The nurse walks into a client's room and discovers the radioactive uterine implant lying on the bed. What action should the nurse take first?
Choose
... [Show More] One
1. Put on gloves.
2. Pick up implant with tongs.
3. Place implant in lead lined container.
4. Call radiation department to take the implant out of the room.
1
Rationale
1. Correct: The first thing the nurse should do is to put on gloves.
2. Incorrect: This is the second action the nurse should do: pick up the implant with tongs.
3. Incorrect: This action would be third: place the implant in a lead lined container.
4. Incorrect: This would be the fourth action: call the radiology department to take the implant out of the room.
The nurse is teaching a group of female clients how to perform a self-breast exam. One client reports no family history of breast cancer and indicates disinterest in learning the technique. What is the most appropriate response by the nurse?
Choose One
1. "You can ask your healthcare provider to do this with your yearly physical."
2. "If you have no family history of cancer, you won't need to worry about this."
3. "Self-breast exams may detect changes early enough for successful treatment."
4. "You have the right to refuse anything related to health because of client rights."
3
Rationale
3. CORRECT. The nurse responds to this client's incorrect statement by presenting an accurate fact in a non-judgmental and open manner, allowing for further discussion about breast cancer facts. The nurse has a responsibility to provide the client important data about the topic of self-breast exams.
I. INCORRECT. A breast exam completed only once a year is not often enough. Self-breast exams should be done monthly by both male and female clients. Some cancers are so aggressive that waiting a year could lead to a terminal diagnosis.
2. INCORRECT. This comment by the nurse is totally false. A family history of cancer is not a precursor to the occurrence of breast cancer.
4. INCORRECT. Though this closed-ended statement is accurate, the nurse has not provided the client with any information which could correct the client's misconceptions about breast-cancer.
The nurse is educating a group of college students about early signs and symptoms of cancer. When explaining the mnemonic "C-A-U-T-I-O-N", the nurse explains the 'N' stands for what sign/symptom?
Choose One
1. Nausea
2. Nipple drainage
3. Nagging cough
4. Nose bleeds
3
Rationale
3. CORRECT. The mnemonic "C-A-U-T-I-O-N" represents an easy way to recall the seven early warning signs and symptoms of potential cancer. Each letter indicates a specific body alteration that should be reported to the primary healthcare provider. 'N' stands for a nagging cough or hoarseness.
1. INCORRECT. Though indigestion and difficulty swallowing are considered among the seven warning signs of cancer, nausea and vomiting are vague symptoms which can be attributed to a variety of disorders. These do not represent the "N" in 'CAUTION'.
2. INCORRECT. While any type of drainage from the breast should be reported to the primary healthcare provider, drainage is represented under the "U" for unusual discharge or bleeding. This is not the correct interpretation for the "N".
4. INCORRECT. A nose bleed could be the result of many factors, including clotting issues or even a dry environment. This symptom does not represent an early sign of cancer.
A client had radiation seeds implanted to treat prostate cancer. When entering the room to initiate discharge teaching, the nurse observes the spouse emptying the client's urinal. What is the nurse's priority action?
Choose One
1. Immediately escort spouse to ED to check radiation levels.
2. Begin discharge teaching to the client and spouse.
3. Have spouse wash hands thoroughly and apply sterile gloves.
4. Explain that spouse must remain outside the room until urinal is emptied.
2
Rationale
2. CORRECT. Internal radiation, also called brachytherapy, is placed inside the body as close to the cancer as possible. Internal radiation therapy can be permanent or temporary as well as sealed or unsealed, which refers to the amount of radiation risk posed by the client. Implanted seeds used to treat prostate cancer are a type of sealed radiation, indicating the body fluids are not radioactive. Emptying the urinal poses no risk to the spouse.
1. INCORRECT. Implanted seeds are a type of sealed radiation. Therefore, the client's body fluids are not radioactive, though the spouse should use some precautions when in proximity to the client for a few days. No need to check the spouse for radiation levels.
3. INCORRECT. Even though the client will be immunosuppressed, there is no need for the spouse to use sterile gloves. However, washing hands and using regular gloves is always a good idea.
4. INCORRECT. The spouse does not need to remain outside the room, particularly since the client is about to be discharged home. The client's body fluids are not radioactive.
A client is to begin external beam radiation for Ewing's sarcoma. What symptoms would the nurse teach the client to expect during radiation treatments?
Select All That Apply
1. Nausea and Vomiting
2. Skin shedding
3. Erythema with pain
4. Pancytopenia
5. Exhaustion
2, 3, 4, 5
Rationale
2., 3, 4 and 5. CORRECT. External beam radiation uses high energy proton rays to deliver radiation from outside the body. This therapy prevents cell reproduction and destroys cancer cells. Expected side effects can be topical or physiological, depending on the area radiated. Skin radiated by the beam becomes reddened (erythema), dry and peeling. Shedding skin and even blistering may occur because of multiple treatments. As radiation enters tissues, damage affects even healthy tissue like bone marrow. The client may eventually develop pancytopenia: a lack of all blood components, including red cells, white cells and platelets. As the body struggles with cancer and the effects of radiation, the client may experience severe or overwhelming fatigue which needs reported to the primary healthcare provider.
1. INCORRECT. Nausea and vomiting, along with other gastrointestinal symptoms, are usually associated with the use of chemotherapy and not necessarily radiation therapy.
What does the nurse need to remember when caring for clients on the oncology unit who have a radiation implant?
Select All That Apply
1. Nursing assignments should be rotated weekly.
2. The nurse should care for no more than 3 clients with a radiation implant per shift.
3. Limit visitors to 60 minutes per day.
4. Wear film badge throughout assigned shift.
5. Educate visitors to stay at least 6 feet from the client.
4, 5
Rationale
4., & 5. Correct. Wear a film badge at all times so that you know how much radiation you are getting.Visitors should stay at least 6 feet from the source to decrease exposure to radiation. The closer you get the more radiation exposure.
1. Incorrect: Nursing assignments should be rotated daily, so that the nurse is not continuously exposed.
2. Incorrect: The nurse should only care for one client with a radiation implant in a given shift.
3. Incorrect: Visitors should be limited to 30 minutes per day in order to decrease exposure to radiation.
The nurse is educating a group of college students about cancer prevention and screening. Which secondary prevention actions should the nurse include?
Select All That Apply
1. Annual mamogram starting at age 40.
2. Maintain normal body weight.
3. Cancer support group.
4. Colonoscopy beginning at age 50.
5. Limit or eliminate alcohol intake.
1, 4
Rationale
1., & 4. Correct: Secondary prevention includes screenings to pick up on cancer early. Screening is very important because then we have a greater chance for cure or control. Annual mamogram starting at age 40 with two views of each breast is recommended if the client has no family history of breast cancer. Colonoscopy at age 50, then every 10 years after that if there has been no problem is also recommended.
2. Incorrect: Maintaining a normal body weight is considered primary prevention (ways to help prevent the actual occurrence of cancer).
3. Incorrect: Support groups and rehabilitation programs are considered tertiary prevention (focuses on the management of long term care for clients with complex treatments for cancer).
5. Incorrect: Limiting or eliminating alcohol intake is considered primary prevention.
The nurse is preparing a class on cancer prevention. Which risk factor should the nurse discuss with the class as being a preventable risk factor?
Select All That Apply
1. Smoking tobacco
2. Drinking alcohol
3. Eating a high fiber diet
4. Increasing fish consumption
5. Protect skin from sunlight by using tanning beds
1, 2
Rationale
1., & 2. Correct: Tobacco is the #1 cause of preventable cancer. Alcohol plus tobacco are co-carcinogenic.
3. Incorrect: A low fiber diet is bad. You don't have much motility in your intestines, so you are retaining carcinogens longer.
4. Incorrect: Increasing fish consumption is a good thing. You want to avoid increased red meat consumption and animal fat.
5. Incorrect: Tanning beds are just as bad as exposure to sunlight. Both cause exposure to ultra-violet radiation.
A client is scheduled to be admitted to the surgical unit post total laryngectomy. What nursing intervention should the nurse include in the plan of care?
Select All That Apply
1. Position left-side lying, supine.
2. Place on clear liquid diet after peristalsis returns.
3. Monitor tracheostomy for pulsations with heart beat.
4. Provide mouth care every 2 hours.
5. Maintain a humidified environment.
3, 4, 5
Rationale
3.,4., & 5. Correct: If a client's trach is pulsating with the heartbeat, you need to notify the primary healthcare provider immediately, as this could lead to rupture of the innominate artery. Frequent mouth care will decrease the bacterial count in the mouth. We are trying to prevent pneumonia. When breathing in and out through a trach, the client will not be able to warm, filter, and humidify the air. The air is really dry, so it irritates the trach. That is why when the client first gets the trach it has a lot of secretions. A humidified environment will help.
1. Incorrect: Where is the surgery? At the neck. Swelling! So place mid-fowlers, head of bed 35-45 degrees.
2. Incorrect: Peristalsis can disrupt the suture line. NG tube feedings will be provided to protect the suture line.
The nurse is preparing discharge teaching instructions for a client post right radical mastectomy with reconstruction. What instruction should the nurse include?
Select All That Apply
1. Squeeze tennis ball with right hand every 2-4 hours while awake.
2. No blood pressure readings in right arm for one year.
3. Wear gloves when gardening.
4. Wear your watch on the left wrist.
5. Brush your hair with your left hand until pain free.
1, 3, 4
Rationale
1., 3., & 4. Correct: Squeezing a tennis ball will help promote new circulation. Protect the hand and arm at all times. A tiny cut could turn into a major infection, so wearing gloves while gardening is a good idea. Since the mastectomy was on the right breast, the client can wear a watch on the left wrist. Do not wear anything constricting on the right wrist, or arm.
2. Incorrect: No blood pressure reading in right arm ever.
5. Incorrect: We want the client to use the affected arm when brushing hair. This will help promote new circulation and will help prevent frozen shoulder. So, this client should use the right hand to brush her hair. [Show Less]