A patient with multiple myeloma is receiving chemotherapy and is at risk for bone fractures. What intervention should the nurse prioritize to reduce this risk?
- A. Encouraging bed rest
- B. Promoting bed rest to avoid injury
- C. Encouraging weight-bearing exercises
- D. Ensuring adequate hydration
Correct Answer: B
Rationale: The correct answer is B: 'Promoting bed rest to avoid injury.' In patients with multiple myeloma undergoing chemotherapy, encouraging bed rest can lead to muscle weakness and bone loss, increasing the risk of fractures. Promoting bed rest to avoid injury means advising the patient on safe movement and activities to prevent fractures. Encouraging weight-bearing exercises (choice C) would be more beneficial than bed rest as it helps in maintaining bone density and strength. Ensuring adequate hydration (choice D) is essential for overall health but does not directly address the risk of bone fractures associated with multiple myeloma and chemotherapy. Choice A, 'Encouraging bed rest,' is incorrect as it may worsen the risk of fractures rather than reduce it.
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A client who has been receiving radiation therapy for bladder cancer tells the nurse that it feels as if she is voiding through the vagina. The nurse interprets that the client may be experiencing which condition?
- A. Rupture of the bladder
- B. The development of a vesicovaginal fistula
- C. Extreme stress caused by the diagnosis of cancer
- D. Altered perineal sensation as a side effect of radiation therapy
Correct Answer: B
Rationale: The correct answer is B. A vesicovaginal fistula is an abnormal connection between the bladder and the vagina, leading to the passage of urine through the vagina. This condition can occur due to various reasons, including radiation therapy. Choice A, rupture of the bladder, is incorrect because a rupture would present with more severe symptoms and is not consistent with the client's description. Choice C, extreme stress, is incorrect as it does not explain the physical symptom of voiding through the vagina. Choice D, altered perineal sensation, is incorrect as it does not involve a direct connection between the bladder and the vagina.
As part of chemotherapy education, the nurse teaches a female client about the risk for bleeding and self-care during the period of greatest bone marrow suppression (the nadir). The nurse understands that further teaching is needed if the client makes which statement?
- A. I should avoid blowing my nose.
- B. I may need a platelet transfusion if my platelet count is too low.
- C. I should take aspirin for my headache as soon as I get home.
- D. I will count the number of pads and tampons I use when menstruating.
Correct Answer: C
Rationale: The correct answer is C. Taking aspirin is not recommended during periods of bone marrow suppression as it can increase the risk of bleeding. Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that can impair platelet function, further exacerbating the risk of bleeding. Choices A, B, and D are all appropriate statements for a client at risk for bleeding and undergoing chemotherapy. Blowing the nose gently, being prepared for a platelet transfusion if needed, and monitoring menstrual bleeding are all important aspects of self-care during this period.
The nurse is teaching a client about the risk factors associated with colorectal cancer. The nurse determines that further teaching is necessary related to colorectal cancer if the client identifies which item as an associated risk factor?
- A. Age younger than 50 years
- B. History of colorectal polyps
- C. Family history of colorectal cancer
- D. Chronic inflammatory bowel disease
Correct Answer: A
Rationale: The correct answer is A: Age younger than 50 years. Colorectal cancer is more commonly diagnosed in individuals over the age of 50, so being younger than 50 is not typically considered a significant risk factor. Choice B, history of colorectal polyps, is a known risk factor as polyps can develop into cancer over time. Choice C, family history of colorectal cancer, is a well-established risk factor due to genetic predisposition. Choice D, chronic inflammatory bowel disease, such as Crohn's disease or ulcerative colitis, increases the risk of developing colorectal cancer. Therefore, the incorrect choice is A as age younger than 50 years is not a common risk factor for colorectal cancer.
A patient with non-Hodgkin's lymphoma is receiving information from the oncology nurse. The patient asks the nurse why she should stop drinking and smoking and stay out of the sun. What would be the nurse's best response?
- A. Everyone should do these things because they are health promotion activities that apply to everyone.
- B. You don't want to develop a second cancer, do you?
- C. You need to do this just to be on the safe side.
- D. It's important to reduce other factors that increase the risk of second cancers.
Correct Answer: D
Rationale: The nurse should encourage patients to reduce other factors that increase the risk of developing second cancers, such as the use of tobacco and alcohol and exposure to environmental carcinogens and excessive sunlight. Choice A is too general and does not address the specific concerns of a cancer patient. Choice B uses fear tactics, which may not be the most effective approach. Choice C is vague and does not provide a clear rationale for the behavior change, unlike Choice D which specifically links the behaviors to reducing the risk of second cancers.
Which of the following management strategies is not included for a patient taking chemotherapeutic drugs?
- A. Limit exposure of pregnant visitors
- B. Protect client from infection
- C. Allow client to use makeup and wig
- D. Administer IV fluids as ordered
Correct Answer: C
Rationale: The correct answer is C. Chemotherapy can lead to hair loss, and while using wigs is common, it is not a primary management strategy. The focus should be on limiting exposure to pregnant visitors to prevent harm to the fetus, protecting the client from infections due to a compromised immune system, and administering IV fluids as ordered to maintain hydration levels. Allowing the client to use makeup and wigs is not a primary concern when managing a patient taking chemotherapeutic drugs.
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