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The nurse is caring for a patient with stage IV metastatic breast cancer, who has metastasis to the bone.
During assessment, the patient appears severely weak, fatigued, confused, and continually repeats "I'm so thirsty!” What will the nurse implement in the patient's plan of care?

Notify the provider that the patient is exhibiting signs of hypercalcemia and draw blood to obtain ionized calcium level.

Notify the provider that the patient is exhibiting signs of tumor lysis syndrome and draw blood to obtain uric acid level.

Notify the provider that the patient is exhibiting signs of infection and request an order for blood cultures.

Notify the provider that the patient is exhibiting signs of bleeding and request an order for a packed red blood cell transfusion.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Hypercalcemia is common in patients with bone metastasis. Symptoms include weakness, fatigue, confusion, and excessive thirst. The nurse should notify the provider and draw blood to obtain the ionized calcium level for proper diagnosis and treatment.

Choice B rationale

Tumor lysis syndrome typically occurs in patients with rapidly proliferating tumors undergoing treatment, leading to the release of intracellular contents. Symptoms include hyperuricemia, not excessive thirst. This choice does not match the patient's presentation.

Choice C rationale

While infection can cause weakness and confusion, it does not typically cause extreme thirst. The patient's symptoms are more indicative of hypercalcemia, making this choice less relevant.

Choice D rationale

Bleeding can cause weakness and confusion due to anemia, but it does not cause extreme thirst. The symptoms of the patient are more aligned with hypercalcemia than bleeding.

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Correct Answer is C

Explanation

Choice A rationale

Placing the patient in a private, lead-lined room is unnecessary for external radiation therapy, which does not make the patient radioactive. This consideration is more applicable to internal radiation therapy (brachytherapy), where radioactive materials are placed inside the body.

Choice B rationale

While dosimeter badges are essential for monitoring radiation exposure, they are more relevant for healthcare workers who may be exposed to radiation, not for patients receiving external radiation therapy. The patient themselves are not a source of radiation exposure.

Choice C rationale

Monitoring the patient's skin integrity is crucial because external radiation can cause skin irritation and damage. Avoiding exposure to extreme heat or cold helps prevent additional skin trauma and promotes healing.

Choice D rationale

Restricting visitors and posting radioactive precautions signs are unnecessary for patients receiving external radiation therapy. These precautions are more applicable to internal radiation therapy, where the patient may emit radiation.

A. Metformin. B. Warfarin. C. Sertraline. D. Methylprednisolone.

Correct Answer is B

Explanation

Choice A rationale

Metformin is used to manage diabetes, primarily by improving insulin sensitivity and reducing glucose production in the liver. Levothyroxine, used to treat hypothyroidism, does not significantly impact the action of metformin. The two medications do not have a direct interaction that decreases metformin's efficacy.

Choice B rationale

Levothyroxine can decrease the action of warfarin by increasing the metabolism of clotting factors in the liver, which may reduce the anticoagulant effect of warfarin. This interaction necessitates closer monitoring of INR (International Normalized Ratio) levels and potential dose adjustments of warfarin to maintain its therapeutic effect.

Choice C rationale

Sertraline is an antidepressant that belongs to the selective serotonin reuptake inhibitor (SSRI) class. While it can interact with other medications, levothyroxine does not significantly decrease its action. Therefore, no major adjustments are needed when both drugs are prescribed together.

Choice D rationale

Methylprednisolone, a corticosteroid, is used for its anti-inflammatory and immunosuppressant properties. Levothyroxine does not decrease the action of methylprednisolone. These medications do not have a significant pharmacological interaction that would require adjusting methylprednisolone’s dosage.

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The nurse is caring for a patient with stage IV metastatic breast cancer, who has metastasis to the bone.During assessment, the patient appears severely weak, fatigued, confused, and continually repeats "I'm so thirsty!” What will the nurse implement in the patient's plan of care?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient receiving external radiation for lung cancer.What nursing considerations will the nurse implement to reduce the risks related to this treatment?

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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The nurse is caring for a patient with stage IV metastatic breast cancer, who has metastasis to the bone.
During assessment, the patient appears severely weak, fatigued, confused, and continually repeats "I'm so thirsty!” What will the nurse implement in the patient's plan of care?