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A patient has been assigned the nursing diagnosis of imbalanced nutrition: less than body requirements related to painful oral ulcers. Which nursing action will be most effective in improving oral intake?
- A. Offer the patient frequent small snacks between meals.
- B. Assist the patient to choose favorite foods from the menu.
- C. Provide teaching about the importance of nutritional intake.
- D. Apply prescribed anesthetic gel to oral lesions before meals.
Correct Answer: D
Rationale: Painful oral ulcers from cancer or chemo kill appetite anesthetic gel (e.g., lidocaine) numbs them pre-meal, making eating bearable. Snacks and favorites tempt but don't dull pain. Teaching informs, not fixes. Nurses in oncology prioritize this pain relief drives intake, tackling the root of this nutrition nosedive.
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Diabetes is associated with pathophysiological mechanisms that contribute to the development of cardiovascular events. Question: What is the approximate percentage of diabetes patients who also have hypertension?
- A. 25%
- B. 50%
- C. 75%
- D. 100%
Correct Answer: C
Rationale: Diabetes and hypertension 75% overlap, sugar and pressure tag-team hearts. Nurses watch this, a chronic duo hit.
The nurse is orienting a new nurse to the oncology unit. When reviewing the safe administration of antineoplastic agents, what action should the nurse emphasize?
- A. Adjust the dose to the patient's present symptoms
- B. Wash hands with an alcohol-based cleanser following administration
- C. Use gloves and a lab coat when preparing the medication
- D. Dispose of the antineoplastic wastes in the hazardous waste receptacle
Correct Answer: D
Rationale: Antineoplastics are hazardous proper disposal in designated receptacles is critical to protect staff, patients, and the environment from toxic exposure. Gloves and gowns are standard for prep, but the question stresses one action, and disposal trumps as a universal safety net. Dosing's fixed by protocol, not symptoms tweaking's dangerous. Alcohol-based cleansers don't cut it post-exposure; soap and water are needed pre- and post-handling to remove residue. Emphasizing disposal aligns with OSHA and oncology nursing standards, ensuring chemo waste (e.g., IV bags, syringes) doesn't leak into regular trash, a key lesson for newbies in this high-stakes field.
After percutaneous cervical cordotomy:
- A. Ptosis and miosis occur on same side as the thermal lesion.
- B. Temporary reduced power in the arm or leg occur on the same side as the thermal lesion.
- C. Patients are likely to stay in hospital until retitration of opioid medication is complete.
- D. Immediately after successful cervical cordotomy, the pretreatment dose of opioid is likely to be reduced by 10%.
Correct Answer: A
Rationale: Post-percutaneous cervical cordotomy (PCC), outcomes relate to its C1-C2 approach. Ptosis and miosis (Horner's syndrome) occur ipsilateral to the lesion from sympathetic chain disruption common but often transient. Weakness, if any, affects the contralateral side due to corticospinal tract proximity, not ipsilateral, and is rare with modern precision. Hospital stay varies; opioid retitration may occur outpatient unless complications arise. Successful PCC reduces opioid needs by >50% often, not just 10%, due to effective pain relief. Neuropathic pain can emerge from tract damage. Horner's syndrome's ipsilateral presentation is a hallmark, reflecting local anatomy and PCC's occasional sympathetic impact, typically self-limiting.
The following strategies can be used to help patients overcome the barriers and challenges faced in insulin therapy EXCEPT:
- A. Engage the patient in shared decision making
- B. Threaten the patient into adherence with insulin therapy
- C. Provide close supervision and follow-up when the patient is newly initiated on insulin therapy
- D. Offer measures to reduce weight gain through lifestyle and dietary advice, concomitant use of insulin with metformin, SGLT-2 inhibitors, GLPIRA
Correct Answer: B
Rationale: Insulin's hurdles yield to shared decisions, close watch, weight tricks, and goal setting empowering, not bullying. Threats tank trust and adherence, backfiring in chronic care where buy-in's king. Support beats scare tactics, aligning with diabetes' need for partnership, a strategy flop amid solid aids.
A patient with lung cancer develops syndrome of inappropriate antidiuretic hormone secretion (SIADH). After reporting symptoms of weight gain, weakness, and nausea and vomiting to the physician, you would anticipate which initial order for the treatment of this patient?
- A. A fluid bolus as ordered
- B. Fluid restrictions as ordered
- C. Urinalysis as ordered
- D. Sodium-restricted diet as ordered
Correct Answer: B
Rationale: SIADH, common in lung cancer, overproduces ADH, retaining water and diluting sodium hyponatremia causes weight gain, weakness, nausea. Fluid restriction, the initial fix, curbs water intake, raising sodium levels naturally, tackling the root imbalance. A fluid bolus worsens dilution, risking seizures. Urinalysis checks concentration, not a treatment. Sodium restriction deepens hyponatremia, counterproductive. Anticipating fluid limits aligns with SIADH's pathophysiology nurses expect this order to stabilize the patient, monitoring for symptom relief or escalation, a frontline step in managing this paraneoplastic crisis.