A nurse is planning care for a client who is receiving targeted radiation therapy to the neck. The nurse should plan to monitor the client for which of the following as an adverse effect of this therapy?

Constipation

Decreased tear production

Mouth ulcers

Peripheral neuropathy

Answer and Explanation

The Correct Answer is C

Choice A reason: Constipation can be a side effect of many cancer treatments, including radiation therapy. However, it is not commonly associated with targeted radiation therapy to the neck. Constipation is more often related to opioid pain medications, decreased physical activity, or dietary changes that a patient may experience during cancer treatment.

Choice B reason: Decreased tear production is not a typical side effect of targeted radiation therapy to the neck. This condition, known as dry eye syndrome, is more commonly associated with radiation therapy that affects the eye or orbital area directly.

Choice C reason: Mouth ulcers, also known as mucositis, are a common adverse effect of radiation therapy to the neck. Radiation can damage the mucosal lining of the mouth, leading to painful sores that can affect a patient's ability to eat, speak, and swallow. These ulcers typically develop one to two weeks after starting treatment and may persist for some time after the treatment ends.

Choice D reason: Peripheral neuropathy, which involves damage to the peripheral nerves and often results in symptoms like numbness, tingling, or pain in the hands and feet, is not a common side effect of radiation therapy to the neck. It is more frequently associated with certain chemotherapeutic agents or radiation therapy to areas of the body where peripheral nerves are located.

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Correct Answer is C

Explanation

Choice A reason: The statement that a DNR prescription means the client will only receive pain medication is incorrect. A DNR (Do Not Resuscitate) order does not affect the provision of treatments other than those required to resuscitate the patient if their heart stops or they stop breathing. Patients with a DNR can still receive all other medical treatments and interventions aimed at managing symptoms and improving quality of life, including pain management.

Choice B reason: A DNR prescription does not limit the current treatment regimen in terms of ongoing treatments for the patient's condition. The DNR order specifically refers to not performing CPR (cardiopulmonary resuscitation) if the patient's breathing or heart stops. All other aspects of the patient's care plan, including aggressive treatments, can continue if they align with the patient's wishes and medical advice.

Choice C reason: This is the correct statement. A DNR prescription allows the patient to continue with their current treatment regimen. It is a directive that applies only in the event of cardiac or respiratory arrest, indicating that CPR should not be performed. However, it does not preclude the patient from receiving other medical treatments or interventions.

Choice D reason: A DNR prescription does not inherently limit the ability to receive invasive procedures. The decision to pursue or avoid invasive procedures would be based on the patient's overall treatment goals, prognosis, and personal preferences, not solely on the presence of a DNR order.

A. A client who has a headache following a grade 1 concussion. B. A client who has experienced brain death and is awaiting organ procurement. C. A client who has a score of 10 on the Glasgow Coma Scale following a motor vehicle crash. D. A client who has a score of 0 on the NIH Stroke Scale following a transient ischemic attack.

Correct Answer is C

Explanation

Choice A reason: A headache following a grade 1 concussion, while requiring monitoring, does not typically necessitate immediate proximity to the nurses' station. Grade 1 concussions are considered mild and usually do not involve loss of consciousness.

Choice B reason: A client who has experienced brain death and is awaiting organ procurement will not benefit from being close to the nurses' station due to the irreversible nature of brain death. The care for such a client is focused on maintaining organ viability for transplantation.

Choice C reason: A client with a score of 10 on the Glasgow Coma Scale following a motor vehicle crash should be placed closest to the nurses' station. A GCS score of 10 indicates a moderate level of impairment in consciousness and potentially unstable vital signs, requiring close monitoring and rapid nursing intervention.

Choice D reason: A score of 0 on the NIH Stroke Scale indicates no observable neurological deficit. Clients with a transient ischemic attack (TIA) and a score of 0 would require less intensive observation compared to those with higher scores or other acute neurological injuries.

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A nurse is planning care for a client who is receiving targeted radiation therapy to the neck. The nurse should plan to monitor the client for which of the following as an adverse effect of this therapy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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