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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A patient who is undergoing consolidation therapy for the treatment of leukemia has been experiencing debilitating fatigue. How can the nurse best meet this patients needs for physical activity?
- A. Teach the patient about the risks of immobility and the benefits of exercise.
- B. Assist the patient to a chair during awake times, as tolerated.
- C. Collaborate with the physical therapist to arrange for stair exercises.
- D. Teach the patient to perform deep breathing and coughing exercises.
Correct Answer: B
Rationale: For patients undergoing consolidation therapy for leukemia, severe fatigue is a common side effect of treatment due to factors such as anemia, decreased nutritional intake, and the body's response to chemotherapy. While exercise is beneficial, the patient's fatigue may limit their ability to engage in strenuous activity. Assisting the patient to sit in a chair during awake times is a practical way to encourage some physical activity while respecting their fatigue levels. This intervention helps prevent complications associated with immobility, such as muscle atrophy and venous stasis, without overwhelming the patient. It allows the patient to engage in light activity that is manageable and promotes recovery.
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.
Traditionally, nurses have been involved with tertiary cancer prevention. However, an increasing emphasis is being placed on both primary and secondary prevention. What would be an example of primary prevention?
- A. Yearly Pap tests
- B. Testicular self-examination
- C. Teaching patients to wear sunscreen
- D. Screening mammograms
Correct Answer: C
Rationale: Primary prevention involves actions taken to reduce the risk of developing cancer by preventing exposure to known risk factors or promoting healthy behaviors. Teaching patients to wear sunscreen is an example of primary prevention because it aims to reduce the risk of skin cancer by minimizing exposure to harmful ultraviolet (UV) radiation from the sun. Encouraging protective measures such as wearing sunscreen, avoiding tanning beds, and wearing protective clothing are all steps to prevent skin cancer before it develops.
An oncology patient has just returned from the post-anesthesia care unit after an open hemicolectomy. This patient¢â‚¬â„¢s plan of nursing care should prioritize which of the following?
- A. Assess the patient hourly for signs of compartment syndrome.
- B. Assess the patient¢â‚¬â„¢s fine motor skills once per shift.
- C. Assess the patient¢â‚¬â„¢s wound for dehiscence every 4 hours.
- D. Maintain the patient¢â‚¬â„¢s head of bed at 45 degrees or more at all times.
Correct Answer: C
Rationale: After an open hemicolectomy (surgical removal of part of the colon), monitoring the surgical wound for signs of dehiscence (wound reopening) is a critical nursing priority. Dehiscence is a serious postoperative complication that can occur if the surgical site does not heal properly. Regular wound assessments every 4 hours allow the nurse to identify early signs of complications, such as redness, swelling, increased drainage, or separation of the wound edges. Early detection is key to preventing further complications, such as infection or evisceration (protrusion of abdominal organs through the wound).
An oncology nurse educator is providing health education to a patient who has been diagnosed with skin cancer. The patient¢â‚¬â„¢s wife has asked about the differences between normal cells and cancer cells. What characteristic of a cancer cell should the educator cite?
- A. Malignant cells contain more fibronectin than normal body cells.
- B. Malignant cells contain proteins called tumor-specific antigens.
- C. Chromosomes contained in cancer cells are more durable and stable than those of normal cells.
- D. The nuclei of cancer cells are unusually large, but regularly shaped.
Correct Answer: B
Rationale: Malignant (cancer) cells often express tumor-specific antigens (TSAs), which are proteins or markers on the surface of cancer cells that are not found on normal cells. These antigens are produced due to genetic mutations in cancer cells and can sometimes be used to help the immune system recognize and attack cancerous cells. Tumor-specific antigens play a key role in cancer diagnosis, monitoring, and targeted therapies.