The hospice nurse is caring for a patient with cancer in her home. The nurse has explained to the patient and the family that the patient is at risk for hypercalcemia and has educated them on the signs and symptoms of this health problem. What else should the nurse teach this patient and family to do to reduce the patient¢â‚¬â„¢s risk of hypercalcemia?

Correct Answer: C

Rationale: In the context of caring for a patient with cancer who is at risk for hypercalcemia, the correct answer is C) Consume 2 to 4 L of fluid daily. This is crucial because adequate hydration helps to promote renal excretion of excess calcium, thus reducing the risk of hypercalcemia. By encouraging the patient to increase their fluid intake, the nurse is actively supporting the patient's overall health and helping to manage a potential complication of cancer treatment. Option A) Stool softeners are contraindicated is incorrect because stool softeners can actually be beneficial in managing constipation, a common side effect of cancer treatment, which can contribute to hypercalcemia. Option B) Laxatives should be taken daily is incorrect as daily laxative use may lead to electrolyte imbalances and exacerbate the risk of hypercalcemia. Option D) Restrict calcium intake is incorrect because while excessive calcium intake can contribute to hypercalcemia, a complete restriction of calcium is not necessary. It is more important to focus on adequate hydration and monitoring calcium levels rather than strict dietary restrictions. Educationally, it is important for nurses and healthcare providers to understand the importance of fluid balance in managing complications such as hypercalcemia in cancer patients. Teaching patients and families about the significance of hydration can empower them to actively participate in their care and improve outcomes.

Correct Answer: C

Rationale: In this scenario, the most appropriate action for the nurse is option C: Ask if he would like you to sit with him while he collects his thoughts. This response demonstrates empathy, active listening, and a willingness to provide emotional support to the patient. Option A is incorrect as it dismisses the patient's emotional distress and fails to address his needs. Option B, offering to call pastoral care, may be appropriate but does not directly address the patient's immediate need for support in that moment. Option D, telling the patient that you can understand how he's feeling, while well-intentioned, may come off as dismissive or presumptive of the patient's emotions. Educationally, this question highlights the importance of therapeutic communication and empathy in nursing care, especially in oncology and palliative settings where patients often experience intense emotional distress. Nurses must be equipped with skills to provide emotional support and create a safe space for patients to express their feelings during difficult times.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) "Chew with care to avoid inadvertently biting the tongue." This advice is crucial for a patient with stomatitis, as the oral anesthetic can numb the mouth, increasing the risk of unintentional biting. By emphasizing the importance of being cautious while chewing, the nurse can help prevent oral injuries and promote better healing of the stomatitis. Option B) "Use the oral anesthetic 1 hour prior to meal time" is incorrect because the timing of the oral anesthetic does not directly relate to the prevention of biting the tongue. This information does not address the patient's safety during eating. Option C) "Brush teeth before and after eating" is incorrect in this context as it focuses on oral hygiene rather than preventing injury while eating. While oral hygiene is important, it is not the most relevant advice for this specific situation. Option D) "Swallow slowly and deliberately" is also incorrect as it does not specifically address the risk of biting the tongue due to the numbness caused by the oral anesthetic. In an educational context, it is essential for nurses to provide precise and practical instructions to patients to ensure their safety and well-being, especially when dealing with side effects of medications like stomatitis. By explaining the rationale behind the correct answer, nurses can empower patients to take an active role in their care and recovery.

Correct Answer: A

Rationale: In the context of caring for a patient with Hodgkin lymphoma, the main goal of care is typically the cure of the disease. Hodgkin lymphoma is a type of cancer that can be curable, especially when diagnosed and treated in the early stages. The primary focus of treatment is to achieve a complete remission and cure the patient of the cancer. Option B, enhancing quality of life, is an important aspect of oncology nursing care but may not always be the main goal when dealing with a curable cancer like Hodgkin lymphoma. In this case, the priority is often on achieving a cure rather than solely focusing on quality of life. Option C, controlling symptoms, and option D, palliation, are more relevant in the context of managing advanced or terminal cancers where the main goal may shift towards symptom management and improving quality of life rather than aiming for a cure. In an educational context, it is crucial for nurses to understand the specific goals of care for different types of cancers to provide appropriate and effective care to their patients. Recognizing the main goal of care for a particular cancer helps nurses prioritize interventions and outcomes to best meet the needs of the patient.

Correct Answer: D

Rationale: In the context of acute myeloid leukemia (AML), the correct answer is D) An aggressive course of chemotherapy. This is because induction therapy for AML typically involves a combination of chemotherapy agents to rapidly reduce the number of leukemia cells in the body and induce a remission. Chemotherapy is the standard first-line treatment for AML and aims to eradicate cancer cells in the bone marrow and blood. Option A) Daily treatment with targeted therapy medications is not typically used as the primary induction therapy for AML. Targeted therapy may be used in specific cases or as a maintenance therapy after initial treatment. Option B) Radiation therapy is not a standard first-line treatment for AML. It is more commonly used in specific situations such as central nervous system involvement or palliative care. Option C) Hematopoietic stem cell transplantation (HSCT) is not typically part of the initial induction therapy for AML. HSCT is usually considered after achieving remission with induction therapy in order to prevent relapse or for patients with high-risk disease. Understanding the rationale behind the choice of treatment in AML is crucial for nurses caring for patients undergoing cancer therapy. It helps them provide accurate information to patients, manage side effects effectively, and support patients through their treatment journey.