Nokea
The nurse is orienting a new nurse to the oncology unit. When reviewing the safe administration of antineoplastic agents, what action should the nurse emphasize?
- A. Adjust the dose to the patient's present symptoms
- B. Wash hands with an alcohol-based cleanser following administration
- C. Use gloves and a lab coat when preparing the medication
- D. Dispose of the antineoplastic wastes in the hazardous waste receptacle
Correct Answer: D
Rationale: Antineoplastics are hazardous proper disposal in designated receptacles is critical to protect staff, patients, and the environment from toxic exposure. Gloves and gowns are standard for prep, but the question stresses one action, and disposal trumps as a universal safety net. Dosing's fixed by protocol, not symptoms tweaking's dangerous. Alcohol-based cleansers don't cut it post-exposure; soap and water are needed pre- and post-handling to remove residue. Emphasizing disposal aligns with OSHA and oncology nursing standards, ensuring chemo waste (e.g., IV bags, syringes) doesn't leak into regular trash, a key lesson for newbies in this high-stakes field.
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After percutaneous cervical cordotomy:
- A. Ptosis and miosis occur on same side as the thermal lesion.
- B. Temporary reduced power in the arm or leg occur on the same side as the thermal lesion.
- C. Patients are likely to stay in hospital until retitration of opioid medication is complete.
- D. Immediately after successful cervical cordotomy, the pretreatment dose of opioid is likely to be reduced by 10%.
Correct Answer: A
Rationale: Post-percutaneous cervical cordotomy (PCC), outcomes relate to its C1-C2 approach. Ptosis and miosis (Horner's syndrome) occur ipsilateral to the lesion from sympathetic chain disruption common but often transient. Weakness, if any, affects the contralateral side due to corticospinal tract proximity, not ipsilateral, and is rare with modern precision. Hospital stay varies; opioid retitration may occur outpatient unless complications arise. Successful PCC reduces opioid needs by >50% often, not just 10%, due to effective pain relief. Neuropathic pain can emerge from tract damage. Horner's syndrome's ipsilateral presentation is a hallmark, reflecting local anatomy and PCC's occasional sympathetic impact, typically self-limiting.
A client tells the oncology nurse about an upcoming vacation to the beach to celebrate completing radiation treatments for cancer. What response by the nurse is most appropriate?
- A. Avoid getting salt water on the radiation site.
- B. Do not expose the radiation area to direct sunlight.
- C. Have a wonderful time and enjoy your vacation!
- D. Remember you should not drink alcohol for a year.
Correct Answer: B
Rationale: Post-radiation skin at the treatment site remains highly sensitive to ultraviolet (UV) rays due to damage to the epidermal layer, increasing the risk of burns, irritation, or delayed healing. The nurse's most appropriate response is to advise against exposing the radiation area to direct sunlight, a precaution that persists for at least a year after treatment to protect skin integrity. Avoiding saltwater isn't a standard concern unless the skin is broken, which isn't indicated here. Simply wishing the client well ignores the teaching opportunity and potential risk. The alcohol restriction isn't a universal post-radiation rule unless tied to specific treatments or conditions not mentioned. Educating about sun exposure empowers the client to enjoy the vacation safely, aligning with nursing's preventive care focus and ensuring the celebration isn't marred by avoidable complications.
The spinothalamic and dorsal column sensation are examined as part of a neurological examination. One of the items belonging to dorsal column sensation is the sense of vibration, which is examined by means of a tuning fork. Question: What is the required frequency of this tuning fork?
- A. 512 Hz
- B. 256 Hz
- C. 128 Hz
- D. 64 Hz
Correct Answer: C
Rationale: Vibration check 128 Hz hums right, dorsal column's sweet spot, not higher or lower. Nurses tune this, a chronic nerve test.
All of the following are potential factors leading to weight gain EXCEPT:
- A. Disrupted circadian rhythm
- B. Use of anti-histamines and sulphonylureas
- C. Changes in gut microbiota
- D. Controlled food portions that are of low energy density
Correct Answer: D
Rationale: Weight gain factors include disrupted circadian rhythm (metabolic dysregulation), antihistamines/sulphonylureas (appetite increase, insulin secretion), and gut microbiota shifts (altered energy harvest). Controlled food portions of low energy density (e.g., vegetables) reduce calorie intake, aiding weight loss, not gain, per obesity research. This exception highlights dietary control's role in managing chronic conditions like diabetes or obesity, guiding physicians in patient counseling for sustainable weight regulation.
A 50-year-old man diagnosed with leukemia will begin chemotherapy. What would the nurse do to combat the most common adverse effects of chemotherapy?
- A. Administer an antiemetic
- B. Administer an antimetabolite
- C. Administer a tumor antibiotic
- D. Administer an anticoagulant
Correct Answer: A
Rationale: Chemo's nastiest duo nausea and vomiting strike most patients, triggered by gut and brain reactions to drugs like cyclophosphamide. Antiemetics (e.g., ondansetron) preempt this, keeping patients eating and hydrated, a frontline move in oncology. Antimetabolites (like methotrexate) and tumor antibiotics (like doxorubicin) are chemo agents, not side-effect fixes. Anticoagulants dodge clots, not nausea. Nurses prioritize this relief, knowing it's the biggest hurdle to treatment tolerance.