Nokea
A patient with multiple myeloma has developed hypercalcemia. What symptoms should the nurse monitor for in this patient?
- A. Increased heart rate
- B. Decreased urine output
- C. Muscle weakness
- D. Hypertension
Correct Answer: C
Rationale: The correct answer is C: Muscle weakness. In patients with multiple myeloma who have developed hypercalcemia, monitoring for muscle weakness is crucial. Hypercalcemia can lead to muscle weakness due to its effects on neuromuscular function. Choice A, increased heart rate, is more commonly associated with conditions like dehydration or anxiety rather than hypercalcemia. Choice B, decreased urine output, is commonly seen in conditions leading to acute kidney injury rather than hypercalcemia. Choice D, hypertension, is not a typical symptom of hypercalcemia and is more commonly associated with other conditions like uncontrolled high blood pressure.
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While a patient is receiving IV doxorubicin hydrochloride for the treatment of cancer, the nurse observes swelling and pain at the IV site. The nurse should prioritize what action?
- A. Stopping the administration of the drug immediately
- B. Notifying the patient's physician
- C. Continuing the infusion but decreasing the rate
- D. Applying a warm compress to the infusion site
Correct Answer: A
Rationale: The correct action for the nurse to take when observing swelling and pain at the IV site during the administration of doxorubicin hydrochloride is to stop the administration of the drug immediately. Doxorubicin hydrochloride can cause severe tissue damage, so discontinuing the infusion is crucial to prevent further harm to the patient. Notifying the physician is important, but it should not take precedence over stopping the drug. Continuing the infusion, even at a decreased rate, can exacerbate tissue damage. Applying a warm compress is not appropriate in this situation and may worsen the tissue injury caused by the drug.
Nurse Jane is providing care for a client with superior vena cava syndrome. Which of the following interventions would be the priority?
- A. Elevate the head of the bed
- B. Administer steroids as prescribed
- C. Provide supplemental oxygen
- D. Administer diuretics as prescribed
Correct Answer: A
Rationale: The correct answer is to elevate the head of the bed. Elevating the head of the bed can help reduce the pressure on the superior vena cava, improve venous return, and facilitate breathing in clients with superior vena cava syndrome. Administering steroids (Choice B) may be necessary in some cases, but it is not the priority in the immediate care of a client with superior vena cava syndrome. Providing supplemental oxygen (Choice C) may help improve oxygenation but does not directly address the underlying issue of venous congestion. Administering diuretics (Choice D) may be contraindicated as it can further decrease preload and worsen the condition in superior vena cava syndrome.
A client with cancer is receiving palliative care. Which statement by the client indicates an understanding of palliative care?
- A. Palliative care focuses on managing symptoms and improving quality of life.
- B. Palliative care is only provided when curative treatment is no longer an option.
- C. Palliative care includes interventions to prolong life at all costs.
- D. Palliative care provides support for both the client and their family.
Correct Answer: A
Rationale: The correct answer is A. Palliative care focuses on managing symptoms and improving the quality of life for clients with serious illnesses like cancer. Choice B is incorrect as palliative care can be provided alongside curative treatments. Choice C is incorrect because palliative care does not aim to prolong life at all costs; it focuses on improving the quality of life. Choice D is partially correct but does not fully capture the essence of palliative care, which includes symptom management and holistic support for the client and their family.
The patient is anxious about subjection to radiation therapy. Which of the following statements of the student nurse requires additional teaching?
- A. Teletherapy is radiation from an external source.
- B. Brachytherapy can be administered via oral or IV.
- C. Brachytherapy is a radiation from inside the patient's body.
- D. Chemotherapy is effective in killing all cancer cells.
Correct Answer: D
Rationale: The correct answer is D because the statement 'Chemotherapy is effective in killing all cancer cells' is incorrect. Chemotherapy does not kill all cancer cells and is not the same as radiation therapy. Chemotherapy targets rapidly dividing cells, including cancer cells, but it may not kill every single cancer cell. It is important for the student nurse to understand and communicate this distinction to the patient. Choices A, B, and C provide accurate information about teletherapy, brachytherapy, and chemotherapy, respectively, and do not require additional teaching.
A nurse is caring for a patient who has been diagnosed with leukemia. The nurse's most recent assessment reveals the presence of ecchymoses on the patient's sacral area and petechiae on her forearms. In addition to informing the patient's primary care provider, what action should the nurse take?
- A. Initiate measures to prevent venous thromboembolism (VTE).
- B. Check the patient's most recent platelet level.
- C. Place the patient on protective isolation.
- D. Ambulate the patient to promote circulatory function.
Correct Answer: B
Rationale: The patient's signs of ecchymoses and petechiae are suggestive of thrombocytopenia, which is a common complication of leukemia. Thrombocytopenia is a condition characterized by a low platelet count, leading to abnormal bleeding. Checking the patient's most recent platelet level is crucial to assess the severity of thrombocytopenia and guide further interventions. Initiating measures to prevent venous thromboembolism (VTE) (Choice A) is not directly related to the patient's current signs. Placing the patient on protective isolation (Choice C) is not necessary for ecchymoses and petechiae. Ambulating the patient (Choice D) is not appropriate without addressing the underlying cause of abnormal bleeding.