Which signs and symptoms are important for the nurse to report to the next shift?
Mild fatigue
Nausea and vomiting
Fever and chills
Dry, itchy skin
The Correct Answer is C
Rationale:
A. Mild fatigue is common in many patients, especially those undergoing cancer treatment, and is not immediately life-threatening. While it should be monitored, it does not require urgent reporting to the next shift.
B. Nausea and vomiting are expected side effects of many treatments, including chemotherapy. They should be managed symptomatically, but in the absence of severe dehydration or inability to tolerate fluids, they are not considered urgent for shift-to-shift reporting.
C. Fever and chills in a patient, particularly one with neutropenia or immunosuppression, may indicate a serious infection. In these patients, infections can progress rapidly and become life-threatening, so this must be reported immediately to ensure prompt intervention, including assessment, blood cultures, and possible initiation of antibiotics.
D. Dry, itchy skin is a common, non-urgent side effect of cancer treatments or environmental factors. While it should be addressed to maintain comfort and skin integrity, it does not require urgent reporting.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Filgrastim does not reduce GI toxicity. It specifically targets the bone marrow to stimulate white blood cell production and does not affect nausea, diarrhea, or mucositis caused by chemotherapy.
B. Filgrastim does the opposite of immune suppression. It stimulates the bone marrow to produce neutrophils, enhancing the patient’s immune function, especially after chemotherapy or surgery.
C. Filgrastim has no effect on nausea, vomiting, or appetite. Antiemetic medications, not filgrastim, are used to manage these symptoms.
D. Filgrastim (Neupogen) is a colony-stimulating factor that promotes the production of neutrophils in the bone marrow. After bowel resection and chemotherapy, patients are at risk for neutropenia, which increases susceptibility to infection. Administering filgrastim helps raise WBC counts, enhancing immune defense and reducing infection risk.
Correct Answer is D
Explanation
Rationale:
A. Bleeding is not a common side effect of opioids. While cancer itself or certain treatments (like chemotherapy or thrombocytopenia) may increase bleeding risk, opioid use does not directly cause bleeding.
B. Mucositis is inflammation and ulceration of the mucous membranes, commonly seen with chemotherapy or radiation therapy, not from opioid use.
C. Opioid medications generally cause the opposite effect—constipation, rather than diarrhea. Diarrhea may occur in some cancer patients due to treatment or disease, but it is not expected from opioid therapy.
D. Opioids slow gastrointestinal motility by binding to mu-opioid receptors in the gut. This can lead to constipation and, if untreated, fecal impaction, especially in clients who are immobile or have limited physical activity. Anticipating this effect allows the nurse to implement preventive measures, such as increasing fluid and fiber intake if tolerated, encouraging mobility as possible, and using stool softeners or laxatives.
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