Nokea
The nurse is reviewing the medication record for a client receiving chemotherapy and notes that the client is receiving epoetin alfa (Epogen). The nurse determines that this medication has been prescribed to:
- A. Increase white blood cell production
- B. Treat anemia
- C. Reduce pain
- D. Prevent infection
Correct Answer: B
Rationale: Epoetin alfa (Epogen) is a synthetic form of erythropoietin, a hormone that stimulates the production of red blood cells in the bone marrow. Chemotherapy often leads to anemia due to its effects on rapidly dividing cells, including those in the bone marrow responsible for red blood cell production. By administering epoetin alfa, the healthcare provider aims to increase the red blood cell count and improve hemoglobin levels, thereby alleviating symptoms associated with anemia, such as fatigue and weakness.
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A nurse knows that the patient with stage 3 based on Ann-arber staging has:
- A. 2 or more lymph node involvement and outside the lymph nodes
- B. 2 or more lymph node involvement on one side of the body
- C. 2 or more lymph nodes on the breasts
- D. 2 or more lymph node involvement on both sides of the body
Correct Answer: D
Rationale: In the Ann Arbor staging system for lymphomas, Stage 3 indicates that the disease has spread beyond the initial lymph node region to involve lymph nodes on both sides of the diaphragm (i.e., the areas above and below the diaphragm). This includes lymphatic involvement in both the thoracic and abdominal regions, signifying a more advanced disease state.
The nurse is caring for a 39-year-old woman with a family history of breast cancer. She requested a breast tumor marking test and the results have come back positive. As a result, the patient is requesting a bilateral mastectomy. This surgery is an example of what type of oncologic surgery?
- A. Salvage surgery
- B. Palliative surgery
- C. Prophylactic surgery
- D. Reconstructive surgery
Correct Answer: C
Rationale: Prophylactic surgery refers to the preventive removal of tissues or organs at high risk for developing cancer, even when no cancer is currently present. In this case, the patient has a positive breast tumor marking test and a significant family history of breast cancer, which places her at increased risk for developing the disease. A bilateral mastectomy is performed to significantly reduce this risk by removing both breasts, thereby preventing the potential future occurrence of breast cancer.
The public health nurse is presenting a health-promotion class to a group at a local community center. Which intervention most directly addresses the leading cause of cancer deaths in North America?
- A. Monthly self-breast exams
- B. Smoking cessation
- C. Annual colonoscopies
- D. Monthly testicular exams
Correct Answer: B
Rationale: In North America, lung cancer is the leading cause of cancer deaths among both men and women, and the primary risk factor for lung cancer is smoking. Therefore, promoting smoking cessation is a critical public health intervention that directly addresses this significant health issue. By helping individuals quit smoking, healthcare providers can significantly reduce the incidence of lung cancer and associated deaths, making this intervention a priority in cancer prevention efforts.
The nurse is caring for a client following a mastectomy. Which nursing intervention would assist in preventing lymphedema of the affected arm?
- A. Placing cool compresses on the affected arm
- B. Elevating the affected arm on a pillow above heart level
- C. Avoiding arm exercises in the immediate postoperative period
- D. Maintaining an intravenous site below the antecubital area on the affected side
Correct Answer: B
Rationale: After a mastectomy, particularly when lymph nodes are removed, there is an increased risk of lymphedema in the affected arm due to impaired lymphatic drainage. Elevating the affected arm above heart level helps promote lymphatic drainage and reduces the risk of swelling. This intervention facilitates the return of lymph fluid and helps prevent fluid accumulation in the arm.
The nurse is caring for a female client experiencing neutropenia as a result of chemotherapy and develops a plan of care for the client. The nurse plans to:
- A. Restrict all visitors
- B. Restrict fluid intake
- C. Teach the client and family about the need for hand hygiene
- D. Insert an indwelling urinary catheter to prevent skin breakdown
Correct Answer: C
Rationale: In clients experiencing neutropenia due to chemotherapy, the immune system is significantly compromised, leaving the client highly susceptible to infections. Meticulous hand hygiene is one of the most effective ways to prevent infections in neutropenic patients. Teaching the client and their family the importance of frequent and proper handwashing helps reduce the transmission of harmful pathogens that could lead to severe infections in the neutropenic client. This simple but essential intervention is crucial in maintaining a safe environment.