A nurse is caring for a patient diagnosed with essential thrombocythemia (ET) who is at risk for thromboembolic events. What nursing intervention is most appropriate for this patient?

Correct Answer: B

Rationale: In caring for a patient with essential thrombocythemia (ET) at risk for thromboembolic events, administering anticoagulant therapy (Option B) is the most appropriate nursing intervention. Anticoagulants help prevent blood clots, reducing the risk of thromboembolic events such as stroke or myocardial infarction in patients with ET. Monitoring for signs of bleeding (Option C) is important due to the increased risk of hemorrhage with anticoagulant therapy, but it is not the most immediate intervention. Encouraging regular physical activity (Option A) is generally beneficial for overall health but does not directly address the specific risk of thromboembolic events in this patient population. Monitoring for signs of infection (Option D) is not directly related to the primary concern of thromboembolic events in patients with ET. This question highlights the importance of understanding the specific pharmacological interventions required for patients with ET to prevent complications and improve outcomes.

Correct Answer: D

Rationale: In the context of a patient with Hodgkin lymphoma receiving radiation therapy, the most common side effect to monitor for is mucositis (Option D). Mucositis is a common adverse effect of radiation therapy, characterized by inflammation and ulceration of the mucous membranes lining the digestive tract. This occurs due to the sensitivity of rapidly dividing mucosal cells to radiation. A) Alopecia is more commonly associated with chemotherapy, which targets rapidly dividing cells such as hair follicles. While radiation therapy can also cause hair loss, it is not the most common side effect in this scenario. B) Fatigue is a common side effect of both radiation therapy and cancer itself. However, in the context of radiation therapy for Hodgkin lymphoma, mucositis is more specific and prevalent. C) Nausea is a side effect commonly associated with chemotherapy rather than radiation therapy. While some patients may experience nausea due to radiation, it is not the most common side effect in this case. Educationally, understanding the specific side effects of different cancer treatments is crucial for nurses to provide comprehensive care. By knowing the expected side effects, nurses can anticipate, monitor, and manage them effectively, ultimately improving patient outcomes and quality of life during cancer treatment.

Correct Answer: D

Rationale: In this scenario, the correct answer is option D: Read the policy on handling radioactive excreta. This answer is the best choice because when caring for a client receiving iodine-131 treatment, it is crucial for the nurse to be knowledgeable about handling radioactive substances safely. Reading the policy on handling radioactive excreta ensures that the nurse understands the proper procedures for managing and disposing of radioactive waste, minimizing the risk of exposure to both the client and healthcare providers. Option A is incorrect because placing the client in protective isolation is not necessary for iodine-131 treatment. This intervention is more relevant for clients with conditions that require protection from external pathogens. Option B is also incorrect as there is no need for pregnant visitors to stay 6 feet away from the client receiving iodine-131 treatment unless specifically indicated in the treatment plan. Option C is not the best choice because special precautions are indeed necessary when caring for a client undergoing iodine-131 treatment due to the potential risks associated with radioactive exposure. Understanding the rationale behind the correct answer is essential for nurses to provide safe and effective care to clients receiving such treatments in an oncology setting.

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: A

Rationale: In this scenario, the correct medication for the client with a hemoglobin of 6.1 mg/dL who refuses blood transfusions is option A) Epoetin alfa. Epoetin alfa is a medication that stimulates red blood cell production in the bone marrow, thereby increasing hemoglobin levels. This is crucial for a symptomatic client with a low hemoglobin level as it can improve oxygen-carrying capacity and alleviate symptoms like fatigue and weakness. Option B) Filgrastim is a medication that stimulates the production of white blood cells and is used to prevent infection in patients undergoing chemotherapy. It is not indicated for increasing hemoglobin levels. Option C) Mesna is a uroprotective agent used to prevent hemorrhagic cystitis in patients receiving ifosfamide or cyclophosphamide chemotherapy. It is not indicated for treating low hemoglobin levels. Option D) Dexrazoxane is a cardioprotective agent used to prevent anthracycline-induced cardiotoxicity in patients receiving doxorubicin or daunorubicin. It is not indicated for increasing hemoglobin levels. Educationally, understanding the rationale behind using Epoetin alfa in this context highlights the importance of managing hematologic side effects of chemotherapy. It also emphasizes the role of supportive care medications in improving quality of life for oncology patients. This case underscores the need for nurses to be knowledgeable about hematologic parameters and appropriate pharmacological interventions in oncology care.