A nurse is preparing a client who is to receive chemotherapy for the treatment of breast cancer. Which of the following actions should the nurse plan to take?
Have the client floss 4 times daily.
Have the client swish with commercial mouthwash before therapy.
Tell the client to expect dark stools following chemotherapy.
Administer an antiemetic prior to the procedure.
The Correct Answer is D
Choice A reason : Having the client floss 4 times daily is not typically recommended during chemotherapy because their gums may be more prone to bleeding due to a decrease in platelets, which is a common side effect of chemotherapy¹. Instead, gentle oral care is advised to prevent damage to the oral mucosa.
Choice B reason : Having the client swish with commercial mouthwash before therapy is not generally recommended because many commercial mouthwashes contain alcohol, which can be irritating to the mucous membranes and may exacerbate chemotherapy-induced mucositis¹. Instead, a saline rinse or a prescribed mouthwash without alcohol may be used to help manage oral hygiene during chemotherapy.
Choice C reason : Telling the client to expect dark stools following chemotherapy could be misleading. While some chemotherapy drugs can cause changes in stool color, dark stools can also indicate gastrointestinal bleeding, which requires immediate medical attention¹. Therefore, patients should be instructed to report any significant changes in stool color to their healthcare provider.
Choice D reason : Administering an antiemetic prior to the procedure is a standard practice to prevent nausea and vomiting associated with chemotherapy¹. Antiemetics are medications that can help control these common side effects, improving the patient's comfort and ability to tolerate the treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason : The symptoms described for the 40-year-old woman align closely with the clinical presentation of a pulmonary embolism. Swelling and pain in the calf may indicate deep vein thrombosis (DVT), which can lead to PE. The presence of chest pain, difficulty breathing, rapid heart rate (tachycardia), and rapid breathing (tachypnea) are hallmark signs of PE³⁴.
Choice B reason : While the 60-year-old man is experiencing fatigue, which can be a symptom of many conditions, there is no direct indication of PE. Acute kidney injury (AKI) after IV antibiotics suggests a different pathophysiology unrelated to PE.
Choice C reason : The 30-year-old man's refusal to ambulate or wear compression stockings after surgery increases his risk for DVT and subsequently PE; however, he does not currently exhibit symptoms that are as indicative of PE as the 40-year-old woman.
Choice D reason : The 55-year-old woman's symptoms could suggest a cardiac event, such as a heart attack, especially with the radiating jaw pain. While PE can present with similar symptoms, the radiating pain is more characteristic of cardiac issues³.
Correct Answer is B
Explanation
Choice A reason : Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) which can be detrimental to patients with congestive heart failure (CHF). NSAIDs can lead to sodium and fluid retention, exacerbating CHF symptoms and potentially leading to a worsening of the condition⁶⁷. Therefore, it is not recommended for managing discomfort in CHF patients.
Choice B reason : Slowing down if feeling tired after exercising is a prudent measure for anyone, especially for CHF patients. It indicates the patient is listening to their body and respecting its limits, which is essential in managing CHF. Overexertion can strain an already compromised heart, so moderation and careful monitoring of physical activity are key¹².
Choice C reason : The recommended daily sodium intake for heart failure patients is generally less than 2,000 mg¹⁶¹⁷¹⁸. A limit of 4 grams per day is significantly higher than the recommended amount and could lead to fluid retention and worsening of heart failure symptoms. Therefore, this statement does not reflect effective teaching.
Choice D reason : Diuretics are often prescribed to CHF patients to manage fluid retention. However, taking diuretics before sleep can lead to nocturia, disrupting sleep due to the need to urinate at night. It is generally recommended to take diuretics earlier in the day, with the last dose no later than 4 p.m., to minimize nighttime disruptions¹³¹⁴. Drinking fluids during the day without restriction can also contribute to fluid overload, which is counterproductive in CHF management.
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