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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: Sitting in a chair is preferable to bed rest, even if a patient is experiencing severe fatigue. A patient who has debilitating fatigue would not likely be able to perform stair exercises. Teaching about mobility may be necessary, but education must be followed by interventions that actually involve mobility. Deep breathing and coughing reduce the risk of respiratory complications but are not substitutes for physical mobility in preventing deconditioning.
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A patient has a diagnosis of multiple myeloma and the nurse is preparing health education in preparation for discharge from the hospital. What action should the nurse promote?
- A. Daily performance of weight-bearing exercise to prevent muscle atrophy
- B. Close monitoring of urine output and kidney function
- C. Daily administration of warfarin (Coumadin) as ordered
- D. Safe use of supplementary oxygen in the home setting
Correct Answer: B
Rationale: Renal function must be monitored closely in the patient with multiple myeloma. Excessive weight-bearing can cause pathologic fractures. There is no direct indication for anticoagulation or supplementary oxygen.
After receiving a diagnosis of acute lymphocytic leukemia, a patient is visibly distraught, stating, I have no idea where to go from here. How should the nurse prepare to meet this patients psychosocial needs?
- A. Assess the patients previous experience with the health care system.
- B. Reassure the patient that treatment will be challenging but successful.
- C. Assess the patients specific needs for education and support.
- D. Identify the patients plan of medical care.
Correct Answer: C
Rationale: In order to meet the patients needs, the nurse must first identify the specific nature of these needs. According to the nursing process, assessment must precede interventions. The plan of medical care is important, but not central to the provision of support. The patients previous health care is not a primary consideration, and the nurse cannot assure the patient of successful treatment.
A nurse is caring for a patient who is being treated for leukemia in the hospital. The patient was able to maintain her nutritional status for the first few weeks following her diagnosis but is now exhibiting early signs and symptoms of malnutrition. In collaboration with the dietitian, the nurse should implement what intervention?
- A. Arrange for total parenteral nutrition (TPN).
- B. Facilitate placement of a percutaneous endoscopic gastrostomy (PEG) tube.
- C. Provide the patient with several small, soft-textured meals each day.
- D. Assign responsibility for the patients nutrition to the patients friends and family.
Correct Answer: C
Rationale: For patients experiencing difficulties with oral intake, the provision of small, easily chewed meals may be beneficial. This option would be trialed before resorting to tube feeding or TPN. The family should be encouraged to participate in care, but should not be assigned full responsibility.
An oncology nurse is caring for a patient with multiple myeloma who is experiencing bone destruction. When reviewing the patients most recent blood tests, the nurse should anticipate what imbalance?
- A. Hypercalcemia
- B. Hyperproteinemia
- C. Elevated serum viscosity
- D. Elevated RBC count
Correct Answer: A
Rationale: Hypercalcemia may result when bone destruction occurs due to the disease process. Elevated serum viscosity occurs because plasma cells excrete excess immunoglobulin. RBC count will be decreased. Hyperproteinemia would not be present.
A nurse is caring for a patient with Hodgkin lymphoma at the oncology clinic. The nurse should be aware of what main goal of care?
- A. Cure of the disease
- B. Enhancing quality of life
- C. Controlling symptoms
- D. Palliation
Correct Answer: A
Rationale: The goal in the treatment of Hodgkin lymphoma is cure. Palliation is thus not normally necessary. Quality of life and symptom control are vital, but the overarching goal is to cure the disease.