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A patient with Hodgkin lymphoma is receiving radiation therapy. What side effect should the nurse monitor for that is most common with this type of treatment?
- A. Alopecia
- B. Fatigue
- C. Nausea
- D. Mucositis
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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The nurse on a bone marrow transplant unit is caring for a patient with cancer who is preparing for HSCT. What is a priority nursing diagnosis for this patient?
- A. Fatigue related to altered metabolic processes
- B. Altered nutrition: less than body requirements related to anorexia
- C. Risk for infection related to altered immunologic response
- D. Body image disturbance related to weight loss and anorexia
Correct Answer: C
Rationale: Patients preparing for hematopoietic stem cell transplantation (HSCT) undergo intensive chemotherapy and/or radiation, which significantly suppresses their immune system. This immunosuppression leads to a heightened risk for infection, making it the most critical nursing diagnosis for these patients. As the body's ability to fight off pathogens is compromised, close monitoring and interventions aimed at preventing infections are essential for their safety and recovery.
The nurse should plan to implement which intervention in the care of a client experiencing neutropenia as a result of chemotherapy?
- A. Restrict all visitors.
- B. Restrict fluid intake.
- C. Teach the client and family about the need for hand hygiene.
- D. Insert an indwelling urinary catheter to prevent skin breakdown.
Correct Answer: C
Rationale: In clients experiencing neutropenia, particularly due to chemotherapy, the immune system is significantly compromised, increasing the risk of infections. Hand hygiene is one of the most effective methods for preventing the spread of pathogens that can lead to infections. Teaching both the client and their family about the importance of frequent and proper handwashing helps create a safer environment and reduces the risk of infections, which can be critical in neutropenic patients.
A nurse is preparing health education for a patient who has received a diagnosis of myelodysplastic syndrome (MDS). Which of the following topics should the nurse prioritize?
- A. Techniques for energy conservation and activity management
- B. Emergency management of bleeding episodes
- C. Technique for the administration of bronchodilators by metered-dose inhaler
- D. Techniques for self-palpation of the lymph nodes
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse is caring for a client with multiple myeloma and is monitoring the client for signs of hypercalcemia. Which symptom would be an early indication?
- A. Polyuria
- B. Polyphagia
- C. Polydipsia
- D. Weight loss
Correct Answer: A
Rationale: In patients with multiple myeloma, hypercalcemia is a common complication due to the release of calcium from the bones as a result of osteolytic lesions. One of the early symptoms of hypercalcemia is polyuria, or increased urine output. This occurs because elevated calcium levels can lead to impaired renal function and increased renal excretion of calcium, which results in increased urine production. Early recognition of polyuria can help prompt further evaluation and management of hypercalcemia, as untreated hypercalcemia can lead to more severe complications.
A client with long-standing heart failure being treated for cancer has received a dose of ondansetron for nausea. What action by the nurse is most important?
- A. Assess the client for a headache or dizziness.
- B. Request a prescription for cardiac monitoring.
- C. Instruct the client to change positions slowly.
- D. Weigh the client daily before eating.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.