A nurse on an oncology unit is caring for a client who is receiving intravenous chemotherapy for the treatment of advanced colon cancer. Which of the following items should be included in the plan of care for this client?

Encourage spicy and highly-seasoned foods to improve intake.

Administer loperamide prophylactically to prevent nausea.

Provide frequent, thorough pain assessments.

Administer the chemotherapy medication through an 18 gauge peripheral line.

Answer and Explanation

The Correct Answer is C

A.   During chemotherapy, many patients experience nausea, vomiting, and changes in taste or appetite. Spicy and highly-seasoned foods can exacerbate gastrointestinal symptoms and may not be well tolerated. It's generally recommended to encourage bland, easy-to-digest foods to help maintain adequate nutrition and reduce discomfort.
B.   Loperamide is not used to prevent nausea; rather, it is an antidiarrheal medication used to treat diarrhea, which can be a side effect of chemotherapy. Nausea prevention is typically managed with antiemetic medications such as ondansetron, metoclopramide, or others prescribed based on the patient's specific needs and chemotherapy regimen.
C.   Pain management is an essential aspect of caring for oncology patients, including those receiving chemotherapy. Cancer and its treatment can cause pain directly or indirectly (such as from procedures or complications). Regular and thorough pain assessments allow for timely intervention and improvement in the client's comfort and quality of life.
D.   Chemotherapy medications are typically administered through central venous access devices (e.g., central lines, PICC lines) rather than through peripheral veins. This is because chemotherapy drugs can be vesicants (causing tissue damage if they leak out of the vein) or irritants to smaller peripheral veins.
Using a larger gauge peripheral line (e.g., 18 gauge) is not standard practice for administering chemotherapy due to the potential risks and complications associated with peripheral administration.

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Correct Answer is D

Explanation

A. ALS is not caused by a virus or inflammation of the nerves. It is a progressive neurodegenerative disease affecting the motor neurons in the brain and spinal cord.
B. While acetylcholine breakdown is involved in other neurological conditions (such as myasthenia gravis), ALS primarily affects motor neurons and does not directly involve acetylcholine metabolism at the neuromuscular junction.
C. ALS does not typically involve significant inflammation or demyelination (which is more characteristic of conditions like multiple sclerosis). Therefore, reducing CNS inflammation is not a therapeutic target in ALS.
D. Riluzole, the medication prescribed for ALS, works by decreasing the release of glutamate, which is a neurotransmitter that can be toxic to nerve cells in high amounts. In ALS, excessive glutamate release is believed to contribute to motor neuron degeneration. By reducing glutamate release, riluzole may help protect motor neurons and slow the progression of the disease.

A. Platelet factor 4 (PF4) bound with heparin forming a PF4-heparin complex. B. Abnormally long von Willebrand factor. C. A deficiency of the enzyme ADAMTS13. D. Platelets which are coated with antibodies.

Correct Answer is D

Explanation

A. This option describes a phenomenon seen in heparin-induced thrombocytopenia (HIT), not in immune thrombocytopenic purpura (ITP). In HIT, antibodies against the PF4-heparin complex can cause platelet activation and aggregation, leading to thrombocytopenia. However, this is not characteristic of ITP.
B. Abnormally long von Willebrand factor is seen in von Willebrand disease (VWD), not in ITP. VWD is a bleeding disorder caused by deficiency or dysfunction of von Willebrand factor, which plays a key role in platelet adhesion and aggregation. It is not typically associated with ITP.

C. ADAMTS13 deficiency is characteristic of thrombotic thrombocytopenic purpura (TTP), not ITP. TTP is a rare blood disorder where small blood clots form in blood vessels throughout the body, leading to thrombocytopenia (low platelet count) and other complications. It is distinct from ITP.
D. In immune thrombocytopenic purpura (ITP), the immune system mistakenly attacks and destroys platelets, leading to a low platelet count. Antibodies, particularly anti-platelet antibodies such as anti-GP IIb/IIIa or anti-GP Ib/IX, coat the surface of platelets. These antibody-coated platelets are recognized and destroyed by macrophages in the spleen and liver, contributing to thrombocytopenia.

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A nurse on an oncology unit is caring for a client who is receiving intravenous chemotherapy for the treatment of advanced colon cancer. Which of the following items should be included in the plan of care for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a new diagnosis of amyotrophic lateral sclerosis (ALS), and a new prescription for riluzole. The nurse understands that this medication works in which of the following ways?

Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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