Nokea
The female client, who has Hodgkin’s lymphoma with cervical and axillary node involvement, is to receive chemotherapy and radiation. The nurse evaluates that the client is coping positively when the client makes which statement?
- A. “I’ve a wig that matches my hair color, but I’ll miss my own hair.”
- B. “I am so glad that the treatments won’t cause me to lose my hair.”
- C. “I’m happy that the drug-radiation combination prevents mucositis.”
- D. “I’ve faith that my doctor will cure me and I’ll never have cancer again.”
Correct Answer: A
Rationale: A. The client is expressing feelings about hair loss but has acted positively related to her feelings and obtained a wig. This statement indicates positive coping. B. This statement reflects that either the client is in denial or is uninformed regarding the effects of chemotherapy and radiation treatments. Chemotherapy and radiation will involve the cervical lymph nodes; side effects will include alopecia. C. Chemotherapy and radiation will involve the cervical lymph nodes; side effects will include mucositis. D. The risk for other cancers is increased after chemotherapy and radiation for Hodgkin’s lymphoma, so long-term surveillance is crucial.
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The nurse is caring for the client receiving combination chemotherapy of oxaliplatin, fluorouracil, and leucovorin. The nurse should assess the client for which common side effects of this chemotherapy regimen?
- A. Neurotoxicities and diarrhea
- B. Cardiomyopathy and dysphagia
- C. Renal insufficiency and gastritis
- D. Photophobia and stomatitis
Correct Answer: A
Rationale: A. Neurotoxicity and diarrhea occur frequently in clients receiving the medication regimen of oxaliplatin (Eloxatin), fluorouracil (5-FU), and leucovorin (Wellcovorin). B. Cardiomyopathy and dysphagia are not common side effects of these chemotherapy agents. C. Renal insufficiency and gastritis are not common side effects of these chemotherapy agents. D. Photophobia and stomatitis are not common side effects of these chemotherapy agents.
The nurse is caring for a child who has hemophilia. He is admitted with a bleeding episode. Which of the following should the nurse expect will be given to stop the bleeding?
- A. Heparin
- B. Cryoprecipitate
- C. Packed cells
- D. Whole blood
Correct Answer: B
Rationale: Cryoprecipitate contains clotting factors, such as factor VIII, essential for stopping bleeding in hemophilia.
The client diagnosed with menorrhagia complains to the nurse of feeling listless and tired all the time. Which scientific rationale would explain why these symptoms occur?
- A. The pain associated with the menorrhagia does not allow the client to rest.
- B. The client’s symptoms are unrelated to the diagnosis of menorrhagia.
- C. The client probably has been exposed to a virus that causes chronic fatigue.
- D. Menorrhagia has caused the client to have decreased levels of hemoglobin.
Correct Answer: D
Rationale: Menorrhagia causes blood loss, lowering hemoglobin (D), leading to fatigue/listlessness. Pain (A) is not primary, symptoms are related (B), and viral fatigue (C) is less likely.
The nurse identifies a concept of hematologic regulation for a client diagnosed with leukemia. Which clinical manifestations support the concept?
- A. The client has petechiae on the trunk and extremities.
- B. The client complains of pain and swelling in the joints.
- C. The client has an Hbg of 9.7 and Hct of 32%.
- D. The client complains of a headache and slurred speech.
Correct Answer: A,C
Rationale: Petechiae (A) and low Hb/Hct (C) reflect leukemia’s impact on hematologic regulation (thrombocytopenia, anemia). Joint pain (B) is less common, and headache/slurred speech (D) suggest stroke.
The nurse is caring for the client who had a left modified radical mastectomy (a total mastectomy with axillary node dissection and removal of the lining over the pectoralis major muscle). Which action by the nurse is appropriate?
- A. Have the client elevate the left arm above the head
- B. Ensure that IV access sites are only on the right side
- C. Have the client view the incision site as soon as possible
- D. Initiate left arm strengthening within 24 hours of surgery
Correct Answer: B
Rationale: A. The arm on the operative side should be elevated on a pillow, but not above the head. B. All IV access sites should be located on the nonoperative side to prevent circulatory impairment. C. Having the client look at the incision should be at the client’s readiness, not as soon as possible. D. Only ROM to the lower arm should be carried out for the first few days after surgery, with exercises and ROM to the shoulder after the drains are removed.