Nokea
The home health nurse is performing a home visit for an oncology patient discharged 3 days ago after completing treatment for non-Hodgkin lymphoma. The nurses assessment should include examination for the signs and symptoms of what complication?
- A. Tumor lysis syndrome (TLS)
- B. Syndrome of inappropriate antiduretic hormone (SIADH)
- C. Disseminated intravascular coagulation (DIC)
- D. Hypercalcemia
Correct Answer: A
Rationale: The correct answer is A: Tumor lysis syndrome (TLS). In this scenario, the oncology patient has completed treatment for non-Hodgkin lymphoma. TLS is a potential complication post-treatment due to the rapid breakdown of cancer cells, leading to release of intracellular contents like potassium, phosphorus, and uric acid into the bloodstream. This can result in electrolyte imbalances, renal failure, and cardiac arrhythmias. The nurse should assess for signs such as hyperkalemia, hyperphosphatemia, hypocalcemia, and elevated uric acid levels. Monitoring renal function and fluid status is crucial.
Summary of other choices:
B: Syndrome of inappropriate ADH (SIADH) is characterized by excessive release of antidiuretic hormone leading to water retention and dilutional hyponatremia. Not typically associated with post-treatment complications in oncology patients.
C: Disseminated intravascular coagulation (DIC)
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A nurse is caring for a hospitalized patientwith a urinary catheter. Which nursing actionbestprevents the patient from acquiring an infection?
- A. Maintaining a closed urinary drainage system
- B. Inserting the catheter using strict clean technique
- C. Disconnecting and replacing the catheter drainage bag once per shift
- D. Fully inflating the catheter’s balloon according to the manufacturer’s recommendation
Correct Answer: A
Rationale: The correct answer is A: Maintaining a closed urinary drainage system. This action prevents infection by reducing exposure to external pathogens. Step 1: A closed system minimizes the risk of contamination. Step 2: It prevents entry of bacteria into the urinary tract. Step 3: Regularly emptying the drainage bag helps maintain a closed system. Step 4: This action promotes patient safety and reduces infection risk. Summary: Choice B (strict clean technique) may reduce infection risk during catheter insertion but does not prevent infections post-insertion. Choice C (replacing drainage bag once per shift) increases infection risk due to frequent disconnection. Choice D (fully inflating catheter balloon) is unrelated to infection prevention.
A nurse is caring for a pregnant patient with active herpes. The teaching plan for this patient should include which of the following?
- A. Babies delivered vaginally may become infected with the virus.
- B. Recommended treatment is excision of the herpes lesions.
- C. Pain generally does not occur with a herpes outbreak during pregnancy.
- D. Pregnancy may exacerbate the mothers symptoms, but poses no risk to the infant.
Correct Answer: A
Rationale: The correct answer is A because babies can become infected with the herpes virus if delivered vaginally. During childbirth, the virus can be passed to the infant, leading to serious health complications. This information is crucial for the patient to understand in order to make informed decisions about delivery options.
Choice B is incorrect because excision of herpes lesions is not the recommended treatment during pregnancy. Treatment typically involves antiviral medications to manage symptoms and reduce the risk of transmission to the baby.
Choice C is incorrect because herpes outbreaks can indeed be painful during pregnancy due to hormonal changes and a weakened immune system. Pain management strategies should be discussed as part of the teaching plan.
Choice D is incorrect because pregnancy can pose a risk to the infant if the mother has active herpes. It is important to manage the condition appropriately to prevent transmission to the baby.
A nurse is caring for a patient who just underwentan intravenous pyelography that revealed a renal calculus obstructing the left ureter. What is the nurse’sfirstpriorityin caring for this patient?
- A. Turn the patient on the right side to alleviate pressure on the left kidney.
- B. Encourage the patient to increase fluid intake to flush the obstruction.
- C. Monitor the patient for fever, rash, and difficulty breathing.
- D. Administer narcotic medications to the patient for pain.
Correct Answer: C
Rationale: The correct answer is C: Monitor the patient for fever, rash, and difficulty breathing. The rationale is as follows:
1. Renal calculus obstruction can lead to complications such as infection, so monitoring for fever is crucial.
2. Rash can indicate an allergic reaction to the contrast dye used in the procedure.
3. Difficulty breathing may signal a severe reaction or complications.
Summary:
A: Turning the patient on the right side does not directly address the urgent need to monitor for potential complications.
B: While fluid intake is important, it is not the immediate priority when the patient is at risk of developing complications.
D: Administering narcotic medications may be necessary for pain relief but does not address the potential emergent issues related to the obstruction.
A patient with Parkinsons disease is experiencing episodes of constipation that are becoming increasingly frequent and severe. The patient states that he has been achieving relief for the past few weeks by using OTC laxatives. How should the nurse respond?
- A. Its important to drink plenty of fluids while youre taking laxatives.
- B. Make sure that you supplement your laxatives with a nutritious diet.
- C. Lets explore other options, because laxatives can have side effects and create dependency.
- D. You should ideally be using herbal remedies rather than medications to promote bowel function.
Correct Answer: C
Rationale: The correct answer is C: Lets explore other options, because laxatives can have side effects and create dependency. The rationale for this is that while laxatives provide temporary relief for constipation, using them long-term can lead to dependency, electrolyte imbalances, and other side effects. The nurse should address the root cause of constipation and explore alternative strategies such as dietary changes, increased fluid intake, exercise, and bowel training. Choices A and B focus on supportive measures rather than addressing the issue of potential dependency on laxatives. Choice D suggests herbal remedies without considering the individual's specific condition and medical history.
An oncology nurse is caring for a patient who has developed erythema following radiation therapy. What should the nurse instruct the patient to do?
- A. Periodically apply ice to the area.
- B. Keep the area cleanly shaven.
- C. Apply petroleum jelly to the affected area.
- D. Avoid using soap on the treatment area.
Correct Answer: C
Rationale: The correct answer is C: Apply petroleum jelly to the affected area. This is because petroleum jelly helps to soothe and protect the skin, reducing dryness and irritation caused by radiation therapy. Ice (A) can further damage the skin, shaving (B) can increase the risk of infection, and soap (D) can be too harsh on the sensitive skin. Therefore, instructing the patient to apply petroleum jelly is the most appropriate recommendation to promote skin healing and comfort.