Anemias
A pregnant woman asks about dietary sources of folic acid. Which food should the nurse recommend?
Leafy green vegetables
Leafy green vegetables are rich in folic acid, which is essential for DNA and RNA production and preventing neural tube defects in pregnancy.
A patient receiving chemotherapy is at risk for extravasation. What is the nurse’s first action?
Stop the infusion immediately
Extravasation (leakage of a vesicant drug into tissue) requires immediate discontinuation to prevent severe damage.
A patient with gout asks which food should be avoided. Which response is correct?
Red meat
Red meat is high in purines, which can increase uric acid levels, leading to gout flares
What is Nadir?
the lowest ANC following chemotherapy, targeted therapy, or radiation therapy that suppresses bone marrow function
A nurse is caring for a patient post-hip replacement. What should be included in discharge instructions?
Avoid crossing legs at the knees
Crossing the legs can cause hip dislocation, so patients should avoid crossing their legs and use abduction pillows.
Which factor is most likely to trigger a sickle cell crisis?
Cold exposure
Cold exposure can trigger a crisis by causing vasoconstriction, which exacerbates sickling of RBCs and impairs blood flow.
A nurse is caring for a patient with tumor lysis syndrome. Which lab value is expected?
Hyperkalemia
Tumor lysis syndrome releases intracellular contents, leading to hyperkalemia, hyperphosphatemia, and hypocalcemia.
What is the priority intervention for a patient with superior vena cava syndrome?
Elevate the head of the bed to 30-45 degrees
Elevating the head of the bed reduces venous pressure and promotes better circulation.
A nurse is preparing to care for a patient undergoing external radiation therapy. Which statement by the patient indicates the need for further education?
"I can apply lotion to my skin before treatment."
Patients should not apply lotions, creams, or ointments before external radiation therapy, as they can alter radiation absorption.
A patient with a leg cast reports numbness and tingling. What should the nurse do first?
Assess for compartment syndrome
Numbness and tingling may indicate compartment syndrome, a medical emergency requiring immediate intervention.
A patient receiving chemotherapy is diagnosed with aplastic anemia. What is the priority nursing concern?
Risk for infection!
Aplastic anemia leads to pancytopenia, increasing infection risk due to decreased white blood cells.
A patient presents with edema in the face, neck, & upper chest. They came in because it has been getting harder to breathe and their shirt has started to feel tight around their neck. What oncologic emergency is this patient presenting with?
Superior Vena Cava Compression
Which treatment is most effective for spinal cord compression due to cancer metastasis?
Ratiation therapy
Radiation therapy shrinks the tumor and reduces pressure on the spinal cord.
A patient undergoing chemotherapy has a WBC count of 900/mm³. What is the priority nursing action?
Place the patient on neutropenic precautions
A WBC count below 2,000/mm³ indicates severe neutropenia, requiring strict infection prevention measures.
A patient with osteoarthritis asks about non-pharmacologic pain relief. Which intervention is most appropriate?
Engage in weight-bearing exercises
Weight-bearing exercises help maintain joint mobility and reduce pain in osteoarthritis.
A nurse is teaching a patient with Von Willebrand Disease about bleeding precautions. Which statement indicates the patient understands the teaching?
"I should use a soft-bristled toothbrush."
Using a soft-bristled toothbrush minimizes gum bleeding, an important precaution for patients with a bleeding disorder.
A nurse is teaching a patient with lymphoma about preventing tumor lysis syndrome. Which instruction should be included?
"Increase fluid intake to at least 3-4 L per day."
Aggressive hydration (3-4 L/day) helps flush out excess electrolytes and prevents complications from tumor lysis syndrome.
Which symptom would indicate worsening hypercalcemia in a patient with cancer?
Decreased deep tendon reflexes
Hypercalcemia can cause decreased deep tendon reflexes, confusion, and muscle weakness.
A nurse is caring for a patient receiving internal radiation therapy. Which safety measure should be implemented?
Visitors should stay at least 6 feet away from the patient.
Internal radiation is transmitted from the body, so visitors must stay at least 6 feet away.
A nurse is teaching a patient with osteoporosis about medication administration. Which instruction is correct for bisphosphonates?
Take on an empty stomach with a full glass of water
Bisphosphonates should be taken on an empty stomach with water, and the patient should remain upright for 30 minutes.
A patient with sickle cell anemia is experiencing severe joint pain and fatigue. What is the priority nursing intervention?
Administer oxygen and IV fluids
In sickle cell crisis, oxygen helps prevent further sickling of RBCs, and IV fluids reduce blood viscosity, improving circulation and oxygenation. Cold compresses should be avoided, as cold temperatures can trigger sickling
A patient with spinal cord compression due to metastatic cancer asks why corticosteroids are prescribed. What is the best response?
"Corticosteroids reduce spinal cord swelling and inflammation."
Corticosteroids help reduce swelling around the spinal cord, alleviating compression symptoms.
A patient with leukemia develops disseminated intravascular coagulation (DIC). Which symptom requires immediate intervention?
Oozing from IV sites
DIC causes uncontrolled bleeding; oozing from IV sites signals severe coagulopathy.
A patient is undergoing chemotherapy and reports nausea and vomiting. What is the best intervention to reduce symptoms?
Offer small, frequent meals with bland foods.
Small, frequent meals with bland foods help manage chemotherapy-induced nausea. High-fat or spicy foods can worsen symptoms.
A patient comes in after a recent diagnosis of Duchenne's Muscular Dystrophy. How should you educate the patient's parents on disease managment.
a. This can be cured with a series of medications
b. Don't worry, your child will grow out of this
c. This can be managed with PT and OT to promote as much independence as possible
d. There is nothing we can do
This can be managed with PT and OT to promote as much independence as possible
Duchenne's is not curable, but you should encourage PT and OT so that the child can maintain as much independence as possible for as long as possible.