Nokea
After the nurse has finished teaching a patient who is scheduled to receive external beam radiation for abdominal cancer about appropriate diet, which dietary selection by the patient indicates that the teaching has been effective?
- A. Fresh fruit salad
- B. Roasted chicken
- C. Whole wheat toast
- D. Cream of potato soup
Correct Answer: B
Rationale: To minimize the diarrhea that is commonly associated with bowel radiation, the patient should avoid foods high in roughage, such as fruits and whole grains. Lactose intolerance may develop secondary to radiation, so dairy products also should be avoided.
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After receiving change-of-shift report, which of the following patients should the nurse assess first?
- A. 35-year-old who has wet desquamation associated with abdominal radiation
- B. 42-year-old who is sobbing after receiving a new diagnosis of ovarian cancer
- C. 24-year-old who is receiving neck radiation and has blood oozing from the neck
- D. 36-year-old who has a new pericardial friction rub after receiving chest radiation
Correct Answer: C
Rationale: Since neck bleeding may indicate possible carotid artery rupture in a patient who is receiving radiation to the neck, this patient should be seen first. The diagnoses and clinical manifestations for the other patients are not immediately life threatening.
Use of dental floss is contraindicated in the patient with which of the following assessment findings?
- A. Halitosis
- B. A decreased platelet count
- C. An increased white blood cell count
- D. Xerostomia
Correct Answer: B
Rationale: Use of dental floss is contraindicated in the patient that has a decreased platelet count but otherwise critical to use to enhance oral care. Halitosis, xerostomia, and an increased WBC are not contraindications for the use of dental floss.
The nurse is preparing a patient for a biopsy of a lump in the right breast and the patient asks the nurse about the difference between a benign tumour and a malignant tumour. Which of the following responses by the nurse is correct?
- A. Benign tumours do not cause damage to other tissues.
- B. Benign tumours are likely to recur in the same location.
- C. Malignant tumours may spread to other tissues or organs.
- D. Malignant cells reproduce more rapidly than normal cells.
Correct Answer: C
Rationale: The major difference between benign and malignant tumours is that malignant tumours invade adjacent tissues and spread to distant tissues and benign tumours never metastasize. The other statements are inaccurate. Both types of tumours may cause damage to adjacent tissues. Malignant cells do not reproduce more rapidly than normal cells. Benign tumours do not usually recur.
During a routine health examination, a patient tells the nurse about a family history of colon cancer. Which of the following actions should the nurse take next?
- A. Educate the patient about the need for a colonoscopy at age 50.
- B. Teach the patient how to do home testing for fecal occult blood.
- C. Obtain more information from the patient about the family history.
- D. Schedule a sigmoidoscopy to provide baseline data about the patient.
Correct Answer: C
Rationale: The patient may be at increased risk for colon cancer, but the nurse's first action should be further assessment. The other actions may be appropriate, depending on the information that is obtained from the patient with further questioning.
The nurse is caring for a patient undergoing external radiation and has developed a dry desquamation of the skin in the treatment area. Which of the following patient statements indicates that the nurse's teaching about management of the skin reaction has been effective?
- A. I can buy some aloe gel to use on the area.
- B. I will expose the treatment area to a sun lamp daily.
- C. I can use ice packs to relieve itching in the treatment area.
- D. I will scrub the area with warm water to remove the scales.
Correct Answer: A
Rationale: Aloe gel and cream may be used on the radiated skin area. Ice and sunlamps may injure the skin. Treatment areas should be cleaned gently to avoid further injury.