A patient has just completed radiation therapy for breast cancer. During a follow-up appointment, which patient statement would indicate a need for further education regarding skin care?

I should wear loose-fitting clothing over the treated area.

I can use a heating pad to relieve discomfort in the treated area,

it's important to protect the treated area from direct sunlight.

I should avoid using perfumed lotions on the treated area.

Answer and Explanation

The Correct Answer is B

Rationale:

A. Wearing loose-fitting clothing over the treated area is appropriate. Tight clothing can irritate sensitive skin, cause friction, and worsen radiation dermatitis, so loose clothing helps protect the area and promotes healing.

B. Using a heating pad on the treated area is contraindicated. Radiation-damaged skin is more sensitive and prone to burns or injury, and external heat sources can exacerbate skin irritation or cause burns. This statement indicates a need for further education about safe pain management and skin care after radiation therapy.

C. Protecting the treated area from direct sunlight is essential. Radiation-treated skin is more susceptible to sunburn and long-term damage, so using sunscreen, protective clothing, or avoiding sun exposure is important.

D. Avoiding perfumed or harsh lotions is correct. Fragrances and chemicals can irritate sensitive, post-radiation skin, so patients should use mild, unscented moisturizers to maintain skin integrity.

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Correct Answer is B

Explanation

Rationale:

A. Advising the patient to use over-the-counter antidiarrheal medication may mask symptoms but does not address the underlying cause. If the diarrhea is due to an infection, particularly Clostridium difficile, using antidiarrheals could worsen the condition by retaining toxins in the colon.

B. Assessing the patient for signs of Clostridium difficile (C. difficile) infection is the priority. PPIs reduce gastric acidity, which can alter gut flora and increase susceptibility to C. difficile overgrowth, especially in patients with new-onset diarrhea and abdominal pain. Early recognition is critical to prevent severe colitis, dehydration, sepsis, or toxic megacolon. The nurse should monitor for frequent watery stools, fever, abdominal tenderness, and laboratory confirmation through stool testing.

C. Instructing the patient to discontinue the PPI immediately is not recommended without provider guidance. Abrupt cessation may worsen GERD symptoms, and the underlying cause of diarrhea must first be evaluated.

D. Recommending increased fiber intake may help manage some types of diarrhea, but in the presence of possible C. difficile infection, this approach is not appropriate and could exacerbate discomfort or bloating.

A. Subcutaneous nodules on the ulnar side of the arm. B. A dry, red rash across the bridge of the nose and on the cheeks. C. A grey colored, non-purpuric papular rash. D. Pitting edema of the hands and fingers.

Correct Answer is B

Explanation

Rationale:

A. Subcutaneous nodules on the ulnar side of the arm are characteristic of rheumatoid arthritis, not systemic lupus erythematosus. Rheumatoid nodules typically occur over pressure points and are associated with long-standing, seropositive rheumatoid arthritis rather than SLE.

B. A dry, red rash across the bridge of the nose and cheeks is the classic malar (butterfly) rash, a hallmark finding in systemic lupus erythematosus. This rash often spares the nasolabial folds and may worsen with sun exposure (photosensitivity). Its presence supports the diagnosis of SLE and is an expected assessment finding.

C. A grey-colored, non-purpuric papular rash is not typical of SLE. Cutaneous manifestations of SLE most commonly include the malar rash, discoid lesions, and photosensitive rashes rather than grey papular eruptions.

D. Pitting edema of the hands and fingers is not a classic early finding of SLE. While edema may occur secondary to renal involvement (lupus nephritis), it is more commonly seen in the lower extremities and is not a defining or expected primary assessment finding.

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A patient has just completed radiation therapy for breast cancer. During a follow-up appointment, which patient statement would indicate a need for further education regarding skin care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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