A client with cancer is admitted to a short-term rehabilitation facility. The nurse prepares to administer the client's oral chemotherapy medications. What action by the nurse is most appropriate?

Correct Answer: D

Rationale: In the context of administering oral chemotherapy medications to a client with cancer in a short-term rehabilitation facility, the most appropriate action by the nurse is option D, which is to wear personal protective equipment (PPE) when handling the medications. The rationale behind this is that chemotherapy medications are cytotoxic and can be harmful if they come into contact with the skin or mucous membranes. Wearing PPE such as gloves, gown, and mask provides a barrier of protection for the nurse against potential exposure to these hazardous substances, thereby ensuring the safety of both the nurse and the client. Options A and B are incorrect because crushing oral chemotherapy medications or giving them with just water can alter the medication's intended absorption and effectiveness. Chemotherapy drugs are often formulated in specific ways to ensure their proper release and absorption in the body, and altering this can result in suboptimal treatment outcomes. Option C is also incorrect because all chemotherapy medications require special precautions due to their cytotoxic nature. Failing to take appropriate precautions when handling these medications can lead to serious health risks for healthcare providers and clients alike. In an educational context, it is crucial for nursing students to understand the importance of following safety protocols when administering chemotherapy medications to prevent accidental exposure and ensure the effectiveness of treatment. Emphasizing the use of PPE and proper handling procedures is essential in promoting safe and quality care for clients receiving chemotherapy.

Correct Answer: C

Rationale: In this scenario, the nurse should assess the client with a serum potassium level of 2.8 mEq/L (2.8 mmol/L) first. This is because tyrosine kinase inhibitors (TKIs) can cause electrolyte imbalances, particularly hypokalemia, which can lead to serious cardiac complications like arrhythmias. Therefore, addressing the potassium level promptly is crucial to prevent potential life-threatening issues. Option A (dry, itchy, peeling skin) is a common side effect of TKIs but does not pose an immediate threat to the client's life or require urgent intervention. Option B (serum calcium of 9.2 mg/dL) is within the normal range and does not suggest an acute issue requiring immediate attention. Option D (weight gain of 0.5 lb in 1 day) may indicate fluid retention, but it is not as urgent as correcting a dangerously low potassium level. Educationally, this question highlights the importance of prioritizing assessments based on the potential severity of the client's condition. Understanding the side effects and complications of specific medications, such as TKIs, is crucial for nurses caring for oncology patients to ensure timely and appropriate interventions.

Correct Answer: B

Rationale: In the context of a client with long-standing heart failure being treated for cancer and given ondansetron for nausea, the most important action for the nurse to take is to request a prescription for cardiac monitoring (Option B). This is crucial because ondansetron can prolong the QT interval on an electrocardiogram, which can be particularly risky for patients with heart failure due to the potential for arrhythmias and other cardiac complications. Assessing the client for a headache or dizziness (Option A) is important in general when administering medications like ondansetron, but it is not the most critical action in this specific case where cardiac monitoring takes precedence due to the client's underlying heart failure. Instructing the client to change positions slowly (Option C) is important for patients on certain medications to prevent orthostatic hypotension, but it is not the most crucial action given the potential cardiac effects of ondansetron in a patient with heart failure. Weighing the client daily before eating (Option D) is not directly related to the administration of ondansetron or the client's heart failure and cancer treatment. In an educational context, this question highlights the importance of understanding the potential side effects and interactions of medications, especially in patients with comorbidities such as heart failure. It emphasizes the need for nurses to prioritize actions based on the specific risks posed by medications in individual patient scenarios to ensure safe and effective care.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) Allowing a very tired client to skip oral hygiene and sleep. This action requires intervention from the nurse because maintaining proper oral hygiene is crucial for oncology patients to prevent complications such as oral mucositis, infections, and discomfort. Skipping oral hygiene can lead to oral health issues that could exacerbate the patient's condition and quality of life. Option B) Assisting clients with washing the perianal area every 12 hours is an appropriate task for the assistive personnel on an oncology unit to maintain skin integrity and prevent infections, so it does not require intervention. Option C) Helping the client use a soft-bristled toothbrush for oral care is also a suitable action as it is gentle on the sensitive oral tissues of oncology patients, promoting oral hygiene without causing harm. Option D) Reminding the client to rinse the mouth with water or saline is another important aspect of oral care for oncology patients to prevent dryness, infections, and mucositis. This action does not require intervention as it contributes to the overall oral hygiene regimen. In an educational context, this question highlights the importance of proper oral hygiene in oncology care and the role of healthcare professionals in ensuring that all aspects of patient care are addressed, even when tasks are delegated to assistive personnel. It underscores the critical thinking and decision-making skills required in nursing practice to prioritize patient needs and intervene when necessary to maintain patient well-being.

Correct Answer: C

Rationale: In the context of a client undergoing chemotherapy at risk for developing mucositis, the most appropriate nursing intervention to help manage this condition is option C: Teach the client to avoid spicy or acidic foods. This intervention is correct because spicy or acidic foods can further irritate and inflame the oral mucosa, exacerbating mucositis symptoms. By advising the client to avoid these types of foods, we aim to reduce irritation and promote healing of the oral mucosa during chemotherapy. Option A (Encourage the client to drink plenty of fluids) is a good general recommendation for overall health but may not directly address the specific issue of mucositis. Option B (Administer antifungal mouthwash) is not the best choice for managing mucositis unless there is a specific fungal infection present. Option D (Apply a topical anesthetic to the oral mucosa before meals) may provide symptomatic relief but does not address the underlying cause of mucositis. In an educational context, it's crucial for nurses to understand the pathophysiology of mucositis and how chemotherapy can lead to this condition. Teaching clients about proper oral care, including avoiding irritating foods, is essential in managing mucositis and improving their quality of life during cancer treatment.