A sixteen-12 months-vintage girl affected person reports alopecia as a result of chemotherapy,
prompting the nursing diagnoses of disturbed body image and situational low vanity. What
motion by means of the affected person could first-rate indicate that the patient is assembly the
intention of stepped forward frame photograph and shallowness?
A) The affected person requests that her own family carry her makeup and wig.
B) The patient begins to talk about the future along with her family.
C) The patient reviews much less disruption from pain and soreness.
D) The affected person cries overtly whilst discussing her disease. - ANS-Ans: A
Chapter: sixteen
Client Needs: C
Cognitive Level: Analysis
Difficulty: Difficult
Integrated Process: Nursing Process
Objective: 7
Page and Header: 382, Nursing Care of Patients with Cancer
Feedback: Requesting her wig and makeup shows that the patient with alopecia is becoming
inquisitive about searching her exceptional and that her body photo and vanity can be
enhancing. The other alternatives may additionally imply that different nursing goals are being
met, however they do not determine advanced body picture and shallowness.
A 58-12 months-vintage male patient has been hospitalized for a wedge resection of the left
lower lung lobe after a recurring chest x-ray suggests carcinoma. The affected person is tense
and asks if he can smoke. Which declaration by the nurse might be maximum healing?
A) "Smoking is the motive you're right here."
B) "The health practitioner left orders for you no longer to smoke."
C) "You're worrying approximately the surgery. Do you spot smoking as helping?"
D) "Smoking is OK right now, but after your surgical treatment it's contraindicated." - ANS-Ans:
C
Chapter: sixteen
Client Needs: C
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Communication and Documentation
Objective: three
Page and Header: 349, Management of Cancer
Feedback: This acknowledges the affected person's emotions and encourages him to evaluate
his preceding conduct. Option A belittles the patient. Option B does not address the patient's
tension. Option D would be relatively adverse to this patient.
,A chemotherapy drug that reasons alopecia is prescribed for a patient. Which motion ought to
the nurse take to maintain the affected person's self-esteem?
A. Tell the affected person to restriction social contacts until regrowth of the hair happens.
B. Encourage the patient to buy a wig or hat and wear it as soon as hair loss starts.
C. Teach the patient to softly wash hair with a slight shampoo to limit hair loss.
D. Inform the patient that hair usually grows again as soon as the chemotherapy is complete. -
ANS-ANS: B
The patient is taught to count on hair loss and to be organized with wigs, scarves, or hats.
Limiting social contacts isn't always appropriate at a time whilst the affected person is likely to
want a very good social guide device. The harm happens at the hair follicle and could arise no
matter mild washing or use of a moderate shampoo. The information that the hair will develop
returned is not right away useful in keeping the affected person's shallowness.
A hospitalized patient who has obtained chemotherapy for leukemia develops neutropenia.
Which commentary by way of the nurse could suggest a want for further teaching?
A. The patient ambulates several times a day inside the room.
B. The affected person's site visitors bring in some sparkling peaches from domestic.
C. The affected person cleans with a warm washcloth after having a stool.
D. The patient uses soap and shampoo to shower each other day. - ANS-ANS: B
Fresh, thinned-skin end result are not approved in a neutropenic weight loss program because
of the chance of micro organism being gift. The affected person must ambulate inside the room
rather than the health facility hallway to avoid exposure to other patients or traffic. Because
overuse of soap can dry the pores and skin and increase infection hazard, showering each
different day is appropriate. Careful cleansing after having a bowel motion will assist save you
pores and skin breakdown and contamination.
A affected person develops neutropenia after receiving chemotherapy. Which data
approximately ways to prevent contamination will the nurse consist of within the teaching plan
(pick all that observe)?
A. Cook food thoroughly before consuming.
B. Choose low fiber, low residue ingredients.
C. Avoid public transportation such as buses.
D. Use rectal suppositories if wanted for constipation.
E. Talk to the oncologist earlier than having any dental work performed. - ANS-ANS: A, C, E
Eating handiest cooked meals and warding off public transportation will decrease infection
danger. A excessive-fiber diet is usually recommended for neutropenic patients to decrease
constipation. Because bacteria may additionally enter the move all through dental paintings or
oral surgical treatment, the patient may additionally want to put off dental paintings or take
antibiotics.
A patient has been assigned the nursing diagnosis of imbalanced nutrition: much less than body
requirements associated with painful oral ulcers. Which nursing action can be only in improving
oral intake?
A. Offer the patient frequent small snacks between meals.
B. Assist the patient to select favored ingredients from the menu.
C. Provide teaching about the significance of nutritional intake.
D. Apply the ordered anesthetic gel to oral lesions before food. - ANS-ANS: D
,Because the etiology of the affected person's bad nutrition is the painful oral ulcers, the
excellent intervention is to use anesthetic gel to the lesions before the patient eats. The other
movements is probably beneficial for different sufferers with impaired nutrients, but might no
longer be as beneficial for this affected person.
A patient newly identified with most cancers is scheduled to begin chemotherapy remedy. The
affected person asks the nurse what the most not unusual side impact of chemotherapy is. What
would be the first-class answer the nurse should deliver?
A) Alopecia
B) Nausea and vomiting
C) Altered glucose metabolism
D) Increased urge for food - ANS-Ans: B
Chapter: 16
Client Needs: D-2
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Teaching/Learning
Objective: 7
Page and Header: 356, Management of Cancer
Feedback: Nausea and vomiting are the most not unusual side consequences of chemotherapy
and may persist for as long as 24 to 48 hours after its management. Antiemetic pills are often
prescribed for these sufferers. Other aspect consequences include bone marrow suppression,
anorexia, vaginal dryness, and hair loss. Less common consequences consist of altered
glucose metabolism and jaundice.
A affected person receiving head and neck radiation for larynx most cancers has ulcerations
over the oral mucosa and tongue and thick, ropey saliva. Which commands must the nurse give
to this affected person?
A. Remove meals particles from the teeth and oral mucosa with a stiff toothbrush.
B. Use cotton-tipped applicators dipped in hydrogen peroxide to smooth the enamel.
C. Gargle and rinse the mouth several instances a day with an antiseptic mouthwash.
D. Rinse the mouth before and after every meal and at bedtime with a saline solution. -
ANS-ANS: D
The patient need to rinse the mouth with a saline solution regularly. A gentle toothbrush is used
for oral care. Hydrogen peroxide might also harm tissues. Antiseptic mouthwashes may
additionally aggravate the oral mucosa and aren't encouraged.
A affected person present process outside radiation has evolved a dry desquamation of the skin
within the treatment vicinity. The nurse teaches the patient approximately management of the
skin response. Which assertion, if made by using the patient, indicates the coaching became
powerful?
A. "I should buy some aloe vera gel to apply at the region."
b. "I will reveal the remedy area to a solar lamp daily."
c. "I can use ice packs to relieve itching within the treatment location."
d. "I will scrub the vicinity with heat water to take away the scales." - ANS-ANS: A
, Aloe vera gel and cream may be used at the radiated skin region. Ice and sunlamps may also
injure the pores and skin. Treatment areas have to be cleaned gently to avoid further damage.
A affected person who has ovarian most cancers is crying and tells the nurse, "My husband not
often visits. He just would not care." The husband shows to the nurse that he in no way knows
what to say to help his spouse. Which nursing diagnosis is maximum suitable for the nurse to
add to the plan of care?
A. Compromised circle of relatives coping related to disruption in way of life
b. Impaired domestic renovation associated with perceived function modifications
c. Risk for caregiver position strain associated with burdens of caregiving duties
d. Dysfunctional family approaches associated with impact of infection on family contributors -
ANS-ANS: D
The information suggest that this prognosis is maximum suitable because negative verbal
exchange most of the family participants is affecting own family tactics. No records advise a
change in lifestyle or its role as an etiology. The records do not guide impairment in domestic
renovation or a burden due to caregiving responsibilities.
A patient who has severe ache associated with terminal pancreatic cancer is being cared for at
domestic by means of circle of relatives participants. Which finding with the aid of the nurse
shows that coaching regarding pain control has been effective?
A. The affected person uses the ordered opioid ache medicinal drug on every occasion the ache
is more than 5 (zero to ten scale).
B. The patient has the same opinion to take the medicinal drugs through the IV course which
will improve analgesic effectiveness.
C. The patient takes opioids across the clock on a normal time table and uses additional doses
when leap forward ache takes place.
D. The patient states that nonopioid analgesics may be used when the maximal dose of the
opioid is reached with out adequate pain alleviation. - ANS-ANS: C
For chronic cancer pain, analgesics have to be taken on a scheduled basis, with additional
doses as wanted for step forward pain. Taking the medicinal drugs only when pain reaches a
certain stage does now not provide powerful pain manipulate. Although nonopioid analgesics
also can be used, there is no maximum dose of opioid. Opioids are given until pain manipulate
is performed. The IV path is not more powerful than the oral direction, and generally the oral
course is desired.
A affected person who's being handled for degree IV lung cancer tells the nurse about
new-onset back pain. Which motion must the nurse take first?
A. Give the affected person the prescribed PRN opioid.
B. Assess for sensation and strength in the legs.
C. Notify the health care company about the signs and symptoms.
D. Teach the affected person a way to use relaxation to reduce ache. - ANS-ANS: B
Spinal twine compression, an oncologic emergency, can arise with invasion of tumor into the
epidural area. The nurse will need to assess the patient in addition for symptoms inclusive of
decreased leg sensation and power and then notify the fitness care issuer. Administration of
opioids or use of rest may be suitable however most effective after the nurse has assessed for
viable spinal wire compression.
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