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Which statement by a patient who is scheduled for a needle biopsy of the prostate indicates that the nurse's teaching about the purpose of the biopsy has been effective?
- A. The biopsy will remove the cancer in my prostate gland.
- B. The biopsy will determine how much longer I have to live.
- C. The biopsy will help decide the treatment for my enlarged prostate.
- D. The biopsy will indicate whether the cancer has spread to other organs.
Correct Answer: C
Rationale: A biopsy is used to determine whether the prostate enlargement is benign or malignant and determines the type of treatment that will be needed. Biopsy does not give information about metastasis, life expectancy, or the impact of cancer on the patient's life; the three remaining statements indicate a need for patient teaching.
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The nurse is caring for a patient who is undergoing bone marrow transplantation. Which of the following information should the nurse include in the patient's teaching plan?
- A. Transplant of the donated cells is painful because of the nerves in the tissue lining the bone.
- B. Donor bone marrow cells are transplanted through an incision into the sternum or hip bone.
- C. The transplant procedure takes place in a sterile operating room to minimize the risk for infection.
- D. Hospitalization will be required 2-4 weeks after transplantation.
Correct Answer: D
Rationale: The patient requires strict protective isolation to prevent infection for 2-4 weeks after marrow transplantation while waiting for the transplanted marrow to start producing cells. The transplanted cells are infused through an IV line, so the transplant is not painful, nor is an operating room or incision required.
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.
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.
The nurse is caring for a patient who is receiving chemotherapy for leukemia. Which of the following observations require intervention by the nurse?
- A. The patient ambulates several times a day in the room.
- B. The patient's temperature is 38.2°C (100.8°F).
- C. The patient cleans with a warm washcloth after having a stool.
- D. The patient uses soap and shampoo to shower every other day.
Correct Answer: B
Rationale: Any temperature above 38°C (100.4°F) in a patient receiving chemotherapy should be investigated immediately. The patient should ambulate in the room rather than the hospital hallway to avoid exposure to other patients or visitors. Because overuse of soap can dry the skin and increase infection risk, showering every other day is acceptable. Careful cleaning after having a bowel movement will help to prevent skin breakdown and infection.
The home health nurse is caring for a patient who has been receiving interferon therapy for treatment of cancer. Which statement by the patient may indicate a need for a change in treatment?
- A. I have frequent muscle aches and pains.
- B. I rarely have the energy to get out of bed.
- C. I experience chills after I inject the interferon.
- D. I take acetaminophen every 4 hours.
Correct Answer: B
Rationale: Fatigue can be a dose-limiting toxicity of biological therapies. Flulike symptoms, such as muscle aches and chills, are common adverse effects of interferon use. Patients are advised to use acetaminophen every 4 hours.