Nokea
After change-of-shift report on the oncology unit, which patient should the nurse assess first?
- A. Patient who has a platelet count of 82,000/µL after chemotherapy
- B. Patient who has xerostomia after receiving head and neck radiation
- C. Patient who is neutropenic and has a temperature of 100.5°F (38.1°C)
- D. Patient who is worried about getting the prescribed long-acting opioid on time
Correct Answer: C
Rationale: Neutropenia plus 100.5°F screams infection sepsis looms, outranking low platelets (A bleeding's later), dry mouth , or opioid timing . Nurses in oncology bolt here fever in a white-cell wasteland's a killer, needing stat eyes.
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For care of a patient who has oral cancer, which task would be appropriate to delegate to the LPN/LVN?
- A. Assist the patient to brush and floss
- B. Explain when brushing and flossing are contraindicated
- C. Give antacids and sucralfate suspension as ordered
- D. Recommend saliva substitutes
Correct Answer: C
Rationale: LPN/LVNs excel in medication administration within their scope, making giving antacids and sucralfate ordered for oral cancer's mucosal protection ideal. Brushing and flossing assistance fits nursing assistants, a basic task. Explaining contraindications requires RN-level judgment to assess risks like bleeding or infection. Recommending saliva substitutes needs physician or pharmacist input, beyond LPN/LVN authority. Medication delivery leverages their training, easing symptoms like pain or ulcers, ensuring safe, supervised care in oral cancer's complex management, a practical delegation choice.
Which of the following statements regarding dietary approaches to obesity treatment is TRUE?
- A. Dietary modifications are generally not sustainable and hence dietary approaches are not as important as pharmacological approaches
- B. There is no Randomised Controlled Trial (RCT) level of evidence regarding decreasing sugar sweetened beverages
- C. Dietary approaches can be broadly categorised into energy-focused, macronutrient-focused, dietary pattern-focused, and dietary timing-focused
- D. Long-term diet trials have shown intermittent fasting to be superior to continuous energy restriction with respect to average weight loss
Correct Answer: C
Rationale: Diet's obesity fight splits smart energy, macros, patterns, and timing frame approaches, a true lens on options like low-carb or fasting. Sustainability varies, RCTs back sugar cuts, fasting ties (not tops) restriction, and proteins sate more than carbs. Clinicians wield this quartet, tailoring chronic plans, a broad truth in food's fat battle.
The clinic nurse is caring for a 42-year-old male oncology patient. He complains of extreme fatigue and weakness after his first week of radiation therapy. Which response by the nurse would best reassure this patient?
- A. These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory and x-ray studies
- B. These symptoms are part of your disease and are an unfortunately inevitable part of living with cancer
- C. Try not to be concerned about these symptoms. Every patient feels this way after having radiation therapy
- D. Even though it is uncomfortable, this is a good sign. It means that only the cancer cells are dying
Correct Answer: A
Rationale: Radiation zaps energy fatigue and weakness are par for the course, tied to inflammation and repair in treated tissues. Saying this, plus promising lab and imaging checks, reassures him it's expected, not a red flag, and keeps him in the loop. Blaming cancer alone dodges the treatment link, unsettling him. Dismissing it as universal or a good sign' feels flippant normal cells die too. Nurses in oncology lean on honesty and vigilance, easing fears while tracking for worse issues like anemia or infection.
Mr Yee two months later. At your last visit he did not want colchicine prophylaxis as he did not want to take 'too many tablets'. He has started and is adherent to his urate lowering agent. Last month, his uric acid had decreased to 390 mmol/L. He had a gout flare last week, hence he came to your clinic today to ask about colchicine prophylaxis. Which is correct advice regarding colchicine prophylaxis?
- A. Offer to start colchicine at 500 mcg once daily or alternate days as gout prophylaxis as his renal function is abnormal
- B. Colchicine cannot help to reduce the frequency of flares especially during the first six months of Urate lowering therapy
- C. Tell him that if he is started on clarithromycin, he does not need to inform his doctor or pharmacist that he is on colchicine regularly as colchicine can have drug interactions
- D. Regular colchicine prophylaxis in someone with normal renal function and regular monitoring can lead to renal failure
Correct Answer: A
Rationale: With eGFR 55 mL/min and a recent flare despite uric acid dropping to 390 mmol/L, colchicine prophylaxis at 500 mcg daily or alternate days is appropriate, adjusting for reduced renal clearance to prevent toxicity. Flares are common early in ULT as urate mobilizes, and colchicine reduces this, contrary to the false claim it can't help. Clarithromycin interacts dangerously with colchicine (CYP3A4 inhibition), requiring disclosure. Colchicine doesn't cause renal failure with monitoring; toxicity does. This dose suits chronic gout management safely.
A patient who is scheduled for a breast biopsy asks the nurse the difference between a benign tumor and a malignant tumor. Which answer by the nurse is correct?
- A. Benign tumors do not cause damage to other tissues.
- B. Benign tumors are likely to recur in the same location.
- C. Malignant tumors may spread to other tissues or organs.
- D. Malignant cells reproduce more rapidly than normal cells.
Correct Answer: C
Rationale: Malignant tumors metastasize spreading to distant sites via lymph or blood unlike benign ones, which stay put. That's the key split. Benign tumors can still mess up nearby tissues by pressing on them (e.g., a benign meningioma squeezing brain), so A's off. B's wrong benign tumors rarely recur if fully removed; malignancy's more prone to that. D's a myth malignant cells don't always divide faster; some, like chronic leukemia, creep along. Nurses in oncology nail this down for patients facing biopsies, like this breast case, where fear of spread drives the question. Explaining metastasis clarifies why malignant's scarier it's not just growth, it's invasion, a game-changer for prognosis and treatment.