Nokea
The nurse is caring for a client who is scheduled for chemotherapy. Which is the best statement the nurse can make about the client experiencing chemotherapy-induced alopecia?
- A. The hair loss is usually temporary.'
- B. New hair growth will return without any change to color or texture.'
- C. Clients with alopecia will have delay in grey hair.'
- D. Wigs can be used after the chemotherapy is completed.'
Correct Answer: A
Rationale: Alopecia associated with chemotherapy is usually temporary and will return after the therapy is completed. New hair growth may return unchanged, but there is no guarantee and color, texture, and quality of hair may not be changed. There is no correlation between chemotherapy and delay in greying of hair. Use of wigs, scarves, and head coverings can be used by clients at any time during treatment plan.
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The client is scheduled for a breast lump excision and sentinel node biopsy. What should the nurse know in planning care for the client with a positive biopsy?
- A. A lump excision is not necessary.
- B. A wide excision of lump will be performed.
- C. The lump and all axillary lymph nodes will be excised.
- D. The entire breast and all regional lymph nodes will be excised.
Correct Answer: B
Rationale: The sentinel node is the first node in which a tumor will drain; if no malignant cells are found there, additional excision or radical removal will not be necessary. Excision of the lump along with a wide margin of cancer-free tissue is standard treatment for malignant tumors.
The nurse is caring for a thyroid cancer client following oral radioactive iodine treatment. Which teaching point is most important?
- A. Shield your throat area when near others.'
- B. Flush the toilet several times after every use.'
- C. Prepare food separately from family members.'
- D. Use disposable utensils for the next month.'
Correct Answer: B
Rationale: Iodine 131 is a systemic internal radiation that is excreted through body fluids, especially urine. Flushing the toilet several times after each use will avoid the exposure of others to radioactive exposure. Shielding the throat area is not effective because this form of treatment is systemic. Preparing food separately is not necessary, but the use of separate eating utensils will be necessary for the first 8 days.
The nurse working on a bone marrow unit knows that it is a priority to monitor which of the following in a client who has just undergone a stem cell transplant?
- A. Monitor the client's toilet patterns.
- B. Monitor the client closely to prevent infection.
- C. Monitor the client's physical condition.
- D. Monitor the client's heart rate.
Correct Answer: B
Rationale: Until transplanted stem cells begin to produce blood cells, these clients have no physiologic means to fight infection, which makes them very prone to infection. They are at high risk for dying from sepsis and bleeding before engraftment. Therefore, a nurse must closely monitor clients and take measures to prevent infection. Monitoring client's toilet patterns, physical condition, and heart rate does not prevent the possibility of the client getting an infection.
A client asks the nurse what is causing the fatigue following radiotherapy. What is the nurse's best response?
- A. The cancer is spreading to other parts of the body.
- B. The cancer cells are dying in large numbers.
- C. Fighting off infection is an exhausting venture.
- D. Substances are released when tumor cells are destroyed.
Correct Answer: D
Rationale: Fatigue results from substances being released when tumor cells are destroyed during radiotherapy. The spreading of cancer can cause many symptoms dependent on location and type of cancer, but it is not a significant factor in the development of fatigue with radiotherapy. The production of healthy cells can increase metabolic rate, but death of cancer cells does not support fatigue in this case. Fighting infection can cause fatigue, but there is no evidence provided to support the presence of infection in this client.
A client with a 4-cm breast mass is scheduled for biopsy with frozen section followed by lumpectomy and possible mastectomy. The client asks the nurse, 'Why can't the doctor tell me specifically whether I will need to have my entire breast removed'? Which is the best response from the nurse?
- A. The doctor will know which surgery is required, once the tumor is exposed.'
- B. The frozen section will determine presence of cancer and type of surgery required.'
- C. You need to trust your doctor to provide you with the best of care.'
- D. You seem anxious about your upcoming surgery.'
Correct Answer: B
Rationale: Although experienced surgeons can often predict the type of tumor upon opening, seeing the tumor does not determine presence or absence of cancer cells. The client may be anxious about upcoming surgery, but this response does not address the question posed by the client. Trusting the surgeon is important, but this response is not appropriate for the question asked. A frozen section during surgery allows the pathologist to quickly examine the tissue under microscope allowing the surgeon to make a decision for best surgical approach.