Nurse Lisa is assessing a client who has just completed radiation therapy to the neck area. Which of the following findings is most concerning?
- A. Erythema in the treated area
- B. Difficulty swallowing
- C. Dry, peeling skin
- D. Hoarseness
Correct Answer: B
Rationale: Difficulty swallowing (dysphagia) following radiation therapy to the neck area is a significant concern because it can indicate serious complications such as esophageal stricture, inflammation, or damage to the surrounding tissues, including the esophagus. This can lead to malnutrition, dehydration, or aspiration, all of which require prompt intervention. Radiation therapy can cause irritation and scarring in the esophageal and throat tissues, which may progressively worsen if not treated. Therefore, dysphagia should be addressed immediately to prevent further complications.
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Nurse Mandy is teaching a client about the side effects of radiation therapy. Which of the following should the nurse emphasize?
- A. Radiation therapy is painless.
- B. You may experience hair loss.
- C. Fatigue is a common side effect.
- D. You may experience nausea and vomiting.
Correct Answer: C
Rationale: Fatigue is one of the most frequent and profound side effects of radiation therapy. It often occurs because radiation can damage both cancerous and healthy cells, and the body requires energy to repair the damage caused by the treatment. Fatigue from radiation can be cumulative, meaning it may worsen as treatments progress, and can significantly affect the client's daily activities, requiring the nurse to educate the client on energy conservation techniques.
Which of the following statements by the oncology nurse displays understanding about antineoplastic medications?
- A. Chemotherapy is not going to spread throughout the body
- B. Chemotherapy affects the immune system
- C. Chemotherapy is specific to cancer cells only
- D. Chemotherapy makes the patient radioactive
Correct Answer: B
Rationale: Chemotherapy targets rapidly dividing cells, which include both cancerous and healthy cells, such as those in the bone marrow, hair follicles, and the lining of the digestive tract. Since the bone marrow produces immune cells (white blood cells), chemotherapy can weaken the immune system by reducing the body's ability to produce these cells, making patients more susceptible to infections. This is why close monitoring and supportive measures to protect immune function are important during chemotherapy treatment.
A patient with acute myeloid leukemia (AML) is receiving induction therapy. What is the priority nursing intervention during this phase of treatment?
- A. Administering pain management
- B. Monitoring for signs of infection
- C. Providing emotional support
- D. Monitoring fluid balance
Correct Answer: B
Rationale: Induction therapy for acute myeloid leukemia (AML) involves intensive chemotherapy aimed at achieving remission by eliminating a large number of cancerous cells. However, this aggressive treatment also severely reduces the production of healthy blood cells, including neutrophils, which leads to neutropenia (a dangerously low number of neutrophils). This makes the patient highly susceptible to infections, which can be life-threatening. Monitoring for signs of infection is critical during this phase, as infections may occur quickly and progress rapidly due to the compromised immune system. Early detection and prompt treatment of infections are vital to improving patient outcomes during induction therapy.
A patient newly diagnosed with cancer is scheduled to begin chemotherapy treatment and the nurse is providing anticipatory guidance about potential adverse effects. When addressing the most common adverse effect, what should the nurse describe?
- A. Pruritis (itching)
- B. Nausea and vomiting
- C. Altered glucose metabolism
- D. Confusion
Correct Answer: B
Rationale: Nausea and vomiting are among the most common and distressing side effects of chemotherapy. Chemotherapy drugs target rapidly dividing cells, including cancer cells, but they also affect healthy cells in the gastrointestinal (GI) tract, triggering the release of chemicals that stimulate the brain's vomiting center. These side effects can occur immediately (acute), be delayed, or even anticipatory, and often require management with antiemetic (anti-nausea) medications to improve the patient's comfort and quality of life during treatment.
A client is receiving rituximab and asks how it works. What response by the nurse is best?
- A. It causes rapid lysis of the cancer cell membranes.
- B. It destroys the enzymes needed to create cancer cells.
- C. It prevents the start of cell division in the cancer cells.
- D. It sensitizes certain cancer cells to chemotherapy.
Correct Answer: C
Rationale: Rituximab is a monoclonal antibody that targets CD20, a protein found on the surface of certain B-cells, including some cancerous B-cells, such as in non-Hodgkin's lymphoma and chronic lymphocytic leukemia (CLL). Rituximab works by binding to the CD20 protein, which leads to the destruction of the cancerous B-cells through various mechanisms, including preventing the initiation of cell division. By blocking the division process, rituximab helps slow the growth and proliferation of cancer cells, allowing the immune system and additional treatments to clear them more effectively.