Nokea
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.
You may also like to solve these questions
A chemotherapeutic agent known to cause alopecia is prescribed for a patient. Which of the following actions should the nurse plan to implement to help maintain the patient's self-esteem?
- A. Suggest that the patient limit social contacts until regrowth of the hair occurs.
- B. Encourage the patient to purchase a wig or hat and wear it once hair loss begins.
- C. Have the patient wash the hair gently with a mild shampoo to minimize hair loss.
- D. Inform the patient that the hair will grow back once the chemotherapy is complete.
Correct Answer: B
Rationale: The patient is taught to anticipate hair loss and to be prepared with wigs, scarves, or hats. Limiting social contacts is not appropriate at a time when the patient is likely to need a good social support system. The damage occurs at the hair follicle and will occur regardless of gentle washing or use of a mild shampoo. The information that the hair will grow back is not immediately helpful in maintaining the patient's self-esteem.
When reviewing the chart for a patient with cervical cancer, the nurse notes that the cancer is staged as Tis, N0, M0. Which of the following statements is accurate related to this staging?
- A. The cancer is localized to the cervix.
- B. The cancer cells are well differentiated.
- C. Further testing is needed to determine the spread of the cancer.
- D. It is difficult to determine the original site of the cervical cancer.
Correct Answer: A
Rationale: Cancer in situ indicates that the cancer is localized to the cervix and is not invasive at this time. Cell differentiation is not indicated by clinical staging. Because the cancer is in situ, the origin is the cervix. Further testing is not indicated given that the cancer has not spread.
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.
The nurse is teaching a patient who has a new diagnosis of acute leukemia about the complications associated with chemotherapy. The patient is restless and is looking away, never making eye contact. After the teaching, the patient asks the nurse to repeat all of the information. Based on this assessment, which of the following nursing diagnoses is most likely for this patient?
- A. Ineffective denial related to ineffective coping strategies (leukemia diagnosis)
- B. Acute confusion related to pain (infiltration of leukemia cells into the central nervous system)
- C. Anxiety related to threat of death (leukemia diagnosis)
- D. Deficient knowledge (of chemotherapy) related to insufficient interest in learning
Correct Answer: C
Rationale: The patient who has a new cancer diagnosis is likely to have high anxiety, which may impact learning and require that the nurse repeat and reinforce information. The patient's history of a recent diagnosis suggests that infiltration of the leukemia is not a likely cause of the confusion. The patient asks for the information to be repeated, indicating that lack of interest in learning and denial are not etiological factors.
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.