A nurse is caring for a client who is receiving brachytherapy for endometrial cancer.
Which of the following actions should the nurse take?
Place the client's soiled bed linens in a biohazard bag outside the client's room.
Wear an isolation gown when caring for the client.
Keep visitors at least 6 feet (1.8 m) away from the client.
Discard the radioactive source in the client's trash can.
The Correct Answer is C
Answer is c. Keep visitors at least 6 feet (1.8 m) away from the client.
a. Place the client's soiled bed linens in a biohazard bag outside the client's room: While it is essential to follow standard precautions for handling potentially contaminated linens, soiled bed linens from a client undergoing brachytherapy do not require special handling in a biohazard bag unless contaminated with blood or bodily fluids. Brachytherapy involves the internal placement of radioactive sources near or within the tumor site, but the risk of contamination from bodily fluids is minimal. Therefore, soiled linens can be managed according to standard facility protocols for handling linens.
b. Wear an isolation gown when caring for the client: This option is incorrect because wearing an isolation gown is not necessary for radiation safety during brachytherapy. Radiation exposure is primarily managed through the use of lead aprons, gloves, and other shielding devices when directly handling radioactive sources or being in close proximity to the client during treatment sessions. Isolation gowns are typically used to prevent the spread of infection and are not specifically designed to shield against radiation exposure.
c. Keep visitors at least 6 feet (1.8 m) away from the client: Correct. This action minimizes radiation exposure to visitors, as brachytherapy involves the internal placement of radioactive material near or within the tumor site. Maintaining a distance of at least 6 feet (1.8 meters) from the client helps reduce the risk of radiation exposure to visitors while allowing them to provide support and companionship to the client. Visitors should also be informed about radiation safety precautions and instructed to limit their time spent near the client during treatment.
d. Discard the radioactive source in the client's trash can: This option is incorrect because radioactive sources used in brachytherapy must be handled and disposed of by trained personnel following established radiation safety protocols. Disposing of radioactive material in a client's regular trash can poses significant risks of exposure to others and is not permitted. Proper disposal procedures for radioactive sources involve packaging them in approved containers and returning them to the facility's radiation safety department for appropriate disposal or recycling.
In summary, the correct answer is c because keeping visitors at least 6 feet (1.8 meters) away from the client helps minimize their radiation exposure during brachytherapy, which involves the internal placement of radioactive material near or within the tumor site. This action aligns with radiation safety principles and helps protect both the client and visitors from unnecessary radiation exposure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","E"]
Explanation
Choice A rationale:
Depression commonly coexists with eating disorders. Patients with eating disorders often experience profound sadness, hopelessness, and a distorted body image, leading to depressive symptoms. Addressing both conditions simultaneously is crucial for effective treatment.
Choice B rationale:
Obsessive-compulsive disorder (OCD) frequently accompanies eating disorders. Obsessive thoughts about body weight, shape, and food intake are common in individuals with eating disorders. These obsessions can lead to compulsive behaviors, such as strict dietary rules or excessive exercise, reinforcing the connection between eating disorders and OCD.
Choice C rationale:
Schizophrenia is not typically considered a comorbidity of eating disorders. Schizophrenia involves distorted thinking, hallucinations, and impaired emotional responses, which are distinct from the symptoms of eating disorders. While it's essential to assess patients comprehensively, schizophrenia is not a common comorbidity of eating disorders.
Choice D rationale:
Breathing-related sleep disorder is not a direct comorbidity of eating disorders. However, individuals with severe eating disorders, especially anorexia nervosa, may experience complications like sleep apnea due to extreme weight loss. While this is a potential issue, it is not a direct comorbidity of eating disorders for all patients.
Choice E rationale:
Anxiety often coexists with eating disorders. Anxiety about body weight, shape, and food intake is a significant concern for individuals with eating disorders. This anxiety can further perpetuate disordered eating behaviors, creating a cycle that is challenging to break without addressing the underlying anxiety.
Correct Answer is A
Explanation
Choice A rationale: Evaluating the fetal heart rate tracing is the most critical action in this scenario. The client is at 31 weeks of gestation and reports decreased fetal movement, which could indicate fetal distress. The nurse should first assess the fetal heart rate tracing to ensure the fetus is not in distress. Normal fetal heart rate is between 110 and 160 beats per minute.
Choice B rationale: Obtaining a 24-hour urine collection is important for assessing proteinuria, a sign of preeclampsia, but it is not the most immediate concern. The nurse can initiate this after ensuring the fetus is not in distress.
Choice C rationale: Administering acetaminophen PO (by mouth) can help relieve the client’s headache, but it is not the most immediate concern. The nurse can administer this medication after ensuring the fetus is not in distress and initiating other prescribed treatments.
Choice D rationale: Administering magnesium sulfate IV (intravenously) can prevent seizures in clients with preeclampsia. However, before administering this medication, the nurse should ensure that the fetus is not in distress.
Choice E rationale: Administering betamethasone IM (intramuscularly) can help accelerate fetal lung maturity in case of preterm labor. However, before administering this medication, the nurse should ensure that the fetus is not in distress.
Choice F rationale: Inserting an indwelling urinary catheter can help monitor urine output, which is important for clients receiving magnesium sulfate because oliguria can be a sign of magnesium toxicity. However, before inserting the catheter, the nurse should ensure that the fetus is not in distress.
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