A female client with breast cancer is scheduled to receive a series of radiotherapy (RT). She has red hair, fair skin, and freckles. She tells the nurse that her skin is particularly sensitive to the sun, so she is worried that the radiation will adversely affect her skin. Which information should the nurse provide this client about RT? Select all that apply.

Both the sun and radiation can damage the skin because it has a rapid renewal rate.

lonizing energy of RT penetrates to the target tumor and does not affect the skin like sun rays.

Shielding helps to localize the entrance of RT and protects other sensitive areas.

Special gels can be prescribed for local application to promote healing and comfort.

Application of cold compresses after treatment decreases the skin's sensitivity.

Answer and Explanation

Correct Answer : A,C,D

Rationale:
A. Both the sun and radiation can damage the skin because it has a rapid renewal rate:
The skin’s high cellular turnover makes it vulnerable to damage from both UV radiation and radiation therapy. Clients with fair skin are especially prone to radiation dermatitis due to lower melanin protection.

B. Ionizing energy of RT penetrates to the target tumor and does not affect the skin like sun rays: Although radiation targets deeper tissues, the skin at the entry site can still be affected. Radiation can cause localized skin damage, including dryness, erythema, or peeling.

C. Shielding helps to localize the entrance of RT and protects other sensitive areas:
Radiation therapy uses shielding and precise targeting to minimize exposure to surrounding tissues. However, the entry site of the beam still receives some exposure, making localized protection and care essential.

D. Special gels can be prescribed for local application to promote healing and comfort:
Topical agents like hydrophilic creams or corticosteroid gels may be recommended to soothe irritated skin and promote healing during radiation therapy. These help manage symptoms like dryness and inflammation.

E. Application of cold compresses after treatment decreases the skin's sensitivity: Cold compresses are not typically recommended after radiation, as they may constrict blood flow and delay healing. Instead, gentle skincare routines and prescribed topical treatments are preferred.

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Free Nursing Study Resources

Correct Answer is C

Explanation

Rationale:
A. Hold the skin fold throughout the injection: Pinching the skin may be helpful to avoid intramuscular injection, especially in thin clients, but it's not required throughout the entire injection process. It is not the most critical technique compared to air bubble retention.

B. Insert the needle at a 90 degree angle: A 90-degree angle is appropriate for clients with sufficient subcutaneous tissue, but in thinner clients a 45-degree angle may be safer. The angle depends on the client’s body habitus and is not universally required.

C. Retain the air bubble in the syringe barrel: The air bubble helps ensure that the full dose is delivered and prevents medication from tracking through subcutaneous tissue, which could cause bruising. It should not be expelled before administering enoxaparin.

D. Massage the area after injection: Massaging the site can increase the risk of bruising and tissue irritation with anticoagulants like enoxaparin. Gentle pressure may be applied if needed, but the site should not be massaged.

A. Separate fluids from meals. B. Plan meals to include rice porridge. C. Eliminate acidic food choices. D. Offer more bread and cheese. E. Provide small frequent meals.

Correct Answer is ["A","E"]

Explanation

Rationale:

A. Separate fluids from meals: Fluids should be consumed at least 30 minutes before or after meals to prevent gastric overdistention and dumping syndrome, which are common after bariatric surgery.

B. Plan meals to include rice porridge: Rice porridge is high in simple carbohydrates, which can cause dumping syndrome and rapid gastric emptying. It is not ideal post-surgery.

C. Eliminate acidic food choices: Acidic foods like citrus or tomatoes may cause discomfort, but they are not universally contraindicated. Tolerance varies by individual, so elimination is not routinely necessary.

D. Offer more bread and cheese: Bread can form a sticky bolus that’s hard to swallow post-op, and cheese is high in fat. Both can cause discomfort or intolerance early in recovery.

E. Provide small frequent meals: After bariatric surgery, the stomach’s capacity is reduced, so clients need to eat small, frequent meals to meet nutritional needs and prevent nausea or vomiting.

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Naxlex Comprehensive Predictor Exams

The nurse is preparing to administer enoxaparin 30 mg subcutaneously using a pre-filled syringe containing 30 mg in 0.3 mL. Which action should the nurse implement?

Correct Answer is C

Explanation

Which dietary intervention(s) should the nurse include in the plan of care for a client who had bariatric surgery? Select all that apply.

Correct Answer is ["A","E"]

Explanation

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