Nokea
A nurse who works in an oncology clinic is assessing a patient who has arrived for a 2-month follow-up appointment following chemotherapy. The nurse notes that the patient's skin appears yellow. Which blood tests should be done to further explore this clinical sign?
- A. Liver function tests (LFTs)
- B. Complete blood count (CBC)
- C. Platelet count
- D. Blood urea nitrogen and creatinine
Correct Answer: A
Rationale: Corrected Detailed Rationale: Yellow skin is a sign of jaundice, which is often associated with liver disease. Liver function tests (LFTs) help in evaluating liver health and function. A complete blood count (CBC) primarily assesses red and white blood cells and platelets, not directly related to jaundice. Platelet count specifically measures platelets in the blood and is unrelated to the yellow skin observed in this patient. Blood urea nitrogen and creatinine tests focus on kidney function, not typically associated with yellow skin, making them less relevant in this context.
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All of the following are warning signs of cancer except:
- A. Patient palpates a bump on the side of the breast
- B. Bruises are found on the body that the client cannot explain
- C. Patient often complains of impaired digestion
- D. Patient has blood-tinged sputum
Correct Answer: D
Rationale: The correct answer is D. Blood-tinged sputum is not a typical warning sign of cancer but rather a symptom that can indicate other serious conditions like respiratory issues or infections. Choices A, B, and C are common warning signs of cancer: palpable lumps or bumps, unexplained bruises, and persistent digestive issues are often associated with cancer and should be evaluated by a healthcare professional for further assessment and diagnosis.
A nurse works with clients who have alopecia from chemotherapy. What action by the nurse takes priority?
- A. Helping clients adjust to their appearance.
- B. Reassuring clients that this change is temporary.
- C. Referring clients to a reputable wig shop.
- D. Teaching measures to prevent scalp injury.
Correct Answer: D
Rationale: The correct answer is D: Teaching measures to prevent scalp injury. Alopecia makes the scalp more vulnerable to injury, so educating clients on protective measures is crucial. Choices A and B focus on emotional support and reassurance, which are important but secondary to physical safety. Referring clients to a wig shop (choice C) addresses appearance but does not directly address the physical risk associated with scalp vulnerability.
A healthcare professional is assessing a female client who is taking hormone therapy for breast cancer. What assessment finding requires the healthcare professional to notify the primary health care provider immediately?
- A. Irregular menses.
- B. Edema in the lower extremities.
- C. Ongoing breast tenderness.
- D. Red, warm, swollen calf.
Correct Answer: D
Rationale: The correct answer is D. A red, warm, swollen calf may indicate a deep vein thrombosis, which is a medical emergency. This finding requires immediate notification of the primary health care provider to prevent potential complications such as pulmonary embolism. Choices A, B, and C are not indicative of life-threatening conditions and should be monitored but do not require immediate notification like a suspected deep vein thrombosis.
Nurse Kate is reviewing the complications of conization with a client who has microinvasive cervical cancer. Which complication, if identified by the client, indicates a need for further teaching?
- A. Infection
- B. Hemorrhage
- C. Cervical stenosis
- D. Ovarian perforation
Correct Answer: D
Rationale: The correct answer is D, 'Ovarian perforation.' Ovarian perforation is not a complication associated with conization; therefore, if the client identifies this as a potential complication, it indicates a need for further teaching. Choices A, B, and C are incorrect: Infection, hemorrhage, and cervical stenosis are potential complications of conization, so identifying them would not necessarily indicate a need for further teaching.
In caring for a patient with a diagnosis of acute myeloid leukemia (AML) receiving induction therapy on the oncology unit, what nursing action should be prioritized in the patient's care plan?
- A. Protective isolation and vigilant use of standard precautions
- B. Provision of a high-calorie, low-texture diet and appropriate oral hygiene
- C. Including the family in planning the patient's activities of daily living
- D. Monitoring and treating the patient's pain
Correct Answer: A
Rationale: The correct answer is A: Protective isolation and vigilant use of standard precautions. Induction therapy for acute myeloid leukemia (AML) can lead to neutropenia, significantly increasing the risk of infections. Therefore, the priority is to protect the patient from potential pathogens by implementing protective isolation measures and adhering to strict standard precautions. This action is crucial for the patient's survival. Choice B is incorrect as nutritional support and oral hygiene are important but not the priority in this situation. Choice C, involving the family in planning activities, is a valuable aspect of care but not the priority during induction therapy. Choice D, monitoring and treating pain, is essential but ensuring protection against infection takes precedence due to the high risk of neutropenia.