Nokea
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.
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Nurse Mike is providing care to a client with chronic myelogenous leukemia (CML). The nurse knows that the client is at risk for tumor lysis syndrome. Which of the following laboratory values requires immediate intervention?
- A. Increased uric acid level
- B. Increased serum potassium level
- C. Increased serum sodium level
- D. Increased fibrinogen level
Correct Answer: A
Rationale: The correct answer is A: Increased uric acid level. In tumor lysis syndrome, rapid cell destruction releases large amounts of potassium, phosphate, and nucleic acids into the bloodstream. Uric acid can accumulate rapidly, leading to hyperuricemia, which can result in kidney damage due to urate crystal deposition. Immediate intervention is necessary to prevent renal complications. Choices B, C, and D are incorrect because while electrolyte imbalances are common in tumor lysis syndrome, hyperuricemia with potential kidney damage is the priority concern that requires immediate attention.
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.
Nurse Ben is reviewing the laboratory results of a client undergoing chemotherapy. Which of the following values would require immediate intervention?
- A. Platelet count of 150,000/mm3
- B. White blood cell count of 6,000/mm3
- C. Hemoglobin level of 14 g/dL
- D. Absolute neutrophil count of 500/mm3
Correct Answer: D
Rationale: An absolute neutrophil count of 500/mm3 indicates severe neutropenia, putting the client at high risk for infection. Neutrophils are crucial in fighting off infections; a low count increases susceptibility to infections. Platelet count, white blood cell count, and hemoglobin levels are within normal ranges and do not require immediate intervention in this scenario.
A client receiving chemotherapy is experiencing severe nausea and vomiting. Which intervention should the nurse implement first?
- A. Administer antiemetics 30 minutes before chemotherapy.
- B. Offer small, frequent meals that are bland and easy to digest.
- C. Encourage the client to rest after meals to reduce nausea.
- D. Instruct the client to use relaxation techniques.
Correct Answer: A
Rationale: The correct answer is A: Administer antiemetics 30 minutes before chemotherapy. Administering antiemetics before chemotherapy is crucial to prevent nausea rather than treating it after it occurs. This proactive approach helps in minimizing the side effects. Choice B, offering small, frequent meals, can be beneficial but is not the first intervention for severe nausea and vomiting. Choice C, encouraging rest after meals, may help but is not the priority when the client is experiencing severe symptoms. Choice D, instructing the client to use relaxation techniques, is not the first-line intervention for severe nausea and vomiting in a client receiving chemotherapy.
In an adult patient, which assessment finding is considered diagnostic of Hodgkin lymphoma?
- A. Schwann cells
- B. Reed-Sternberg cells
- C. Lewy bodies
- D. Loops of Henle
Correct Answer: B
Rationale: The correct answer is B: Reed-Sternberg cells. In Hodgkin lymphoma, the presence of Reed-Sternberg cells in lymph node biopsy is diagnostic. These cells are large, atypical cells originating from B-lymphocytes. They are distinctive in appearance and are key to diagnosing Hodgkin lymphoma. Choices A, C, and D are incorrect because Schwann cells are related to nerve function, Lewy bodies are associated with Parkinson's disease, and Loops of Henle are structures in the kidney, none of which are specific to Hodgkin lymphoma.