Nokea
An oncology patient has begun to experience skin reactions to radiation therapy, prompting the nurse to make the diagnosis Impaired Skin Integrity: erythematous reaction to radiation therapy. What intervention best addresses this nursing diagnosis?
- A. Apply an ice pack or heating pad PRN to relieve pain and pruritis
- B. Avoid skin contact with water whenever possible
- C. Apply phototherapy PRN
- D. Avoid rubbing or scratching the affected area
Correct Answer: D
Rationale: Radiation erythema's tender rubbing or scratching tears it open, risking infection. Ice or heat burns it worse; water's fine for gentle cleaning, not avoidance. Phototherapy's for jaundice, not this. Nurses push hands off' to protect radiated skin, a staple in oncology to heal without added damage.
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Which atypical pneumonia can be vaccinated against?
- A. coxiella burnetii
- B. mycoplasma pneumoniae
- C. chlamydia pneumoniae
- D. legionella
Correct Answer: A
Rationale: Coxiella Q fever has a vaccine, not mycoplasma, chlamydia duo, or legionella. Nurses jab this chronic farm bug shield.
A nurse provides care on a bone marrow transplant unit and is preparing a female patient for a hematopoietic stem cell transplantation (HSCT) the following day. What information should the nurse emphasize to the patient's family and friends?
- A. Your family should likely gather at the bedside in case there's a negative outcome
- B. Make sure she doesn't eat any food in the 24 hours before the procedure
- C. Wear a hospital gown when you go into the patient's room
- D. Do not visit if you've had a recent infection
Correct Answer: D
Rationale: HSCT wipes out immunity, leaving patients prone to sepsis recent infections in visitors could bring pathogens (e.g., flu, strep) into her sterile bubble. Telling family to skip visits if sick is priority, trumping gown-wearing (useful but secondary) or fasting (not typically 24 hours). Gathering for a bad outcome's overly grim HSCT's risky but not a death sentence pre-procedure. Nurses stress this to shield the patient during the 2-4 week engraftment window, when neutropenia peaks, making infection control the linchpin of pre-transplant education in oncology.
Erysipelas
- A. responds to erythromycin
- B. is caused strep pneumoniae
- C. results from microorganism exotoxin production
- D. typically occurs on the neck
Correct Answer: A
Rationale: Erysipelas erythro clears strep pyogenes, not pneumo, toxins, neck-only, or TEN's peel. Nurses dose this chronic red edge.
A widowed mother of four school-age children is hospitalized with metastatic ovarian cancer. The patient is crying and tells the nurse that she does not know what will happen to her children when she dies. Which response by the nurse is most appropriate?
- A. Don't you have any friends that will raise the children for you?'
- B. Would you like to talk about options for the care of your children?'
- C. For now you need to concentrate on getting well and not worrying about your children.'
- D. Many patients with cancer live for a long time, so there is time to plan for your children.'
Correct Answer: B
Rationale: Metastatic ovarian cancer's end-stage she's scared for her kids. Asking about options opens a lifeline, validating her fear without shutting it down. Friends assumes too much; get well' dodges reality; long time' sugarcoats. Nurses in oncology lean in here listening, planning ease her burden, a human touch amid grim odds.
The emergency management of the patient with acute asthma does not include:
- A. Performing a rapid physical examination
- B. Performing spirometry or peak flow on arrival
- C. Giving oxygen and short acting bronchodilator
- D. Close monitoring to determine efficacy of treatment and improvement or deterioration
Correct Answer: B
Rationale: Acute asthma's rush exam, O2, bronchodilators, tight watch saves breath fast. Spirometry's a no too tough mid-wheeze, delays care. Nurses skip it, a chronic flare's urgent dodge.