Nokea
The nurse is caring for a patient who is receiving intravesical bladder chemotherapy. Which of the following adverse effects should the nurse monitor for in this patient?
- A. Nausea
- B. Alopecia
- C. Mucositis
- D. Hematuria
Correct Answer: D
Rationale: The adverse effects of intravesical chemotherapy are confined to the bladder. The other adverse effects are associated with systemic chemotherapy.
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A chemotherapeutic agent known to cause alopecia is prescribed for a patient. Which of the following actions should the nurse plan to implement to help maintain the patient's self-esteem?
- A. Suggest that the patient limit social contacts until regrowth of the hair occurs.
- B. Encourage the patient to purchase a wig or hat and wear it once hair loss begins.
- C. Have the patient wash the hair gently with a mild shampoo to minimize hair loss.
- D. Inform the patient that the hair will grow back once the chemotherapy is complete.
Correct Answer: B
Rationale: The patient is taught to anticipate hair loss and to be prepared with wigs, scarves, or hats. Limiting social contacts is not appropriate at a time when the patient is likely to need a good social support system. The damage occurs at the hair follicle and will occur regardless of gentle washing or use of a mild shampoo. The information that the hair will grow back is not immediately helpful in maintaining the patient's self-esteem.
Which of the following information noted by the nurse reviewing the laboratory results of a patient who is receiving chemotherapy is most important to report to the health care provider?
- A. Hematocrit of 30%
- B. Platelets of 150 ?? 10^9/L
- C. Hemoglobin of 161 g/L
- D. WBC count of 4 ?? 10^9/L
Correct Answer: D
Rationale: The low WBC count places the patient at risk for severe infection and is an indication that the chemotherapeutic drug dose may need to be lower or that white blood cell (WBC) growth factors such as filgrastim are needed. The other laboratory data do not indicate any immediate life-threatening adverse effects of the chemotherapy.
Which of the following nursing actions will be most effective in improving oral intake for a patient with the nursing diagnosis of imbalanced nutrition: less than body requirements related to painful oral ulcers?
- A. Offer the patient frequent small snacks between meals.
- B. Assist the patient to choose favourite foods from the menu.
- C. Provide education about the importance of nutritional intake.
- D. Apply the ordered anaesthetic gel to oral lesions before meals.
Correct Answer: D
Rationale: Since the etiology of the patient's poor nutrition is the painful oral ulcers, the best intervention is to apply anaesthetic gel to the lesions before the patient eats. The other actions might be helpful for other patients with impaired nutrition, but would not be as helpful for this patient.
External-beam radiation is planned for a patient with endometrial cancer. The nurse teaches the patient which of the following important measures to help prevent complications from the effects of the radiation?
- A. Test all stools for the presence of blood.
- B. Maintain a high-residue, high-fibre diet.
- C. Clean the perianal area carefully after every bowel movement
- D. Inspect the mouth and throat daily for the appearance of thrush.
Correct Answer: C
Rationale: Radiation to the abdomen will affect organs in the radiation path, such as the bowel, and cause frequent diarrhea. Careful cleaning of this area will help decrease the risk for skin breakdown and infection. Stools are likely to have occult blood from the inflammation associated with radiation, so routine testing of stools for blood is not indicated. Radiation to the abdomen will not cause stomatitis. A low-residue diet is recommended to avoid irritation of the bowel when patients receive abdominal radiation.
When reviewing the chart for a patient with cervical cancer, the nurse notes that the cancer is staged as Tis, N0, M0. Which of the following statements is accurate related to this staging?
- A. The cancer is localized to the cervix.
- B. The cancer cells are well differentiated.
- C. Further testing is needed to determine the spread of the cancer.
- D. It is difficult to determine the original site of the cervical cancer.
Correct Answer: A
Rationale: Cancer in situ indicates that the cancer is localized to the cervix and is not invasive at this time. Cell differentiation is not indicated by clinical staging. Because the cancer is in situ, the origin is the cervix. Further testing is not indicated given that the cancer has not spread.