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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: Thrombocytopenia is a condition characterized by a low platelet count, which increases the risk of bleeding and hemorrhage. Patients receiving chemotherapy agents like carmustine may experience thrombocytopenia as a significant side effect. Epistaxis (nosebleeds) is a common symptom associated with thrombocytopenia, as the blood vessels can become more fragile, and even minor trauma or spontaneous bleeding can occur. Therefore, assessing for signs of bleeding, including epistaxis, is crucial in patients at risk for thrombocytopenia.
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A nurse enters the room of a patient with bladder cancer. The patient asks the nurse about the actions of chemotherapeutic drugs. Which of the following statements by the nurse is correct?
- A. Chemotherapeutic drugs will kill all of your cancer cells
- B. Chemotherapeutic medications are attracted mostly to slowly dividing cells
- C. Chemotherapy can cure cancer
- D. Chemotherapy is specifically destroying cancer cells
Correct Answer: D
Rationale: Chemotherapy drugs are designed to target and destroy rapidly dividing cells, which include cancer cells. Cancer cells often divide more quickly than normal cells, and chemotherapeutic agents exploit this characteristic to inhibit their growth and promote cell death. While chemotherapy can also affect other rapidly dividing normal cells (such as those in the bone marrow, gastrointestinal tract, and hair follicles), the primary goal is to target cancerous cells.
A client hospitalized for chemotherapy has a hemoglobin of 6.1 mg/dL (61 mmol/L). The client is symptomatic but refuses blood transfusions. What medication does the nurse prepare to administer?
- A. Epoetin alfa.
- B. Filgrastim.
- C. Mesna.
- D. Dexrazoxane.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client with breast cancer is receiving doxorubicin (Adriamycin). The nurse monitors the client closely for:
- A. Pulmonary fibrosis
- B. Cardiotoxicity
- C. Hepatotoxicity
- D. Nephrotoxicity
Correct Answer: B
Rationale: Doxorubicin (Adriamycin) is an anthracycline chemotherapy agent commonly used to treat various cancers, including breast cancer. One of the significant side effects associated with doxorubicin is cardiotoxicity, which can lead to serious complications such as heart failure and arrhythmias. The risk of cardiotoxicity is dose-dependent, meaning that higher cumulative doses increase the likelihood of cardiac damage. Therefore, it is essential for nurses to monitor cardiac function closely through assessments such as echocardiograms or monitoring for signs and symptoms of heart failure, such as shortness of breath, fatigue, and edema.
A 16-year-old female patient experiences alopecia resulting from chemotherapy, prompting the nursing diagnoses of disturbed body image and situational low self-esteem. What action by the patient would best indicate that she is meeting the goal of improved body image and self-esteem?
- A. The patient requests that her family bring her makeup and wig.
- B. The patient begins to discuss the future with her family.
- C. The patient reports less disruption from pain and discomfort.
- D. The patient cries openly when discussing her disease.
Correct Answer: A
Rationale: When a patient experiences alopecia due to chemotherapy, it can significantly impact their self-esteem and body image, particularly in adolescents who are especially sensitive to physical changes. A request for makeup and a wig indicates that the patient is actively taking steps to enhance her appearance and cope with the changes brought on by her treatment. This action reflects a positive engagement with her body image and suggests a desire to feel more comfortable and confident in her appearance, signaling an improvement in her self-esteem.
A nurse works on an oncology unit and delegates personal hygiene to assistive personnel (AP). What action by the AP requires intervention from the nurse?
- A. Allowing a very tired client to skip oral hygiene and sleep.
- B. Assisting clients with washing the perianal area every 12 hours.
- C. Helping the client use a soft-bristled toothbrush for oral care.
- D. Reminding the client to rinse the mouth with water or saline.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.