1.
External-beam radiation is planned for a patient with endometrial cancer. The nurse teaches the patient that an important measure to prevent complications from the effects of the radiation is to
Correct Answer
C. Perform perianal care with sitz baths and meticulous cleaning.
Explanation
Radiation to the abdomen will affect organs in the radiation path. such as the bowel. and cause frequent diarrhea. 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.
2.
Which action by a nursing assistant (NA) caring for a patient with a temporary radioactive cervical implant indicates that the RN should intervene?
Correct Answer
C. The NA stands by the patient’s bed for an hour talking with the patient.
Explanation
Because patients with temporary implants emit radioactivity while the implants are in place. exposure to the patient is limited. Laundry and urine/feces do not have any radioactivity and do not require special precautions. Cervical radiation will not affect the oral mucosa. and alcohol-based mouthwash is not contraindicated.
3.
A patient with Hodgkin’s lymphoma is undergoing external radiation therapy on an outpatient basis. After 2 weeks of treatment. the patient tells the nurse. “I am so tired I can hardly get out of bed in the morning.” An appropriate intervention for the nurse to plan with the patient is to
Correct Answer
C. Establish a time to take a short walk every day.
Explanation
Walking programs are used to keep the patient active without excessive fatigue. Vigorous exercise when the patient is less tired may lead to increased fatigue. Fatigue is expected during treatment and is not an indication of depression. Bed rest will lead to weakness and other complications of immobility.
4.
Which 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?
Correct Answer
A. The patient swims a mile 5 days a week.
Explanation
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.
5.
A patient undergoing external radiation has developed a dry desquamation of the skin in the treatment area. The nurse knows that teaching about management of the skin reaction has been effective when the patient says
Correct Answer
B. “I can buy a steroid cream to use on the itching area.”
Explanation
Steroid (over-the-counter [OTC] hydrocortisone) cream may be used to reduce itching in the area. Ice and sunlamps may injure the skin. Treatment areas should be cleaned gently to avoid further injury.
6.
A patient with metastatic cancer of the colon experiences severe vomiting following each administration of chemotherapy. An important nursing intervention for the patient is to
Correct Answer
C. Administer prescribed antiemetics 1 hour before the treatments.
Explanation
Treatment with antiemetics before chemotherapy may help to prevent anticipatory nausea. Although nausea may lead to poor nutrition. there is no indication that the patient needs instruction about nutrition. The patient should eat small. frequent meals. Offering food and beverages during chemotherapy is likely to cause nausea.
7.
When the nurse is administering a vesicant chemotherapeutic agent intravenously. an important consideration is to
Correct Answer
A. Stop the infusion if swelling is observed at the site.
Explanation
Swelling at the site may indicate extravasation. and the IV should be stopped immediately. The medication should generally be given slowly to avoid irritation of the vein. The size of the catheter is not as important as administration of vesicants into a running IV line to allow dilution of the chemotherapy drug. These medications can be given through peripheral lines. although central vascular access devices (CVADs) are preferred.
8.
A chemotherapeutic agent known to cause alopecia is prescribed for a patient. To maintain the patient’s self-esteem. the nurse plans to
Correct Answer
B. Encourage the patient to purchase a wig or hat and wear it once hair loss begins.
Explanation
The patient is taught to anticipate hair loss and to be prepared with wigs. scarves. or hats. Limiting social contacts is not appropriate at a time when the patient is likely to need a good social support system. The damage occurs at the hair follicle and will occur regardless of gentle washing or use of a mild shampoo. The information that the hair will grow back is not immediately helpful in maintaining the patient’s self-esteem.
9.
A patient with ovarian cancer tells the nurse. “I don’t think my husband cares about me anymore. He rarely visits me.” On one occasion when the husband was present. he told the nurse he just could not stand to see his wife so ill and never knew what to say to her. An appropriate nursing diagnosis in this situation is
Correct Answer
D. Interrupted family processes related to effect of illness on family members.
Explanation
The data indicate that this diagnosis is most appropriate because the family members are impacted differently by the patient’s cancer diagnosis. There are no data to suggest a change in lifestyle or role as an etiology. The data do not support impairment in home maintenance or a burden caused by caregiving responsibilities.
10.
A patient receiving head and neck radiation and systemic chemotherapy has ulcerations over the oral mucosa and tongue and thick. ropey saliva. An appropriate intervention for the nurse to teach the patient is to
Correct Answer
D. Rinse the mouth before and after each meal and at bedtime with a saline solution.
Explanation
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.