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: Lomustine (CeeNU) is typically administered intravenously (I.V.), making choice B the correct administration route. Lomustine is metabolized in the liver and excreted primarily through the kidneys via urine, which accounts for its urinary excretion. Therefore, the major administration route for lomustine is intravenous (I.V.) and the major excretion route is urinary.

Correct Answer: C

Rationale: Nursing considerations with Tretinoin (Retin-A) should include explaining that the medication should not be applied until at least 20 to 30 minutes after washing. This wait time allows the skin to fully dry and reduces the risk of irritation. Applying the medication too soon after washing can increase the likelihood of skin irritation, dryness, and peeling. It is essential to follow this guideline to ensure the effectiveness of the treatment and minimize adverse effects on the skin.

Correct Answer: B

Rationale: Atraumatic care for pediatric patients aims to minimize emotional and psychological distress during hospitalization or medical procedures. Option B, preparing the child before any unfamiliar treatment or procedure by demonstrating it on a stuffed animal, is an appropriate intervention. This technique allows the child to understand what will happen, reduces fear of the unknown, and promotes a sense of control. By using a stuffed animal as a teaching tool, the nurse can provide clear information to the child in a non-threatening way, helping to alleviate anxiety and stress. This intervention encourages trust between the child and healthcare provider and promotes a positive healthcare experience for the pediatric patient.

Correct Answer: C

Rationale: When a client undergoes treatment for a malignant tumor requiring a urinary diversion procedure, such as a urostomy, it is crucial for nurses to closely monitor for any signs of leakage of urine or stool from the anastomosis site. This is important because it can indicate complications such as infection, poor wound healing, or a breakdown in the surgical site. Detecting and addressing leakage promptly can help prevent further complications and ensure the client's recovery progresses smoothly. While the other options may be important aspects of nursing care, observing for leakage of urine or stool from the anastomosis is the most critical factor in managing clients undergoing treatment for a malignant tumor affecting the urinary system.

Correct Answer: A

Rationale: The patient's presentation suggests that he may be suffering from hypermagnesemia (high magnesium levels) due to excessive ingestion of antacid tablets. Symptoms of hypermagnesemia can include flushing, weakness, and low blood pressure. A serum magnesium level of 11mEq/L is consistent with hypermagnesemia. In this scenario, the other values (2mEq/L, 5mEq/L, 1mEq/L) are unlikely to be the correct magnesium level based on the patient's symptoms and history of antacid ingestion.