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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The nurse supervises the care of a patient with a temporary radioactive cervical implant. Which action by unlicensed assistive personnel (UAP), if observed by the nurse, would require an intervention?
- A. The UAP flushes the toilet once after emptying the patient's bedpan.
- B. The UAP stands by the patient's bed for 30 minutes talking with the patient.
- C. The UAP places the patient's bedding in the laundry container in the hallway.
- D. The UAP gives the patient an alcohol-containing mouthwash to use for oral care.
Correct Answer: B
Rationale: Cervical implant's radioactive 30 minutes bedside overshoots exposure limits (under 30's safe); flushing , laundry , and mouthwash don't radiate. Nurses in oncology intervene UAP need time caps to dodge radiation, a safety must.
In a patient with COPD, the risk of postoperative pulmonary complications increases with:
- A. Wheezing on preoperative examination.
- B. A history of preoperative cough.
- C. Low body mass index (BMI).
- D. A serum albumin concentration less than 35 mg litreâ»Â¹.
Correct Answer: A
Rationale: Postoperative pulmonary complications in COPD patients are influenced by disease severity and patient condition. Wheezing indicates active airway obstruction and inflammation, directly increasing the risk of complications like atelectasis or pneumonia due to impaired ventilation and secretion clearance. A preoperative cough may suggest irritation or infection but is less specific than wheezing as a risk predictor. Low BMI reflects malnutrition, a known risk factor, but its impact is less immediate than active respiratory symptoms. Low serum albumin (<35 g/L, not mg/L as stated) also indicates poor nutritional status and healing capacity, elevating risk, but wheezing is more directly tied to airway dynamics. Regional anesthesia may reduce complications compared to general anesthesia, but the question focuses on risk factors. Wheezing's presence signals acute respiratory compromise, making it the strongest preoperative indicator of postoperative issues.
A 16-year-old female patient experiences alopecia resulting from chemotherapy, prompting the nursing diagnoses of disturbed body image and situational low self-esteem. What action by the patient would best indicate that she is meeting the goal of improved body image and self-esteem?
- A. The patient requests that her family bring her makeup and wig
- B. The patient begins to discuss the future with her family
- C. The patient reports less disruption from pain and discomfort
- D. The patient cries openly when discussing her disease
Correct Answer: A
Rationale: Alopecia guts self-image, especially at 16 requesting makeup and a wig shows she's fighting back, reclaiming her look and confidence. It's active, not passive, unlike future talks (hopeful but vague), less pain (physical, not emotional), or crying (raw but not progress). Nurses in oncology cheer this, knowing it signals resilience against chemo's brutal psychosocial hit, a win for body image goals.
A nurse is caring for a client diagnosed with polycythemia vera. Which of the following should the nurse include in the client and family education?
- A. Resume normal activity
- B. Wear support hose while awake
- C. Decrease fluid intake to no more than 1 liter per day
- D. Diet high in vitamin K intake
Correct Answer: B
Rationale: Polycythemia vera thickens blood, slowing venous return support hose boost circulation, cutting clot risk, a practical teaching point for clients and families. Normal activity's fine but misses prevention. Less fluid thickens blood further, dangerous here; high vitamin K aids clotting, counterproductive. Nurses push hose use, easing symptoms like swelling, a key strategy in managing this hyperviscous state.
A 36 year old woman visits her family doctor requesting blood test to check her cholesterol. She has family history of premature coronary heart disease. Physical examinations are unremarkable. Lipid profile is done and shows it the following results: Total cholesterol 5.8 mmol/L, HDL-cholesterol 1.1 mmol/L, LDL-cholesterol 3.6 mmol/L, Triglyceride 2.4 mmol/L. What is the MOST likely diagnosis?
- A. Familial hyperlipidemia
- B. Mixed hyperlipidemia
- C. Hypercholesterolaemia
- D. Familial combined hyperlipidemia
Correct Answer: B
Rationale: Cholesterol 5.8, LDL 3.6, triglycerides 2.4 both up, HDL lowish screams mixed hyperlipidemia, not lone cholesterol or triglyceride spikes. Family heart history hints genetics, but numbers don't pin familial types yet. Nurses flag this chronic dual lipid mess, tied to early coronary risk.