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A patient newly diagnosed with cancer is scheduled to begin chemotherapy treatment and the nurse is providing anticipatory guidance about potential adverse effects. When addressing the most common adverse effect, what should the nurse describe?
- A. Pruritis (itching)
- B. Nausea and vomiting
- C. Altered glucose metabolism
- D. Confusion
Correct Answer: B
Rationale: Nausea and vomiting are among the most common and distressing side effects of chemotherapy. Chemotherapy drugs target rapidly dividing cells, including cancer cells, but they also affect healthy cells in the gastrointestinal (GI) tract, triggering the release of chemicals that stimulate the brain's vomiting center. These side effects can occur immediately (acute), be delayed, or even anticipatory, and often require management with antiemetic (anti-nausea) medications to improve the patient's comfort and quality of life during treatment.
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While giving care to a client with an internal cervical radiation implant, the nurse finds the implant in the bed. The nurse should take which initial action?
- A. Call the health care provider (HCP).
- B. Reinsert the implant into the vagina.
- C. Pick up the implant with gloved hands and flush it down the toilet.
- D. Pick up the implant with long-handled forceps and place it in a lead container.
Correct Answer: D
Rationale: When caring for a client with an internal cervical radiation implant, safety measures must be followed to protect both the client and healthcare personnel from radiation exposure. If the implant becomes dislodged and is found in the bed, the nurse's priority is to handle it safely using long-handled forceps, as direct contact with the implant could result in radiation exposure. The implant should be placed in a lead-lined container, which is specifically designed to shield against radiation, to prevent further contamination or exposure. After securing the implant, the nurse should notify the radiation safety officer or healthcare provider for further guidance.
Which of the following statements by the oncology nurse displays understanding about antineoplastic medications?
- A. Chemotherapy is not going to spread throughout the body
- B. Chemotherapy affects the immune system
- C. Chemotherapy is specific to cancer cells only
- D. Chemotherapy makes the patient radioactive
Correct Answer: B
Rationale: Chemotherapy targets rapidly dividing cells, which include both cancerous and healthy cells, such as those in the bone marrow, hair follicles, and the lining of the digestive tract. Since the bone marrow produces immune cells (white blood cells), chemotherapy can weaken the immune system by reducing the body's ability to produce these cells, making patients more susceptible to infections. This is why close monitoring and supportive measures to protect immune function are important during chemotherapy treatment.
A patient with acute myeloid leukemia (AML) is receiving induction therapy. What is the priority nursing intervention during this phase of treatment?
- A. Administering pain management
- B. Monitoring for signs of infection
- C. Providing emotional support
- D. Monitoring fluid balance
Correct Answer: B
Rationale: Induction therapy for acute myeloid leukemia (AML) involves intensive chemotherapy aimed at achieving remission by eliminating a large number of cancerous cells. However, this aggressive treatment also severely reduces the production of healthy blood cells, including neutrophils, which leads to neutropenia (a dangerously low number of neutrophils). This makes the patient highly susceptible to infections, which can be life-threatening. Monitoring for signs of infection is critical during this phase, as infections may occur quickly and progress rapidly due to the compromised immune system. Early detection and prompt treatment of infections are vital to improving patient outcomes during induction therapy.
A client is admitted to the hospital with a suspected diagnosis of Hodgkin¢â‚¬â„¢s disease. Which assessment finding would the nurse expect to note specifically in the client?
- A. Fatigue
- B. Weakness
- C. Weight gain
- D. Enlarged lymph nodes
Correct Answer: D
Rationale: Hodgkin's disease (Hodgkin's lymphoma) is a type of cancer that originates in the lymphatic system, particularly affecting the lymph nodes. A hallmark sign of Hodgkin's disease is the painless enlargement of lymph nodes, often in the neck, armpit, or groin. These enlarged lymph nodes are typically firm and rubbery to the touch. This is one of the most distinctive and common early signs that healthcare providers look for when diagnosing the disease.
The nurse is caring for a patient with an advanced stage of breast cancer and the patient has recently learned that her cancer has metastasized. The nurse enters the room and finds the patient struggling to breathe and the nurse¢â‚¬â„¢s rapid assessment reveals that the patient¢â‚¬â„¢s jugular veins are distended. The nurse should suspect the development of what oncologic emergency?
- A. Increased intracranial pressure
- B. Superior vena cava syndrome (SVCS)
- C. Spinal cord compression
- D. Metastatic tumor of the neck
Correct Answer: B
Rationale: Superior vena cava syndrome (SVCS) occurs when the superior vena cava, the large vein responsible for returning blood from the upper body to the heart, becomes obstructed or compressed, often due to a tumor, such as metastasized breast cancer. SVCS results in impaired venous drainage, leading to symptoms like distended jugular veins, facial swelling, difficulty breathing (dyspnea), and upper body edema. It is a medical emergency that requires prompt intervention to restore blood flow and alleviate symptoms.