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The client who is receiving doxorubicin for the first time to treat multiple myeloma develops flushing, facial swelling, headache, chills, and back pain. Which statement made by the nurse is best?
- A. “These symptoms usually resolve in 1 day and are limited to the first dose.”
- B. “These are signs of toxicity; you may want to consider refusing treatment.”
- C. “I can give you ondansetron prescribed prn now to alleviate these symptoms.”
- D. “Side effects occur with chemotherapy, but focus on your cancer being cured.”
Correct Answer: A
Rationale: A. This response is best. The nurse informs the client correctly that the symptoms of doxorubicin (Adriamycin) are limited to the first dose. B. The nurse is providing unsolicited advice. C. Ondansetron (Zofran) is an antiemetic and will not alleviate all of the symptoms. D. This response belittles the client’s symptoms. There is no cure for multiple myeloma. Treatment will control the illness and maintain the client’s level of functioning for several years or more.
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The nurse completed teaching the client who had a bone marrow transplant (BMT). Which statement by the client indicates the client misunderstood the expected changes following a BMT?
- A. “I may gain weight from my immunosuppressant medication.”
- B. “Sterility can occur from the chemotherapy and radiation.”
- C. “I may have vision changes from the total body irradiation.”
- D. “Changes to my mouth could include a white, patchy tongue.”
Correct Answer: D
Rationale: A. A common side effect of immunosuppressant medications is weight gain. B. Sterility can occur as a result of chemotherapy and the total body irradiation after BMT. C. Changes in vision are common as a result of the total body irradiation after BMT. D. A white, patchy tongue is a sign of a fungal infection with Candidiasis albicans and would not be an expected change.
The female client recently diagnosed with Hodgkin's lymphoma asks the nurse about her prognosis. Which is the nurse’s best response?
- A. Survival for Hodgkin’s disease is relatively good with standard therapy.
- B. Survival depends on becoming involved in an investigational therapy program.
- C. Survival is poor, with more than 50% of clients dying within six (6) months.
- D. Survival is fine for primary Hodgkin’s, but secondary cancers occur within a year.
Correct Answer: A
Rationale: Hodgkin’s has a good prognosis with standard therapy (A) (5-year survival >85%). Investigational therapy (B) isn’t required, survival isn’t poor (C), and secondary cancers (D) are long-term risks.
A young man who has infectious mononucleosis asks what the treatment is for his condition. What is the best response for the nurse to make?
- A. You will receive large doses of antibiotics for the next 10 days.'
- B. Rest and good nutrition are the best things you can do.'
- C. You will be given an antiviral agent that will help to control the symptoms.'
- D. You will probably be given steroid medications for several months.'
Correct Answer: B
Rationale: Rest and good nutrition support recovery from infectious mononucleosis, a viral illness with no specific antiviral or steroid treatment.
The nurse and an unlicensed assistive personnel (UAP) are caring for clients in a bone marrow transplantation unit. Which nursing task should the nurse delegate?
- A. Take the hourly vital signs on a client receiving blood transfusions.
- B. Monitor the infusion of antineoplastic medications.
- C. Transcribe the HCP’s orders onto the medication administration record (MAR).
- D. Determine the client’s response to the therapy.
Correct Answer: A
Rationale: Taking vital signs (A) is within UAP scope during transfusions. Monitoring chemo (B), transcribing orders (C), and evaluating response (D) require nursing judgment.
A child who has leukemia is to have a bone marrow biopsy performed. How will the child be positioned for this procedure?
- A. On his side with the top knee flexed
- B. Prone
- C. Modified Trendelenburg position
- D. On his back with his head elevated 30 degrees
Correct Answer: B
Rationale: The prone position is used for a bone marrow biopsy from the iliac crest to access the site safely.