AT1 Medical-Surgical: Oncology 20Qw/EXP Review!

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A nurse is providing discharge teaching to a client who is postoperative following a right mastectomy for breast cancer. The client will be discharged with two Jackson-Pratt drainage tubes. Which of the following information should the nurse include in the teaching? A. "Empty the drainage tubes once per day." B. "Showering is permitted before the drainage tubes are removed." C. "The drainage tubes often are removed at the same time as the stitches." D. "Do not begin exercising the arm until the provider removes the drainage tubes."

C. "The drainage tubes often are removed at the same time as the stitches." The nurse should instruct the client that the provider will remove the drainage tubes at the same time the stitches are removed, usually within 7 to 10 days.

A nurse is caring for a client who is receiving chemotherapy to treat cancer. Which of the following adverse effects should the nurse anticipate from the chemotherapy? A. Gingival hyperplasia B. Hirsutism C. Pancytopenia D. Weight gain

C. Pancytopenia Pancytopenia, a deficiency of WBCs, RBCs, and platelet counts, is an expected adverse effect of chemotherapy.

A nurse is monitoring a client who has cancer and is receiving chemotherapy by peripheral IV infusion. The client reports pain at the insertion site and the nurse notes fluid leaking around the catheter. Which of the following actions should the nurse take first? A. Take a photograph of the peripheral IV site. B. Obtain and record the client's vital signs. C. Stop the infusion. D. Identify all medications administered through the IV site for the past 24 hr.

C. Stop the infusion. The nurse should apply the urgent versus nonurgent priority-setting framework. Using this framework, the nurse should consider urgent needs the priority need because they pose more of a threat to the client. The nurse might also need to use Maslow's hierarchy of needs, the ABC priority-setting framework, or nursing knowledge to identify which finding is the most urgent. Many chemotherapy medications are vesicants that can cause extensive tissue damage if extravasation occurs; therefore, the nurse's first action should be to stop the infusion immediately.

A nurse is providing teaching to a client who has cancer and is receiving external radiation therapy. Which of the following statements by the client indicates an understanding of the teaching? A. "I need to protect the area from sunlight." B. "I'm going to apply a heating pad to the area after each treatment." C. "I'll massage the area once per day." D. "I'll wash the markings off after each therapy treatment."

A. "I need to protect the area from sunlight." To prevent skin irritation and subsequent breakdown, the nurse should instruct the client to protect areas of skin from sunlight that receive radiation.

A nurse on an oncology unit is providing discharge teaching to an adolescent female client who received a bone marrow transplant for leukemia. Which of the following information should the nurse include in the teaching? (Select all that apply.) A. "Take your temperature twice each day." B. "You may return to school if you feel strong enough." C. "It is important to always wear shoes." D. "Clean your toothbrush weekly with isopropyl alcohol." E. "Avoid using tampons."

A. Take your temperature twice each day Clients who are postoperative bone marrow transplants are immunosuppressed and should continually monitor for manifestations of infection. A temperature that is greater than 38° C (100° F) should be reported immediately to the provider. C. It is important to always wear shoe A client who had a bone marrow transplant is immunosuppressed and should wear shoes to prevent injury and decrease the risk for infection. E. Avoid using tampons "Avoid using tampons" is correct. The use of tampons is discouraged because they can disrupt the mucosal layer of the vagina and, if left in too long, can support the growth of bacteria.

A nurse is providing discharge teaching to a client following open radical prostatectomy. The client is going home with an indwelling urinary catheter. Which of the following statements by the client indicates an understanding of the teaching? A. "I will be able to take a tub bath in 1 week." B. "I will change the catheter drainage bag once each week." C. "I will use suppositories to prevent constipation." D. "I will regain my bladder control once the catheter is removed."

B. "I will change the catheter drainage bag once each week." The nurse should teach the client how to change the catheter drainage bag and to change the bag at least once each week.

A nurse is caring for a client who has breast cancer and is receiving a combination of chemotherapy medications. The client expresses confusion about the therapy. Which of the following explanations should the nurse provide? A. "The risk of renal toxicity is lessened when a combination of chemotherapy medications are used." B. "The chemotherapy medications act at different stages of cell division so more tumor cells are destroyed." C. "The use of more chemotherapy medications will shorten the time you have to be in treatment." D. "The combination of chemotherapy medications will eliminate the potential for bone marrow suppression."

B. "The chemotherapy medications act at different stages of cell division so more tumor cells are destroyed." Different chemotherapeutic agents act at various stages of cellular mitosis (division). By combining agents, medication therapy is more effective in stopping or slowing the growth of cancerous cells by interfering with their ability to multiply.

A nurse is planning care for a client who has cancer and has developed thrombocytopenia following chemotherapy. Which of the following precautions should the nurse offer to minimize the adverse effects of thrombocytopenia? A. Monitor visitors for manifestations of infection. B. Remind the client to use an electric razor. C. Encourage frequent rest periods. D. Instruct the client to rinse mouth daily with normal saline.

B. Remind the client to use an electric razor. Thrombocytopenia is a decrease in the client's blood platelet count, which places the client at an increased risk of bleeding due to the blood's inability to clot. Therefore, the nurse should institute bleeding precautions, which includes the use of an electric razor.

A nurse is caring for a client who has testicular cancer and is experiencing peripheral neuropathy as an adverse effect of chemotherapy. Which of the following client manifestations is an expected finding of peripheral neuropathy? A. Thinning of the scalp hair B. Tingling of the hands and feet C. Reduced ability to concentrate D.Sores in the mucous membranes

B. Tingling of the hands and feet Several chemotherapeutic agents might cause peripheral neuropathy. One of the major manifestations of peripheral neuropathy is numbness and tingling of an extremity.


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