Nokea
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.
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Which client is at highest risk for developing a lymphoma?
- A. The client diagnosed with chronic lung disease who is taking a steroid.
- B. The client diagnosed with breast cancer who has extensive lymph involvement.
- C. The client who received a kidney transplant several years ago.
- D. The client who has had ureteral stent placements for a neurogenic bladder.
Correct Answer: C
Rationale: Immunosuppression post-transplant (C) increases lymphoma risk (e.g., PTLD). Steroids (A) are lower risk, breast cancer (B) involves metastasis, and stents (D) are unrelated.
The client diagnosed with iron-deficiency anemia is prescribed ferrous gluconate orally. Which should the nurse teach the client?
- A. Take Imodium, an antidiarrheal, over-the-counter (OTC) for diarrhea.
- B. Limit exercise for several weeks until a tolerance is achieved.
- C. The stools may be very dark, and this can mask blood.
- D. Eat only red meats and organ meats for protein.
Correct Answer: C
Rationale: Ferrous gluconate darkens stools (C), potentially masking GI bleeding. Imodium (A) is premature, exercise (B) is encouraged, and diet (D) should be varied, not meat-only.
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 nurse is caring for a client who is thought to have pernicious anemia. What signs and symptoms would the nurse expect in this person?
- A. Easy bruising
- B. Beefy-red tongue
- C. Fine red rash on the extremities
- D. Pruritus
Correct Answer: B
Rationale: A beefy-red tongue is a hallmark symptom of pernicious anemia due to vitamin B12 deficiency.
The client is diagnosed with polycythemia vera. The nurse would prepare to perform which intervention?
- A. Type and crossmatch for a transfusion.
- B. Assess for petechiae and purpura.
- C. Perform phlebotomy of 500 mL of blood.
- D. Monitor for low hemoglobin and hematocrit.
Correct Answer: C
Rationale: Polycythemia vera requires phlebotomy (C) to reduce blood viscosity. Transfusions (A) worsen hyperviscosity, petechiae (B) are for thrombocytopenia, and Hb/Hct (D) are elevated.