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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 nurse is caring for a client diagnosed with polycythemia vera. Which of the following should the nurse include in the client and family education?
- A. Resume normal activity
- B. Wear support hose while awake
- C. Decrease fluid intake to no more than 1 liter per day
- D. Diet high in vitamin K intake
Correct Answer: B
Rationale: Polycythemia vera thickens blood, slowing venous return support hose boost circulation, cutting clot risk, a practical teaching point for clients and families. Normal activity's fine but misses prevention. Less fluid thickens blood further, dangerous here; high vitamin K aids clotting, counterproductive. Nurses push hose use, easing symptoms like swelling, a key strategy in managing this hyperviscous state.
External-beam radiation is planned for a patient with cervical cancer. What instructions should the nurse give to the patient to prevent complications from the effects of the radiation?
- A. Test all stools for the presence of blood.
- B. Maintain a high-residue, high-fiber diet.
- C. Clean the perianal area carefully after every bowel movement.
- D. Inspect the mouth and throat daily for the appearance of thrush.
Correct Answer: C
Rationale: Cervical radiation hits the pelvis diarrhea's a beast from bowel irritation. Gentle perianal cleaning stops skin breakdown and infection, a must-do. Stool blood happens but isn't routine to test diarrhea's expected. High-fiber worsens it low-residue's better. Thrush is oral, not pelvic radiation's turf. Nurses in oncology push this hygiene tip, keeping skin intact amid radiation's gut chaos.
When assigning staff to patients who are receiving chemotherapy, what is the major consideration about chemotherapeutic drugs?
- A. During preparation, drugs may be absorbed through the skin or inhaled
- B. Many chemotherapeutics are vesicants
- C. Chemotherapeutics are frequently given through central venous access devices
- D. Oral and venous routes are the most common
Correct Answer: A
Rationale: Chemotherapy's potency demands safety focus preparation risks skin absorption or inhalation, exposing staff to toxins, necessitating specialized training and protective gear. Vesicants, causing tissue damage if extravasated, are a concern, but preparation hazards affect all drugs, broader in scope. Central venous access is common but a procedural detail, not the primary staffing issue. Route prevalence is logistical, not safety-centric. Prioritizing exposure risk ensures staff handling mixing, drawing minimizes occupational harm, a legal and ethical imperative, shaping assignments to trained personnel, critical in chemotherapy's high-stakes delivery.
A nurse is caring for a 19-year-old male recently diagnosed with leukemia. Which of the following nursing interventions is appropriate for the care of this client?
- A. Fluid restriction
- B. Low residual diet
- C. Therapeutic phlebotomy
- D. Strict hand hygiene to prevent infection
Correct Answer: D
Rationale: Leukemia's marrow mess drops immunity strict hand hygiene shields this 19-year-old from infections, a top intervention as neutrophils crash. Fluid restriction fits overload, not here. Low residual diets aid bowels, irrelevant. Phlebotomy's for polycythemia. Nurses scrub up, guarding this young client, a germ-free must in leukemia's fragile fight.
The nurse is providing preoperative care for a 7-year-old patient with a brain tumor. Which of the following is the priority intervention?
- A. Assessing the child's level of consciousness
- B. Providing a tour of the intensive care unit for the child and parents
- C. Educating the child and parents about shunts
- D. Having the child talk to another child who has had this surgery
Correct Answer: A
Rationale: For a child with a brain tumor preoperatively, assessing level of consciousness (LOC) is the priority, as it monitors for increased intracranial pressure (ICP) from tumor mass effect vital signs like alertness or confusion shift rapidly and signal deterioration needing immediate action. No baseline data exists here, making LOC the first step in the nursing process to guide care. An ICU tour reduces anxiety but delays critical assessment. Shunt education applies post-diagnosis of hydrocephalus, not universally pre-op, and lacks urgency without LOC context. Peer support is psychosocial, not physiological, and secondary. LOC assessment aligns with ABCs (circulation includes cerebral perfusion), ensuring the nurse detects neurological decline early, a cornerstone of pediatric neuro-oncology care before surgery.