The nurse is instructing a client on ways to reduce the risk of lymphedema after a mastectomy. Which of the following should be emphasized?
- A. Elevate the affected arm
- B. Avoid lifting heavy objects
- C. Use compression garments as prescribed
- D. Avoid wearing tight clothing
Correct Answer: D
Rationale: After a mastectomy, particularly when lymph nodes are removed, patients are at increased risk for developing lymphedema, which is a buildup of lymph fluid that can cause swelling in the affected arm. Wearing tight clothing can constrict lymphatic flow and increase the risk of developing lymphedema by impeding normal lymphatic drainage. Therefore, it is crucial to advise patients to avoid tight-fitting clothing, especially around the chest and arm areas.
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A patient¢â‚¬â„¢s most recent diagnostic imaging has revealed that his lung cancer has metastasized to his bones and liver. What is the most likely mechanism by which the patient¢â‚¬â„¢s cancer cells spread?
- A. Hematologic spread
- B. Lymphatic circulation
- C. Invasion
- D. Angiogenesis
Correct Answer: B
Rationale: In the case of lung cancer that has metastasized to the bones and liver, lymphatic circulation is a key mechanism by which cancer cells spread from the primary tumor site to distant organs. Cancer cells can invade nearby lymphatic vessels and travel through the lymphatic system, eventually reaching lymph nodes and spreading to other tissues and organs. This route is significant in the metastasis of many types of cancer, including lung cancer.
A nurse works on an oncology unit and delegates personal hygiene to assistive personnel (AP). What action by the AP requires intervention from the nurse?
- A. Allowing a very tired client to skip oral hygiene and sleep.
- B. Assisting clients with washing the perianal area every 12 hours.
- C. Helping the client use a soft-bristled toothbrush for oral care.
- D. Reminding the client to rinse the mouth with water or saline.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A patient on the oncology unit is receiving carmustine, a chemotherapy agent, and the nurse is aware that a significant side effect of this medication is thrombocytopenia. Which symptom should the nurse assess for in patients at risk for thrombocytopenia?
- A. Interrupted sleep pattern
- B. Hot flashes
- C. Epistaxis (nose bleed)
- D. Increased weight
Correct Answer: C
Rationale: Thrombocytopenia is a condition characterized by a low platelet count, which increases the risk of bleeding and hemorrhage. Patients receiving chemotherapy agents like carmustine may experience thrombocytopenia as a significant side effect. Epistaxis (nosebleeds) is a common symptom associated with thrombocytopenia, as the blood vessels can become more fragile, and even minor trauma or spontaneous bleeding can occur. Therefore, assessing for signs of bleeding, including epistaxis, is crucial in patients at risk for thrombocytopenia.
The nurse is caring for a client with multiple myeloma and is monitoring the client for signs of hypercalcemia. Which symptom would be an early indication?
- A. Polyuria
- B. Polyphagia
- C. Polydipsia
- D. Weight loss
Correct Answer: A
Rationale: In patients with multiple myeloma, hypercalcemia is a common complication due to the release of calcium from the bones as a result of osteolytic lesions. One of the early symptoms of hypercalcemia is polyuria, or increased urine output. This occurs because elevated calcium levels can lead to impaired renal function and increased renal excretion of calcium, which results in increased urine production. Early recognition of polyuria can help prompt further evaluation and management of hypercalcemia, as untreated hypercalcemia can lead to more severe complications.
The nurse is teaching a client about the signs of infection after chemotherapy. Which of the following should the nurse emphasize?
- A. Frequent urination
- B. Increased thirst
- C. Chills and shaking
- D. Fever over 100.4°F (38°C)
Correct Answer: D
Rationale: In clients undergoing chemotherapy, the immune system is often compromised due to the effects of treatment, making them more susceptible to infections. A fever over 100.4°F (38°C) is considered a critical sign of infection in these patients and requires immediate medical evaluation. Fever may indicate the presence of an infection that could escalate quickly in immunocompromised individuals, so it is vital for patients to recognize this symptom and seek prompt medical attention.