The nurse is preparing Cyclophosphamide (Cytoxan). Safe handling of the drug should be implemented to protect the nurse from injury. Which of the following action by the nurse should be corrected?
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Solution
The nurse should wear mask and gloves.
The nurse should be corrected if she is only wearing mask and glove because gowns should also be worn in handling chemotherapeutic drugs. The vials should be vent after mixing to reduce the internal pressure. Air bubbles are expelled on wet cotton to prevent the spread of the chemotherapeutic agent particles.
Chemotherapy is one of the therapeutic modalities for cancer. This treatment is contraindicated to which of the following conditions?
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Solution
All of the above
chemotherapy is contraindicated in cases of infection (chemotherapeutic agents are immunosuppressive), recent surgery (chemotherapeutic agent may retard the healing process), impaired renal and hepatic function (drugs are nephrotoxic and hepatotoxic), recent radiation therapy (immunosuppressive treatment), pregnancy (drugs can cause congenital defects) and bone marrow depression (chemo. Agents may aggravate the condition).
The removal of entire breast, pectoralis major and minor muscles and neck lymph nodes which is followed by skin grafting is a procedure called:
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Solution
Radical mastectomy
Halstead surgery also called radical mastectomy involves the removal of entire breast, pectoralis major and minor muscles and neck lymph nodes. It is followed by skin grafting. Removal of the entire breast, pectoralis major muscle and the axillary lymph nodes is a surgical procedure called modified radical mastectomy. Simple mastectomy is the removal of the entire breast but the pectoralis muscles and nipples remain intact.
A 25 year old patient is inquiring about the methods or ways to detect cancer earlier. The nurse least likely identify this method by stating:
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Solution
Annual Pap smear for sexually active women only.
Early detection of cancer is promoted by annual oral examination, monthly BSE from age 20, annual chest x-ray, yearly digital rectal examination for persons over age 40, annual Pap smear from age 40 and annual physical and blood examination. Letter B is wrong because it says Pap smear should be done yearly for sexually active women. All women should have an annual pap smear by age 40 and up whether sexually active or not.
The client with leukemia is receiving busulfan (Myleran) and allopurinol (Zyloprim). The nurse tells the client that the purpose if the allopurinol is to prevent:
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Solution
Hyperuricemia
Allopurinol decreases uric acid production and reduces uric acid concentrations in serum and urine. In the client receiving chemotherapy, uric acid levels increase as a result of the massive cell destruction that occurs from the chemotherapy. This medication prevents or treats hyperuricemia caused by chemotherapy. Allopurinol is not used to prevent alopecia, nausea, or vomiting.
The female client who has been receiving radiation therapy for bladder cancer tells the nurse that it feels as if she is voiding through the vagina. The nurse interprets that the client may be experiencing:
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Solution
The development of a vesicovaginal fistula
A vesicovaginal fistula is a genital fistula that occurs between the bladder and vagina. The fistula is an abnormal opening between these two body parts and, if this occurs, the client may experience drainage of urine through the vagina. The client’s complaint is not associated with options A, C, and D.
The nurse is admitting a male client with laryngeal cancer to the nursing unit. The nurse assesses for which most common risk factor for this type of cancer?
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Solution
Cigarette smoking
The most common risk factor associated with laryngeal cancer is cigarette smoking. Heavy alcohol use and the combined use of tobacco increase the risk. Another risk factor is exposure to environmental pollutants.
Nurse Farah is caring for a client following a mastectomy. Which assessment finding indicates that the client is experiencing a complication related to the surgery?
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Solution
Arm edema on the operative side
Arm edema on the operative side (lymphedema) is a complication following mastectomy and can occur immediately postoperatively or may occur months or even years after surgery. Options A, C, and D are expected occurrences following mastectomy and do not indicate a complication.
Sarah, a hospice nurse visits a client dying of ovarian cancer. During the visit, the client expresses that “If I can just live long enough to attend my daughter’s graduation, I’ll be ready to die.” Which phrase of coping is this client experiencing?
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Solution
Bargaining
Denial, bargaining, anger, depression, and acceptance are recognized stages that a person facing a life-threatening illness experiences. Bargaining identifies a behavior in which the individual is willing to do anything to avoid loss or change prognosis or fate. Denial is expressed as shock and disbelief and may be the first response to hearing bad news. Depression may be manifested by hopelessness, weeping openly, or remaining quiet or withdrawn. Anger also may be a first response to upsetting news and the predominant theme is “why me?” or the blaming of others.
Mr. Miller has been diagnosed with bone cancer. You know this type of cancer is classified as:
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Solution
sarcoma.
Tumors that originate from bone,muscle, and other connective tissue are called sarcomas.