A client has squamous cell cancer of the right lung that has metastasized to the brain. In addition to chemotherapy for lung cancer, the physician prescribes lomustine (CeeNU), 100 mg/m2 as a single dose, to treat the brain metastasis. What are the major administration and excretion routes of lomustine?

Correct Answer: B

Rationale: The correct answer is B: I.V. administration and urinary excretion. Lomustine is typically administered intravenously, allowing for rapid systemic distribution. The drug is metabolized in the liver and excreted primarily through the kidneys, thus the urinary route. This choice is correct as lomustine's pharmacokinetics align with this pattern. A: Oral administration and urinary - While some drugs are administered orally, lomustine is not typically given orally due to poor bioavailability. C: I.V. administration and fecal excretion - Lomustine is not primarily excreted via the feces, making this choice incorrect. D: Oral administration and fecal excretion - Lomustine is not primarily excreted via the feces, making this choice incorrect.

Correct Answer: A

Rationale: The correct answer is A: Hair loss. Radiation therapy targets fast-growing cancer cells, which can also affect healthy cells such as those in hair follicles, leading to hair loss. This adverse effect occurs commonly with radiation therapy due to its impact on rapidly dividing cells. Hair loss is a well-known side effect that clients undergoing radiation therapy are often prepared for. The other choices, B: Fatigue, C: Stomatitis, and D: Vomiting, are also potential side effects of radiation therapy, but hair loss is specifically associated with radiation treatment due to its effect on hair follicles. Fatigue is a common side effect of cancer treatment in general, stomatitis is more commonly associated with chemotherapy, and vomiting can be a side effect of radiation but is not as directly linked as hair loss.

Correct Answer: D

Rationale: The correct answer is D: Cryptorchidism. Cryptorchidism, or undescended testicle, is a known risk factor for testicular cancer as the undescended testicle is more prone to developing cancerous changes. This condition increases the risk of testicular cancer even if the testicle is surgically corrected later in life. Other choices like A (Testosterone therapy during childhood) and B (Sexually transmitted disease) are not linked to testicular cancer. Choice C (Early onset of puberty) is not a direct risk factor for testicular cancer.

Correct Answer: A

Rationale: The correct answer is A: Avoiding using soap on the irradiated areas. Soap can irritate the skin and exacerbate the risk for impaired skin integrity in a client receiving radiation therapy. By avoiding soap, we minimize the risk of skin breakdown and promote skin healing. B: Applying talcum powder can actually worsen skin irritation and should be avoided. C: Wearing a lead apron is not relevant to the nursing diagnosis of risk for impaired skin integrity. D: Removing thoracic skin markings is not necessary for skin integrity and may disrupt the treatment plan.

Correct Answer: C

Rationale: The correct answer is C: Asymmetry. The ABCD method is a mnemonic used for assessing skin lesions for possible skin cancer. The A in ABCD stands for Asymmetry, indicating that the lesion is not symmetrical in shape or color. Skin cancers often exhibit asymmetrical features. Actinic (Choice A) refers to sun damage, Arcus (Choice B) is a term related to the eye, and Assessment (Choice D) is a general term that does not specifically relate to skin lesion evaluation. By focusing on asymmetry, healthcare providers can identify potential skin cancer lesions early for further evaluation and treatment.