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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, the most common side effects of chemotherapy, may persist for as long as 24 to 48 hours after its administration. Antiemetic drugs are frequently prescribed for these patients. Confusion, alterations in glucose metabolism, and pruritis are not common adverse effects.
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A 60-year-old patient with a diagnosis of prostate cancer is scheduled to have an interstitial implant for high-dose radiation (HDR). What safety measure should the nurse include in this patients subsequent plan of care?
- A. Limit the time that visitors spend at the patients bedside
- B. Teach the patient to perform all aspects of basic care independently
- C. Assign male nurses to the patients care whenever possible
- D. Situate the patient in a shared room with other patients receiving brachytherapy
Correct Answer: A
Rationale: To limit radiation exposure, visitors should generally not spend more than 30 minutes with the patient. Pregnant nurses or visitors should not be near the patient, but there is no reason to limit care to nurses who are male. All necessary care should be provided to the patient and a single room should be used.
The nurse is caring for a patient who is to begin receiving external radiation for a malignant tumor of the neck. While providing patient education, what potential adverse effects should the nurse discuss with the patient?
- A. Impaired nutritional status
- B. Cognitive changes
- C. Diarrhea
- D. Alopecia
Correct Answer: A
Rationale: Alterations in oral mucosa, change and loss of taste, pain, and dysphagia often occur as a result of radiotherapy to the head and neck. The patient is at an increased risk of impaired nutritional status. Radiotherapy does not cause cognitive changes. Diarrhea is not a likely concern for this patient. Radiation only results in alopecia when targeted at the whole brain; radiation of other parts of the body does not lead to hair loss.
You are caring for an adult patient who has developed a mild oral yeast infection following chemotherapy. What actions should you encourage the patient to perform? Select all that apply.
- A. Use a lip lubricant
- B. Scrub the tongue with a firm-bristled toothbrush
- C. Use dental floss every 24 hours
- D. Rinse the mouth with normal saline
- E. Eat spicy food to aid in eradicating the yeast
Correct Answer: A,C,D
Rationale: Stomatitis is an inflammation of the oral cavity. The patient should be encouraged to brush the teeth with a soft toothbrush after meals, use dental floss every 24 hours, rinse with normal saline, and use a lip lubricant. Mouthwashes and hot foods should be avoided.
An oncology nurse is contributing to the care of a patient who has failed to respond appreciably to conventional cancer treatments. As a result, the care team is considering the possible use of biologic response modifiers (BRFs). The nurse should know that these achieve a therapeutic effect by what means?
- A. Promoting the synthesis and release of leukocytes
- B. Focusing the patients immune system exclusively on the tumor
- C. Potentiating the effects of chemotherapeutic agents and radiation therapy
- D. Altering the immunologic relationship between the tumor and the patient
Correct Answer: D
Rationale: BRFs alter the immunologic relationship between the tumor and the cancer patient (host) to provide a beneficial effect. They do not necessarily increase white cell production or focus the immune system solely on the patients. BRFs do not potentiate the effects of radiotherapy and chemotherapy.
The hospice nurse has just admitted a new patient to the program. What principle guides hospice care?
- A. Care addresses the needs of the patient as well as the needs of the family
- B. Care is focused on the patient centrally and the rest of the family is secondary
- C. The focus of all aspects of care is solely on the patient
- D. The care team prioritizes the patients physical needs and the family is responsible for the patients emotional needs
Correct Answer: A
Rationale: The focus of hospice care is on the family as well as the patient. The family is not solely responsible for the patients emotional well-being.