Chapter 20: Concepts of Care for Patients With Cancer Ignatavicius:
Med ical-Surgical Nursing, 10th Edition
1.A nurse in the oncology clinic is providing preoperative education to a
client just diagnosed with cancer. The client has been scheduled for surgery
in 3 days. What action by the nurse is best?
a. Call the client at home the next day to review teaching.
b. Give the client information about a cancer support group.
c. Provide all the preoperative instructions in writing.
d. Reassure the client that surgery will be over soon.: A. Call the client at
home the next day to review teaching.
Clients are often overwhelmed at a sudden diagnosis of cancer and may
be more overwhelmed at the idea of a major operation so soon. This
stress significantly impacts the
client's ability to understand, retain, and recall information. The nurse
would call the client at home the next day to review the teaching and to
answer questions. The client may or may not
be ready to investigate a support group, but this does not help with
teaching. Giving information in writing is important (if the client can read
it), but in itself will not be enough. Telling the client that surgery will be
over soon is giving false reassurance and does nothing for teaching.
2.A nurse is caring for a client admitted for Non-Hodgkin's lymphoma
and chemotherapy. The client reports nausea, flank pain, and muscle
cramps. What action by the nurse is most important?
a. Request an order for serum electrolytes and uric acid.
, Chapter 20: Concepts of Care for Patients With Cancer Ignatavicius:
Med ical-Surgical Nursing, 10th Edition
b. Increase the client's IV infusion rate.
c. Instruct assistive personnel to strain all urine.
d. Administer an IV antiemetic.: A. Request an order for serum
electrolytes and uric acid.
This client's reports are consistent with tumor lysis syndrome, for which
he or she is at risk due to the diagnosis. Early symptoms of TLS stem
from electrolyte imbalances and can
include lethargy, nausea, vomiting, anorexia, flank pain, muscle
weakness, cramps, seizures, and altered mental status. The nurse
would notify the primary health care provider and request an order for
serum electrolytes. Hydration is important in both preventing and
managing this syndrome, but the nurse would not just increase the IV
rate. Assistive personnel may need to strain the client's urine and the
client may
need an antiemetic, but first the nurse would assess the situation further
by obtaining pertinent lab tests.
3.A new nurse has been assigned a client who is in the hospital to
receive iodine-131 treatment.
Which action by the nurse is best?
a. Ensure the client is placed in protective isolation.
b. Have pregnant visitors stay 6 feet from the client
c. No special action is necessary to care for this client.
d. Read the policy on handling radioactive excreta.: D. Read the policy
on handling radioactive excreta.
, Chapter 20: Concepts of Care for Patients With Cancer Ignatavicius:
Med ical-Surgical Nursing, 10th Edition
This type of radioisotope is excreted in body fluids and excreta (urine
and feces) and would not be handled directly. The nurse would read the
facility's policy for handling and disposing
of this type of waste. The other actions are not warranted.
4.A client in the oncology clinic reports her family is frustrated at her
ongoing fatigue 4 months after radiation therapy for breast cancer.
What response by the nurse is most appropriate?
a. "Are you getting adequate rest and sleep each day?"
b. "It is normal to be fatigued even for months afterward."
c. "This is not normal and I'll let the primary health care provider know."
d. "Try adding more vitamins B and C to your diet.": B. "It is normal to be
fatigued even for months afterward."
Radiation-induced fatigue can be debilitating and may last for months
after treatment has ended. Rest and adequate nutrition can affect
fatigue, but it is most important that the client (and family) understands
this is normal.
5.A client is receiving chemotherapy through a peripheral IV
line. What action by the nurse is most important?
a. Assessing the IV site and blood return every hour
b. Educating the client on side effects
c. Monitoring the client for nausea
d. Providing warm packs for comfort: A. Assessing the IV site and blood
return every hour
Med ical-Surgical Nursing, 10th Edition
1.A nurse in the oncology clinic is providing preoperative education to a
client just diagnosed with cancer. The client has been scheduled for surgery
in 3 days. What action by the nurse is best?
a. Call the client at home the next day to review teaching.
b. Give the client information about a cancer support group.
c. Provide all the preoperative instructions in writing.
d. Reassure the client that surgery will be over soon.: A. Call the client at
home the next day to review teaching.
Clients are often overwhelmed at a sudden diagnosis of cancer and may
be more overwhelmed at the idea of a major operation so soon. This
stress significantly impacts the
client's ability to understand, retain, and recall information. The nurse
would call the client at home the next day to review the teaching and to
answer questions. The client may or may not
be ready to investigate a support group, but this does not help with
teaching. Giving information in writing is important (if the client can read
it), but in itself will not be enough. Telling the client that surgery will be
over soon is giving false reassurance and does nothing for teaching.
2.A nurse is caring for a client admitted for Non-Hodgkin's lymphoma
and chemotherapy. The client reports nausea, flank pain, and muscle
cramps. What action by the nurse is most important?
a. Request an order for serum electrolytes and uric acid.
, Chapter 20: Concepts of Care for Patients With Cancer Ignatavicius:
Med ical-Surgical Nursing, 10th Edition
b. Increase the client's IV infusion rate.
c. Instruct assistive personnel to strain all urine.
d. Administer an IV antiemetic.: A. Request an order for serum
electrolytes and uric acid.
This client's reports are consistent with tumor lysis syndrome, for which
he or she is at risk due to the diagnosis. Early symptoms of TLS stem
from electrolyte imbalances and can
include lethargy, nausea, vomiting, anorexia, flank pain, muscle
weakness, cramps, seizures, and altered mental status. The nurse
would notify the primary health care provider and request an order for
serum electrolytes. Hydration is important in both preventing and
managing this syndrome, but the nurse would not just increase the IV
rate. Assistive personnel may need to strain the client's urine and the
client may
need an antiemetic, but first the nurse would assess the situation further
by obtaining pertinent lab tests.
3.A new nurse has been assigned a client who is in the hospital to
receive iodine-131 treatment.
Which action by the nurse is best?
a. Ensure the client is placed in protective isolation.
b. Have pregnant visitors stay 6 feet from the client
c. No special action is necessary to care for this client.
d. Read the policy on handling radioactive excreta.: D. Read the policy
on handling radioactive excreta.
, Chapter 20: Concepts of Care for Patients With Cancer Ignatavicius:
Med ical-Surgical Nursing, 10th Edition
This type of radioisotope is excreted in body fluids and excreta (urine
and feces) and would not be handled directly. The nurse would read the
facility's policy for handling and disposing
of this type of waste. The other actions are not warranted.
4.A client in the oncology clinic reports her family is frustrated at her
ongoing fatigue 4 months after radiation therapy for breast cancer.
What response by the nurse is most appropriate?
a. "Are you getting adequate rest and sleep each day?"
b. "It is normal to be fatigued even for months afterward."
c. "This is not normal and I'll let the primary health care provider know."
d. "Try adding more vitamins B and C to your diet.": B. "It is normal to be
fatigued even for months afterward."
Radiation-induced fatigue can be debilitating and may last for months
after treatment has ended. Rest and adequate nutrition can affect
fatigue, but it is most important that the client (and family) understands
this is normal.
5.A client is receiving chemotherapy through a peripheral IV
line. What action by the nurse is most important?
a. Assessing the IV site and blood return every hour
b. Educating the client on side effects
c. Monitoring the client for nausea
d. Providing warm packs for comfort: A. Assessing the IV site and blood
return every hour
