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A patient has a diagnosis of multiple myeloma and the nurse is preparing health education in preparation for discharge from the hospital. What action should the nurse promote?
- A. Daily performance of weight-bearing exercise to prevent muscle atrophy
- B. Close monitoring of urine output and kidney function
- C. Daily administration of warfarin (Coumadin) as ordered
- D. Safe use of supplementary oxygen in the home setting
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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A patient¢â‚¬â„¢s most recent diagnostic imaging has revealed that his lung cancer has metastasized to his bones and liver. What is the most likely mechanism by which the patient¢â‚¬â„¢s cancer cells spread?
- A. Hematologic spread
- B. Lymphatic circulation
- C. Invasion
- D. Angiogenesis
Correct Answer: B
Rationale: In the case of lung cancer that has metastasized to the bones and liver, lymphatic circulation is a key mechanism by which cancer cells spread from the primary tumor site to distant organs. Cancer cells can invade nearby lymphatic vessels and travel through the lymphatic system, eventually reaching lymph nodes and spreading to other tissues and organs. This route is significant in the metastasis of many types of cancer, including lung cancer.
The nurse is reviewing the medication record for a client receiving chemotherapy and notes that the client is receiving epoetin alfa (Epogen). The nurse determines that this medication has been prescribed to:
- A. Increase white blood cell production
- B. Treat anemia
- C. Reduce pain
- D. Prevent infection
Correct Answer: B
Rationale: Epoetin alfa (Epogen) is a synthetic form of erythropoietin, a hormone that stimulates the production of red blood cells in the bone marrow. Chemotherapy often leads to anemia due to its effects on rapidly dividing cells, including those in the bone marrow responsible for red blood cell production. By administering epoetin alfa, the healthcare provider aims to increase the red blood cell count and improve hemoglobin levels, thereby alleviating symptoms associated with anemia, such as fatigue and weakness.
The nurse is teaching a client about the signs of infection after chemotherapy. Which of the following should the nurse emphasize?
- A. Frequent urination
- B. Increased thirst
- C. Chills and shaking
- D. Fever over 100.4°F (38°C)
Correct Answer: D
Rationale: In clients undergoing chemotherapy, the immune system is often compromised due to the effects of treatment, making them more susceptible to infections. A fever over 100.4°F (38°C) is considered a critical sign of infection in these patients and requires immediate medical evaluation. Fever may indicate the presence of an infection that could escalate quickly in immunocompromised individuals, so it is vital for patients to recognize this symptom and seek prompt medical attention.
The nurse is reviewing the history of a client with bladder cancer. The nurse expects to note documentation of which most common symptom of this type of cancer?
- A. Dysuria
- B. Hematuria
- C. Urgency on urination
- D. Frequency of urination
Correct Answer: B
Rationale: Hematuria, or blood in the urine, is the most common and distinctive symptom associated with bladder cancer. It can present as either gross hematuria (visible blood) or microscopic hematuria (detected only through urinalysis). The presence of blood in the urine often prompts further evaluation for potential underlying causes, including bladder cancer. It is crucial for healthcare providers to recognize this symptom, as early detection significantly impacts treatment outcomes.
A client with long-standing heart failure being treated for cancer has received a dose of ondansetron for nausea. What action by the nurse is most important?
- A. Assess the client for a headache or dizziness.
- B. Request a prescription for cardiac monitoring.
- C. Instruct the client to change positions slowly.
- D. Weigh the client daily before eating.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.