Nokea
The client is admitted with a diagnosis of colon cancer. Which finding in the client’s admission information should prompt the nurse to consider that the cancer may be located in the client’s descending colon?
- A. Pain in the lower abdomen
- B. Change in bowel habits
- C. Bright red blood in the stool
- D. Nausea and vomiting
Correct Answer: C
Rationale: A. Pain may be a symptom of a tumor located on the left side of the colon, but it is not exclusive and could be a symptom of a tumor elsewhere in the colon. B. Change of bowel habits may be a symptom of a tumor located on the left side of the colon, but this is not exclusive and could be a symptom of a tumor elsewhere in the colon. C. Bright red blood in the stool is a sign or symptom of a colorectal tumor located in the descending colon. D. Nausea and vomiting are not symptoms specific to colon cancer.
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The client is symptomatic with a Hgb of 7.8 g/dL, but refuses blood and blood products transfusions for religious reasons. The nurse should prepare the client that the HCP may prescribe which alternatives?
- A. Epoetin alfa
- B. Folic acid
- C. Albumin
- D. Platelets
- E. Fresh frozen plasma
- F. Granulocytes
Correct Answer: A, B,
Rationale: Epoetin alfa (erythropoietin growth factor; Procrit) promotes erythropoiesis (production of RBCs), thus decreasing the need for transfusions. B. Folic acid promotes erythropoiesis and production of WBCs and platelets. C. Albumin is a blood product. D. Platelets are blood products. E. Plasma is a blood product. F. Granulocytes are blood products.
The client is diagnosed with severe iron-deficiency anemia. Which statement is the scientific rationale regarding oral replacement therapy?
- A. Iron supplements are well tolerated without side effects.
- B. There is no benefit from oral preparations; the best route is IV.
- C. Oral iron preparations cause diarrhea if not taken with food.
- D. Very little of the iron supplement will be absorbed by the body.
Correct Answer: D
Rationale: Oral iron has low absorption (D), requiring high doses. Side effects (A) include GI upset, IV (B) is for severe cases, and diarrhea (C) is not primary (constipation is common).
Which action should the nurse expect to perform after a client has a bone marrow biopsy taken from the iliac crest?
- A. Apply pressure to the site for one minute
- B. Administer a narcotic analgesic
- C. Apply an adhesive bandage to the site
- D. Place the client in a recumbent position
Correct Answer: C
Rationale: Applying an adhesive bandage to the site after a bone marrow biopsy prevents bleeding and protects the area. Pressure is typically applied for longer, narcotics are not routine, and recumbent positioning is not required.
The nurse discusses the self-care guidelines to minimize the side effects of radiation on the skin. Which actions to reduce radiation skin reactions should the nurse explain to the client?
- A. Wear loose-fitting, soft clothing over the treated skin.
- B. Use a straight-edged razor to shave hair in the treated area.
- C. Swim only in swimming pools to avoid stagnant water.
- D. Use only skin-care products suggested by the radiation staff.
- E. Apply skin products immediately after radiation treatment.
- F. Wash treated area gently with lukewarm water and mild soap.
Correct Answer: A, D, F,
Rationale: Wearing loose-fitting, soft clothing over the treated skin is a recommended skin-care activity to reduce radiation skin reactions. B. The use of an electric, not a straight-edged, razor for shaving a treated area is recommended. C. Clients are advised to avoid swimming in chlorinated water. D. Using only skin-care products suggested by the radiation staff is a recommended skin-care activity to reduce radiation skin reactions. E. Clients are advised to delay the application of skin-care products within 4 hours of radiation treatment. F. Washing the treated area gently with lukewarm water and mild soap is a recommended skin-care activity to reduce radiation skin reactions.
The nurse is transcribing the HCP’s order for an iron supplement on the MAR. At which time should the nurse schedule the daily dose?
- A. 900
- B. 1000
- C. 1200
- D. 1630
Correct Answer: A
Rationale: Iron supplements are best taken in the morning (0900, A) with food to reduce GI upset and enhance absorption. Later times (B, C, D) are less optimal.