Nokea
The nurse at the clinic is interviewing an older-adult patient who is 160 cm tall and weighs 57 kg. The patient has not seen a health care provider for 20 years. She walks 11 km most days and has a glass of wine two or three times a week. Which topics will the nurse plan to include in patient teaching about cancer screening and decreasing cancer risk?
- A. Pap testing
- B. Tobacco use
- C. Sunscreen use
- D. Mammography
- E. Colorectal screening
Correct Answer: A,C,D,E
Rationale: The patient's age, gender, and history indicate a need for screening or teaching about colorectal cancer, mammography, Pap smears, and sunscreen. The patient does not use excessive alcohol or tobacco, she is physically active, and her body weight is healthy.
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The nurse is caring for a patient who is receiving chemotherapy for leukemia. Which of the following observations require intervention by the nurse?
- A. The patient ambulates several times a day in the room.
- B. The patient's temperature is 38.2°C (100.8°F).
- C. The patient cleans with a warm washcloth after having a stool.
- D. The patient uses soap and shampoo to shower every other day.
Correct Answer: B
Rationale: Any temperature above 38°C (100.4°F) in a patient receiving chemotherapy should be investigated immediately. The patient should ambulate in the room rather than the hospital hallway to avoid exposure to other patients or visitors. Because overuse of soap can dry the skin and increase infection risk, showering every other day is acceptable. Careful cleaning after having a bowel movement will help to prevent skin breakdown and infection.
A patient with a large stomach tumour that is attached to the liver is scheduled to have a debulking procedure. When teaching the patient, which of the following is the expected outcome of this surgery?
- A. Relief of pain by cutting sensory nerves in the stomach
- B. Control of the tumour growth by removal of malignant tissue
- C. Decrease in tumour size to improve the effects of other therapy
- D. Promotion of better nutrition by relieving the pressure in the stomach
Correct Answer: C
Rationale: A debulking surgery reduces the size of the tumour and makes radiation and chemotherapy more effective. Debulking surgeries do not control tumour growth. The tumour is debulked because it is attached to the liver, a vital organ (not to relieve pressure on the stomach). Debulking does not sever the sensory nerves, although pain may be lessened by the reduction in pressure on the abdominal organs.
A patient with metastatic cancer of the colon experiences severe vomiting following each administration of chemotherapy. Which of the following interventions should the nurse implement?
- A. Teach about the importance of nutrition during treatment.
- B. Have the patient eat large meals when nausea is not present.
- C. Offer dry crackers and carbonated fluids during chemotherapy.
- D. Administer prescribed antiemetics 1 hour before the treatments.
Correct Answer: D
Rationale: Treatment with antiemetics before chemotherapy may help prevent nausea. Although nausea may lead to poor nutrition, there is no indication that the patient needs instruction about nutrition. The patient should eat small, frequent meals. Offering food and beverages during chemotherapy is likely to cause nausea.
Use of dental floss is contraindicated in the patient with which of the following assessment findings?
- A. Halitosis
- B. A decreased platelet count
- C. An increased white blood cell count
- D. Xerostomia
Correct Answer: B
Rationale: Use of dental floss is contraindicated in the patient that has a decreased platelet count but otherwise critical to use to enhance oral care. Halitosis, xerostomia, and an increased WBC are not contraindications for the use of dental floss.
The nurse teaches a patient with cancer of the liver about high-protein, high-calorie diet choices. Which of the following snack choices by the patient indicates that the teaching has been effective?
- A. Orange sherbet
- B. Fresh fruit salad
- C. Strawberry yogurt
- D. Cream cheese bagel
Correct Answer: C
Rationale: Yogurt has high biological value because of the protein and fat content. Fruit salad does not have high amounts of protein or fat. Orange sherbet is lower in fat and protein than yogurt. Cream cheese is low in protein.