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A patient with non-Hodgkin lymphoma (NHL) is receiving treatment. What is the most important assessment for the nurse to make in this patient?
- A. Skin integrity
- B. Nutritional status
- C. Respiratory function
- D. Cognitive function
Correct Answer: C
Rationale: The correct answer is C: Respiratory function. In a patient with non-Hodgkin lymphoma (NHL), monitoring respiratory function is crucial due to the potential for complications such as pleural effusion or pneumonia. Assessing skin integrity (choice A) is important but not as critical as monitoring respiratory function in this case. Nutritional status (choice B) and cognitive function (choice D) are also important aspects of care but do not take precedence over assessing respiratory function in a patient with NHL undergoing treatment.
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A 54-year-old has a diagnosis of breast cancer and is tearfully discussing her diagnosis with the nurse. The patient states, 'They tell me my cancer is malignant, while my coworker's breast tumor was benign. I just don't understand at all.' When preparing a response to this patient, the nurse should be cognizant of what characteristic that distinguishes malignant cells from benign cells of the same tissue type?
- A. Slow rate of mitosis of cancer cells
- B. Different proteins in the cell membrane
- C. Differing size of the cells
- D. Different molecular structure in the cells
Correct Answer: B
Rationale: The correct answer is B. Malignant cells have different proteins in their membranes, such as tumor-specific antigens, which distinguish them from benign cells. Choice A is incorrect as cancer cells typically have a rapid and uncontrolled rate of mitosis. Choice C is incorrect as the size of cells alone does not distinguish between malignant and benign cells. Choice D is incorrect as the molecular structure is not the primary characteristic that distinguishes between malignant and benign cells.
A nurse is caring for a patient whose diagnosis of multiple myeloma is being treated with bortezomib. The nurse should assess for what adverse effect of this treatment?
- A. Stomatitis
- B. Nephropathy
- C. Cognitive changes
- D. Peripheral neuropathy
Correct Answer: D
Rationale: The correct answer is D: Peripheral neuropathy. Bortezomib, used in the treatment of multiple myeloma, is known to cause peripheral neuropathy as a significant adverse effect. Stomatitis (Choice A), which is inflammation of the mouth and lips, is not a common adverse effect of bortezomib. Nephropathy (Choice B), referring to kidney disease, is not a typical adverse effect of bortezomib. Cognitive changes (Choice C) are not a commonly reported adverse effect of bortezomib treatment.
An oncology nurse is caring for a patient who has developed erythema following radiation therapy. What should the nurse instruct the patient to do?
- A. Periodically apply ice to the area.
- B. Keep the area cleanly shaven.
- C. Apply petroleum jelly to the affected area.
- D. Avoid using soap on the treatment area.
Correct Answer: D
Rationale: The correct answer is D. When a patient develops erythema following radiation therapy, it is essential to avoid further irritation and potential infection. Using soap on the affected area can exacerbate the condition. Applying ice (choice A) may provide temporary relief for discomfort but does not address the underlying issue. Keeping the area cleanly shaven (choice B) is not necessary and may increase the risk of skin irritation. Applying petroleum jelly (choice C) can trap heat and worsen the erythema, so it is not recommended.
A client with cancer has anorexia and mucositis, and is losing weight. The client's family members continually bring favorite foods to the client and are distressed when the client won't eat them. What action by the nurse is best?
- A. Explain the pathophysiologic reasons behind the client not eating.
- B. Help the family show other ways to demonstrate love and caring.
- C. Suggest foods and liquids the client might be willing to try to eat.
- D. Tell the family the client isn't able to eat now no matter what they bring.
Correct Answer: B
Rationale: The best action for the nurse in this situation is to help the family show other ways to demonstrate love and caring. When a client with cancer is experiencing anorexia and mucositis, it can be challenging for them to eat even their favorite foods. By assisting the family in finding alternative ways to provide comfort and care, the nurse can help create a supportive environment for the client. Option A is not the best choice as explaining the pathophysiologic reasons may not address the emotional needs of the client and family. Option C, suggesting foods and liquids, might not be helpful if the client is unable to tolerate them due to their condition. Option D, telling the family that the client can't eat, may come across as dismissive and not supportive of the family's concerns.
A 62-year-old woman diagnosed with breast cancer is scheduled for a partial mastectomy. The oncology nurse explained that the surgeon will want to take tissue samples to ensure the disease has not spread to adjacent axillary lymph nodes. The patient has asked if she will have her lymph nodes dissected, like her mother did several years ago. What alternative to lymph node dissection will this patient most likely undergo?
- A. Lymphadenectomy
- B. Needle biopsy
- C. Open biopsy
- D. Sentinel node biopsy
Correct Answer: D
Rationale: Sentinel lymph node biopsy is a minimally invasive alternative to more extensive lymph node dissection. This procedure involves identifying and removing the first lymph node(s) to which a tumor drains, known as the sentinel node(s), to determine if cancer has spread beyond the primary site. Choices A, B, and C are incorrect because lymphadenectomy refers to the surgical removal of lymph nodes, needle biopsy involves sampling tissue with a needle for analysis, and open biopsy refers to the surgical removal of a sample of tissue for examination, none of which specifically serve as an alternative to lymph node dissection in this context.