Immune/Cancer ATI

A nurse is preparing a teaching plan for a client who has neutropenia as a result of radiation therapy for the treatment of lung cancer. Which of the following should the nurse plan to include in the teaching? a. Bottled water is an appropriate choice to increase fluid intake. b. The salad bar is a healthy choice when dining out. c. Soft-boiled eggs are an appropriate source of protein. d. Eating at a buffet is a good choice to increase caloric intake.

a. Bottled water is an appropriate choice to increase fluid intake. Clients who have neutropenia are at risk for foodborne illness. Bottled water prevents client exposure to pathogens that may be found in other water sources.

A nurse is teaching a client about the seven warning signs of cancer. Which of the following signs should the nurse include as manifestations of cancer? Select all that apply. a. Bloating b. A nonhealing sore c. Nagging cough d. Change in bowel pattern e. Change in moles

✅b. A nonhealing sore: A client who has cancer might exhibit a nonhealing sore. ✅c. Nagging cough: A client who has cancer might exhibit a nagging cough. ✅d. Change in bowel pattern: A client who has cancer might exhibit a change in bowel pattern. ✅e. Change in moles: A client who has cancer might exhibit a change in the appearance of warts or moles.

A nurse is caring for a client who is receiving cisplatic to treat bladder cancer, After several treatments, the client reports fatigue. Which of the following actions should the nurse take? a. Check the results of the client's most recent CBC. b. Assess the client for a hypersensitivity reaction. c. Evaluate the client for hypercalcemia. d. Examine the client for hepatomegaly.

a. Check the results of the client's most recent CBC. The client might have anemia as a result of myelosuppression (bone marrow suppression) from the chemotherapy. If so, she might require treatment for the anemia (transfusion, medication) and the provider might have to delay further chemotherapy until her blood counts are higher.

A nurse is providing discharge teaching for a client who is postoperative following a simple mastectomy. The client is to begin outpatient radiation therapy the next day. Which of the following instructions about maintaining skin integrity should the nurse include? a. Do not apply heat to the area of irradiation. b. Do not wash the area of irradiation. c. Use an antibiotic ointment to treat skin breakdown. d. Lubricate the skin lubricated with hypoallergenic lotion.

a. Do not apply heat to the area of irradiation. This instruction will help the client avoid tissue damage. Radiated tissue becomes thinner and might lack tissue receptors that would otherwise alert the client to a potential burn injury. When outdoors in sunlight, the client should wear protective clothing over the area of irradiation.

After radiation treatment, a client reports dryness, redness, and scaling of his skin occurring within the designated treatment markings. The nurse should instruct the client to take which of the following actions? a. ​Apply hydrating lotions. b. ​Apply moist heat. c. Sit in the sun for 10 min per day. d. Wash with plain soap and water.

a. ​Apply hydrating lotions. The nurse should instruct the client to gently apply hydrating lotions that do not contain metal, alcohol, or perfume.

A nurse is caring for a client who has myelosuppression after receiving chemotherapy. The nurse should monitor the client for which of the following adverse effect? a. Anorexia and malnutrition b. Bleeding from the gums c. Diarrhea and dehydration d. Full body alopecia

b. Bleeding from the gums Bleeding from the gums is directly related to myelosuppression due to inhibited bone marrow production of blood cells and platelets.

A nurse in a provider's clinic is assessing a client who has cancer and a prescription for methotrexate PO. Which of the following actions should the nurse take when the client reports bleeding gums? a. Explain to the client that this is an expected adverse effect. b. Check the value of the client's current platelet count. c. Instruct the client to use an electric toothbrush. d. Have the client make an appointment to see the dentist.

b. Check the value of the client's current platelet count. The nurse should recognize that the bleeding is likely due to the adverse effect of the chemotherapy and needs to be evaluated further. Bleeding gums is a sign of thrombocytopenia (decreased platelet count) secondary to bone marrow suppression, which can be life-threatening in a client who is receiving chemotherapy.

A nurse is caring for a client who is receiving radiation therapy to treat lung cancer. Which of the following actions should the nurse take? a. Review laboratory test results for low hemoglobin. b. Observe for signs of infection. c. Monitor the mouth for signs of xerostomia. d. Examine the skin for generalized urticaria.

b. Observe for signs of infection. Radiation therapy to sites containing bone marrow (such as the sternum) can lower the WBC count (leukopenia), thus increasing the client's risk for infection. Screening the client for signs of infection is essential at this time.

A nurse is providing teaching to a client who has breast cancer about the adverse effects of chemotherapy. Which of the following client statements indicates an understanding of the teaching? a. "I will take the antiemetic as soon as the chemotherapy infusion is complete." b. "I will run my toothbrush in the dishwasher every month." c. "I'll call my doctor if I notice any unusual menstrual bleeding." d. "I will avoid crowds to keep from infecting others."

c. "I'll call my doctor if I notice any unusual menstrual bleeding." Clients should be taught bleeding precautions and to report bruising or excessive bleeding.

A nurse is preparing a client who is to receive chemotherapy for treatment of ovarian cancer. Which of the following actions should the nurse plan to take? a. Tell the client to expect dark stools following chemotherapy. b.Have the client floss 4 times daily. c. Have the client swish with commercial mouthwash before therapy. d. Administer an antiemetic prior to the procedure.

d. Administer an antiemetic prior to the procedure. The nurse can help prevent nausea and vomiting by administering an antiemetic prior to chemotherapy, and to tell the client to continue taking medication until nausea and vomiting resolve.

A charge nurse is teaching a group of health care workers about hand hygiene to prevent infection. Which of the following information should the charge nurse include in the teaching? a. Keep artificial nails trimmed. b. Use alcohol-based hand rubs before administering eye drops for a client. c. Wash hands with alcohol-based hand rubs when caring for a client who has Clostridium difficile. d. Use chlorhexidine to wash hands if the client is immunosuppressed.

d. Use chlorhexidine to wash hands if the client is immunosuppressed. The CDC recommends health care workers use chlorhexidine for hand washing when providing care to a client who is immunosuppressed.