Nokea
A patient on the oncology unit is receiving carmustine, a chemotherapy agent, and the nurse is aware that a significant side effect of this medication is thrombocytopenia. Which symptom should the nurse assess for in patients at risk for thrombocytopenia?
- A. Interrupted sleep pattern
- B. Hot flashes
- C. Epistaxis (nose bleed)
- D. Increased weight
Correct Answer: C
Rationale: Carmustine, a nitrosourea, slams bone marrow, dropping platelets and causing thrombocytopenia low counts mean bleeding risks soar. Epistaxis (nosebleeds) is a classic sign, as mucosal vessels lack clotting support, especially with counts below 50,000/µL. Sleep issues might tie to discomfort but aren't direct. Hot flashes link to hormonal therapies, not this. Weight gain's unrelated cancer often causes loss. Nurses zero in on bleeding like epistaxis, bruising, or petechiae checking daily for these red flags, vital in oncology to catch and manage this life-threatening chemo fallout early.
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A client in the oncology clinic reports her family is frustrated at her ongoing fatigue 4 months after radiation therapy for breast cancer. What response by the nurse is most appropriate?
- A. Are you getting adequate rest and sleep each day?
- B. It is normal to be fatigued even for years afterward.
- C. This is not normal and I'll let the provider know.
- D. Try adding more vitamins B and C to your diet.
Correct Answer: B
Rationale: Radiation therapy, commonly used for breast cancer, can cause persistent fatigue as a side effect due to cellular damage and the body's prolonged healing process. This fatigue can last for months or even years post-treatment, varying by individual factors like radiation dose and overall health. Telling the client it's normal validates her experience, reduces anxiety, and helps her family understand this as a common outcome rather than a personal failing. Asking about rest is useful but doesn't address the family's frustration or provide context. Declaring it abnormal and escalating to the provider is inaccurate unless other symptoms suggest a new issue, potentially causing unnecessary worry. Suggesting vitamins lacks evidence for resolving radiation-induced fatigue and shifts focus from education. The nurse's role here is to reassure and educate, making the normalization of long-term fatigue the most appropriate response, fostering coping and support within the family.
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 family peripherally
- C. The focus of all aspects of care is solely on the patient
- D. The care team prioritizes the patient's physical needs and the family is responsible for the patient's emotional needs
Correct Answer: A
Rationale: Hospice wraps the patient and family in care physical, emotional, spiritual for both, not just one. It's not patient-only or peripheral family focus; it's a unit. Splitting physical and emotional duties misses the holistic vibe. Nurses in oncology's endgame lean on this, ensuring comfort and support ripple out, easing the load for all as death nears.
Insulin is an anabolic hormone. Question: A catabolic state induced by insulin deficiency has an effect on which metabolism?
- A. Protein metabolism
- B. Glucose metabolism
- C. Fat metabolism
- D. A+B+C
Correct Answer: D
Rationale: Insulin gone, catabolism rages proteins break, glucose spikes, fats burn all unravel. No picking one; it's a full-body crash nurses see this in type 1's ketosis, a chronic fuel flip.
During his internship at a general practice, a medical student is asked to check the blood glucose level in a 30-year-old patient with type 1 diabetes. Acute glycaemic dysregulation is suspected in this patient. The patient asks if the student is going to take a capillary blood sample as shown in the picture below. Which of the following statements applies best in case of suspected acute dysregulation?
- A. The result will equal that of a finger prick sample
- B. The result will be higher than that of a finger prick sample
- C. The result will be lower than that of a finger prick sample
- D. One must not draw blood from this site in this case
Correct Answer: D
Rationale: Acute type 1 chaos no arm vein draw, finger prick's king for fast reads, not this site. Nurses skip this, a chronic crisis dodge.
Assessment of a wound does not include which of the following?
- A. Location
- B. Size
- C. Blood Pressure
- D. Colour of wound
Correct Answer: C
Rationale: Wound checks where, how big, what hue guide care. BP's body-wide, not wound-specific. Nurses skip it, a chronic sore's focus.