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.
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The client is assessing a client who has a new ureterostomy. Which statement by the client indicates the need for more education about urinary stoma care?
- A. I change my pouch every week.
- B. I change the appliance in the morning.
- C. I empty the urinary collection bag when it is two-thirds full.
- D. When I'm in the shower, I direct the flow of water away from my stoma.
Correct Answer: D
Rationale: The correct answer is D because directing water away from the stoma while showering is incorrect. The stoma can and should be cleaned with water. Choices A, B, and C demonstrate proper stoma care practices, such as changing the pouch regularly, changing the appliance in the morning, and emptying the collection bag when it is two-thirds full, which are all appropriate actions for caring for a urinary stoma.
Nurse Rose is caring for a client with cancer who has developed spinal cord compression. Which of the following symptoms would the nurse expect to find?
- A. Decreased deep tendon reflexes
- B. Severe headache
- C. Back pain
- D. Loss of bladder control
Correct Answer: C
Rationale: The correct answer is C: 'Back pain.' Back pain is a common symptom of spinal cord compression in cancer patients. This condition can cause localized or radiating back pain due to the compression of the spinal cord or nerves. While symptoms such as decreased deep tendon reflexes, severe headache, and loss of bladder control can occur in other conditions, back pain is specifically associated with spinal cord compression in cancer patients.
Nurse Joy is caring for a client with cancer who has been receiving cisplatin (Platinol-AQ). Which laboratory result requires an intervention by the nurse?
- A. White blood cell count of 6000 cells/microL
- B. Serum potassium level of 3.5 mEq/L
- C. Blood urea nitrogen (BUN) of 18 mg/dL
- D. Platelet count of 150,000 cells/microL
Correct Answer: C
Rationale: The correct answer is C. A BUN level of 18 mg/dL is within the normal range; however, since cisplatin is nephrotoxic, it requires close monitoring. Elevated BUN levels can indicate impaired kidney function. Choices A, B, and D are within normal ranges and do not directly relate to cisplatin therapy or require immediate intervention.
When preparing for the patient's subsequent care after completing the full course of treatment for acute lymphocytic leukemia without a significant response, what action should the nurse take?
- A. Arrange a meeting between the patient's family and the hospital chaplain.
- B. Assess the factors underlying the patient's failure to adhere to the treatment regimen.
- C. Encourage the patient to vigorously pursue complementary and alternative medicine (CAM).
- D. Identify the patient's specific wishes around end-of-life care.
Correct Answer: D
Rationale: In cases where a patient does not respond appreciably to therapy, it is crucial to identify and respect the patient's choices regarding treatment, including preferences for end-of-life care. Option A is incorrect because it focuses on spiritual support rather than the patient's care preferences. Option B is incorrect as it assumes non-adherence to treatment without evidence. Option C is incorrect as it suggests an alternative treatment approach without considering the patient's wishes for end-of-life care.
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.