Nokea
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: Care to the affected area must focus on preventing further skin irritation, drying, and damage. Soaps, petroleum ointment, and shaving the area could worsen the erythema. Ice is also contraindicated.
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The nurse is orienting a new nurse to the oncology unit. When reviewing the safe administration of antineoplastic agents, what action should the nurse emphasize?
- A. Adjust the dose to the patients present symptoms
- B. Wash hands with an alcohol-based cleanser following administration
- C. Use gloves and a lab coat when preparing the medication
- D. Dispose of the antineoplastic wastes in the hazardous waste receptacle
Correct Answer: D
Rationale: The nurse should use surgical gloves and disposable long-sleeved gowns when administering antineoplastic agents. The antineoplastic wastes are disposed of as hazardous materials. Dosages are not adjusted on a short-term basis. Hand and arm hygiene must be performed before and after administering the medication.
The nurse is admitting an oncology patient to the unit prior to surgery. The nurse reads in the electronic health record that the patient has just finished radiation therapy. With knowledge of the consequent health risks, the nurse should prioritize assessments related to what health problem?
- A. Cognitive deficits
- B. Impaired wound healing
- C. Cardiac tamponade
- D. Tumor lysis syndrome
Correct Answer: B
Rationale: Combining other treatment methods, such as radiation and chemotherapy, with surgery contributes to postoperative complications, such as infection, impaired wound healing, altered pulmonary or renal function, and the development of deep vein thrombosis.
A public health nurse has formed an interdisciplinary team that is developing an educational program entitled Cancer: The Risks and What You Can Do About Them. Participants will receive information, but the major focus will be screening for relevant cancers. This program is an example of what type of health promotion activity?
- A. Disease prophylaxis
- B. Risk reduction
- C. Secondary prevention
- D. Tertiary prevention
Correct Answer: C
Rationale: Secondary prevention involves screening and early detection activities that seek to identify early stage cancer in individuals who lack signs and symptoms suggestive of cancer. Primary prevention is concerned with reducing the risks of disease through health promotion strategies. Tertiary prevention is the care and rehabilitation of the patient after having been diagnosed with cancer.
The nurse is caring for a patient who is to begin receiving external radiation for a malignant tumor of the neck. While providing patient education, what potential adverse effects should the nurse discuss with the patient?
- A. Impaired nutritional status
- B. Cognitive changes
- C. Diarrhea
- D. Alopecia
Correct Answer: A
Rationale: Alterations in oral mucosa, change and loss of taste, pain, and dysphagia often occur as a result of radiotherapy to the head and neck. The patient is at an increased risk of impaired nutritional status. Radiotherapy does not cause cognitive changes. Diarrhea is not a likely concern for this patient. Radiation only results in alopecia when targeted at the whole brain; radiation of other parts of the body does not lead to hair loss.
An oncology patient has just returned from the postanesthesia care unit after an open hemicolectomy. This patients plan of nursing care should prioritize which of the following?
- A. Assess the patient hourly for signs of compartment syndrome
- B. Assess the patients fine motor skills once per shift
- C. Assess the patients wound for dehiscence every 4 hours
- D. Maintain the patients head of bed at 45 degrees or more at all times
Correct Answer: C
Rationale: Postoperatively, the nurse assesses the patients responses to the surgery and monitors the patient for possible complications, such as infection, bleeding, thrombophlebitis, wound dehiscence, fluid and electrolyte imbalance, and organ dysfunction. Fine motor skills are unlikely to be affected by surgery and compartment syndrome is a complication of fracture casting, not abdominal surgery. There is no need to maintain a high head of bed.