A nurse on an oncology unit is caring for a client who is receiving intravenous chemotherapy for the treatment of advanced colon cancer. Which of the following items should be included in the plan of care for this client?

Encourage spicy and highly-seasoned foods to improve intake.

Administer loperamide prophylactically to prevent nausea.

Provide frequent, thorough pain assessments.

Administer the chemotherapy medication through an 18 gauge peripheral line.

Answer and Explanation

The Correct Answer is C

A.   During chemotherapy, many patients experience nausea, vomiting, and changes in taste or appetite. Spicy and highly-seasoned foods can exacerbate gastrointestinal symptoms and may not be well tolerated. It's generally recommended to encourage bland, easy-to-digest foods to help maintain adequate nutrition and reduce discomfort.
B.   Loperamide is not used to prevent nausea; rather, it is an antidiarrheal medication used to treat diarrhea, which can be a side effect of chemotherapy. Nausea prevention is typically managed with antiemetic medications such as ondansetron, metoclopramide, or others prescribed based on the patient's specific needs and chemotherapy regimen.
C.   Pain management is an essential aspect of caring for oncology patients, including those receiving chemotherapy. Cancer and its treatment can cause pain directly or indirectly (such as from procedures or complications). Regular and thorough pain assessments allow for timely intervention and improvement in the client's comfort and quality of life.
D.   Chemotherapy medications are typically administered through central venous access devices (e.g., central lines, PICC lines) rather than through peripheral veins. This is because chemotherapy drugs can be vesicants (causing tissue damage if they leak out of the vein) or irritants to smaller peripheral veins.
Using a larger gauge peripheral line (e.g., 18 gauge) is not standard practice for administering chemotherapy due to the potential risks and complications associated with peripheral administration.

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Correct Answer is B

Explanation

A. Fluticasone is a corticosteroid inhaler used for maintenance therapy to reduce inflammation in the airways over time. It is not a rescue medication for acute symptoms. Clients with COPD should use short-acting bronchodilators (such as albuterol) as their first-line treatment for relieving acute symptoms like shortness of breath or wheezing.
B. This statement is correct. Fluticasone is a corticosteroid medication that, when inhaled, can increase the risk of developing oral candidiasis (thrush). Clients should be instructed to rinse their mouth with water and spit after using the inhaler to minimize this risk. Inspecting the mouth daily for signs of white patches, soreness, or difficulty swallowing is important. If thrush develops, clients may need antifungal treatment.
C. This statement is not necessary for fluticasone inhaler use. Fluticasone is not known to significantly affect heart rate. Monitoring heart rate before each dose is more relevant for medications that can cause changes in heart rate, such as bronchodilators (e.g., beta-agonists). However, clients should monitor for symptoms like palpitations or rapid heart rate and report them to their healthcare provider.
D. Fluticasone is a maintenance medication that should be taken regularly as prescribed, regardless of symptoms. Skipping doses can lead to worsening of COPD symptoms and exacerbations. Clients should adhere to the prescribed dosing schedule to achieve optimal control of their condition.

A. "Carbidopa crosses the blood-brain barrier where it is then converted to dopamine." B. "It may take weeks to begin seeing the effects of this medication." C. “You will remain on the same dosage of this medication for the rest of your life." D. "Levodopa protects carbidopa, preventing carbidopa from being broken down before it reaches the brain."

Correct Answer is B

Explanation

A. Carbidopa itself does not cross the blood-brain barrier. Its primary role in Sinemet is to inhibit the peripheral breakdown of levodopa (the precursor of dopamine) into dopamine before it reaches the brain.
B. It is true that it may take a few weeks to see the full effects of this medication, as the body needs time to adjust to it.
C. Parkinson's disease is progressive, and as the disease advances, the dosage and frequency of levodopa with carbidopa may need to be adjusted to maintain symptom control. Over time, higher doses or additional medications may be required to manage symptoms effectively.
D. Levodopa does not protect Carbidopa; rather, Carbidopa protects Levodopa from early conversion to dopamine outside the brain, which would make it less effective.

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A nurse on an oncology unit is caring for a client who is receiving intravenous chemotherapy for the treatment of advanced colon cancer. Which of the following items should be included in the plan of care for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing education to a client who has chronic obstructive pulmonary disease and will begin using fluticasone by metered dose inhaler every 12 hours for maintenance. Which of the following instructions should the nurse include?

Correct Answer is B

Explanation

A client with Parkinson's disease is started on Levodopa with Carbidopa (Sinemet). What should the nurse include in the patient teaching?

Correct Answer is B

Explanation

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