Nokea
External-beam radiation is planned for a patient with cervical cancer. What instructions should the nurse give to the patient to prevent complications from the effects of the radiation?
- A. Test all stools for the presence of blood.
- B. Maintain a high-residue, high-fiber diet.
- C. Clean the perianal area carefully after every bowel movement.
- D. Inspect the mouth and throat daily for the appearance of thrush.
Correct Answer: C
Rationale: Cervical radiation hits the pelvis diarrhea's a beast from bowel irritation. Gentle perianal cleaning stops skin breakdown and infection, a must-do. Stool blood happens but isn't routine to test diarrhea's expected. High-fiber worsens it low-residue's better. Thrush is oral, not pelvic radiation's turf. Nurses in oncology push this hygiene tip, keeping skin intact amid radiation's gut chaos.
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A nurse is providing discharge teaching to a client who recently underwent a mechanical valve replacement. Which of the following statements by the client indicates the clients correct understanding of the discharge teaching regarding warfarin anticoagulant therapy?
- A. I may need to modify my diet while on this medication
- B. I do not need to take my prescribed medication for the rest of my life
- C. Additional monitoring is not required while on the anticoagulant
- D. I can lead a normal life while on anticoagulants; no restrictions are required
Correct Answer: A
Rationale: Mechanical valves demand warfarin forever diet tweaks, like steady vitamin K, keep INR stable, a sign the client gets it. Lifelong meds, monitoring, and restrictions (e.g., bleeding risk) are non-negotiable. Nurses cheer this dietary nod, ensuring warfarin's tightrope walk succeeds, a smart grasp in this valve swap life.
During his internship at a general practice, a medical student is asked to check the blood glucose level in a 30-year-old patient with type 1 diabetes. Acute glycaemic dysregulation is suspected in this patient. The patient asks if the student is going to take a capillary blood sample as shown in the picture below. Which of the following statements applies best in case of suspected acute dysregulation?
- A. The result will equal that of a finger prick sample
- B. The result will be higher than that of a finger prick sample
- C. The result will be lower than that of a finger prick sample
- D. One must not draw blood from this site in this case
Correct Answer: D
Rationale: Acute type 1 chaos no arm vein draw, finger prick's king for fast reads, not this site. Nurses skip this, a chronic crisis dodge.
A patient on the oncology unit is receiving carmustine, a chemotherapy agent, and the nurse is aware that a significant side effect of this medication is thrombocytopenia. Which symptom should the nurse assess for in patients at risk for thrombocytopenia?
- A. Interrupted sleep pattern
- B. Hot flashes
- C. Epistaxis (nose bleed)
- D. Increased weight
Correct Answer: C
Rationale: Carmustine, a nitrosourea, slams bone marrow, dropping platelets and causing thrombocytopenia low counts mean bleeding risks soar. Epistaxis (nosebleeds) is a classic sign, as mucosal vessels lack clotting support, especially with counts below 50,000/µL. Sleep issues might tie to discomfort but aren't direct. Hot flashes link to hormonal therapies, not this. Weight gain's unrelated cancer often causes loss. Nurses zero in on bleeding like epistaxis, bruising, or petechiae checking daily for these red flags, vital in oncology to catch and manage this life-threatening chemo fallout early.
Mr Soh, a 40-year-old accountant on allopurinol 200 mg OM for the past eight months, reports two recent gout attacks in the last year. He has no other known past medical history. When you probe, he is adherent to allopurinol except for missing it perhaps once or twice a month. His BMI is 25 kg/m², BP 144/94 mmHg. His last uric acid was one month ago, which was 405 mmol/L. He is having a gout attack now. He tells you that his gout attacks are usually aborted with colchicine TDS for two days. Whilst on colchicine, he does not experience diarrhoea except perhaps one episode of loose stools after which he stops colchicine. Which is the most appropriate next step?
- A. Start Hydrochlorothiazide for hypertension
- B. Start Losartan for hypertension
- C. Stop Allopurinol during this acute gout attack and start colchicine
- D. Continue allopurinol at 100 mg OM despite the attack and start colchicine
Correct Answer: B
Rationale: Current gout attack with uric acid 405 mmol/L (above target <360) on allopurinol 200 mg suggests undertreatment. Continue allopurinol (not stop) during flares, add colchicine TDS for acute relief, and address BP 144/94 with Losartan urate-lowering and cardioprotective, unlike HCTZ, which raises urate. Check creatinine and up-titrate allopurinol later. This balances acute and chronic management effectively.
Which of the following is NOT an example of intermittent fasting?
- A. Alternate day fasting
- B. Very low calorie diet
- C. Time restricted feeding
- D. Religious fasting
Correct Answer: B
Rationale: Intermittent fasting flips eating windows alternate days, time limits, 5:2, and religious fasts fit, cycling feast and famine. Very low calorie diets slash intake daily, not intermittently, a steady cut, not a fast. Clinicians spot this outlier, shaping obesity's chronic rhythm, a key distinction in diet's dance.