. Choice A is incorrect because the examination should ideally be done while standing. Choice C is incorrect as the client should use both hands to roll each testicle between the thumb and fingers to feel for any lumps or changes in size. Choice D is incorrect because testicular self-examinations are recommended to be done monthly, not every 6 months, to monitor changes in the testicles.