Nokea
Which of the following information obtained by the nurse about a patient with colon cancer who is scheduled for external radiation therapy to the abdomen indicates a need for patient teaching?
- A. The patient swims in a pool 5 days a week.
- B. The patient has a history of dental caries.
- C. The patient eats frequently during the day.
- D. The patient showers with Dove soap daily.
Correct Answer: A
Rationale: The patient is instructed to avoid swimming in salt water or chlorinated pools during the treatment period. The patient does not need to change the habits of eating frequently or showering with a mild soap. A history of dental caries will not impact the patient who is scheduled for abdominal radiation.
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A patient receiving head and neck radiation has ulcerations over the oral mucosa and tongue and thick, ropey saliva. Which of the following actions should the nurse teach the patient to complete?
- A. Remove food debris from the teeth and oral mucosa with a stiff toothbrush.
- B. Use cotton-tipped applicators dipped in hydrogen peroxide to clean the teeth.
- C. Gargle and rinse the mouth several times a day with an antiseptic mouthwash.
- D. Rinse the mouth before and after each meal and at bedtime with a saline solution.
Correct Answer: D
Rationale: The patient should rinse the mouth with a saline solution frequently. A soft toothbrush is used for oral care. Hydrogen peroxide may damage tissues. Antiseptic mouthwashes may irritate the oral mucosa and are not recommended.
The nurse is preparing a patient for a biopsy of a lump in the right breast and the patient asks the nurse about the difference between a benign tumour and a malignant tumour. Which of the following responses by the nurse is correct?
- A. Benign tumours do not cause damage to other tissues.
- B. Benign tumours are likely to recur in the same location.
- C. Malignant tumours may spread to other tissues or organs.
- D. Malignant cells reproduce more rapidly than normal cells.
Correct Answer: C
Rationale: The major difference between benign and malignant tumours is that malignant tumours invade adjacent tissues and spread to distant tissues and benign tumours never metastasize. The other statements are inaccurate. Both types of tumours may cause damage to adjacent tissues. Malignant cells do not reproduce more rapidly than normal cells. Benign tumours do not usually recur.
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.
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.
The nurse is caring for a patient who is a single mother of four school-age children and is hospitalized with metastatic ovarian cancer. The nurse finds the patient crying, and she tells the nurse that she does not know what will happen to her children when she dies. Which of the following is the most appropriate response?
- A. Why don't we talk about the options you have for the care of your children?
- B. Perhaps the children's father will take care of them when you aren't able to.
- C. For now you need to concentrate on getting well, not worry about your children.
- D. Many patients with cancer live for a long time, so it's time to plan for your children.
Correct Answer: A
Rationale: This response expresses the nurse's willingness to listen and recognizes the patient's concern. The responses beginning 'Many patients with cancer live for a long time' and 'For now you need to concentrate on getting well' close off discussion of the topic and indicate that the nurse is uncomfortable with the topic. In addition, the patient with metastatic ovarian cancer may not have a long time to plan. Although it is possible that the patient's ex-husband will take the children, more assessment information is needed before making plans.