2. A nurse is caring for a client who is undergoing brachytherapy. Which of the followingprecautions should be followed? (Select all that apply.)X The client should have a private room.X Health care personnel should wear a dosimeter film badge.Visitors should stay 4 feet away from the client.Visitors can stay as long as they like.X Children and pregnant women should not visit the client.X Lead container should be kept in the room.X Tongs should be kept in the room.Brachytherapy is internal radiation administered close to the target tissue. A private room,dosimeter film badge, restricted visitation by children and pregnant women, and keepinga lead container and tongs in the room in case of accidental loss of radioactive materialare appropriate precautions. Visitors should stand 6 feet away from the client and limitthe time visiting to 30 min.NCLEX Connection: Reduction of Risk Potential, Potential for Complications of DiagnosticTests/Treatments/ProceduresCancer Treatment Options982 PN ADULT MEDICAL SURGICAL NURSING

3. A nurse is caring for a client who had a mastectomy for breast cancer. The client has beenprescribed tamoxifen (Nolvadex). Which of the following should indicate to the nurse that theclient needs further teaching?A. I may experience hot flashes.B. I may experience nausea and vomiting.C. I may lose weight.D. I may have vaginal bleeding.4. A nurse is caring for a client who is receiving immunotherapy in the outpatient clinic. Whichof the following should the nurse recommend for inclusion in the plan of care? (Select all thatapply.)Get 20 min of direct sunlight a day.X Monitor for changes in vision.X Report flu-like symptoms to provider.X Report changes in hearing.X Monitor for unsteady gait or balance.

1. A nurse should know that which of the following is the most reliable indicator of pain?A. Blood pressureB. Facial expressionC. PulseD. Verbal description of painA clients verbal description of pain is the most reliable indicator of pain. Nonverbal andphysiological indicators, however, should also be included in the pain assessment.NCLEX Connection: Physiological Adaptation, Alterations in Body Systems2. A client who has breakthrough cancer pain has been prescribed oxycodone (OxyContin). Whichof the following side effects of oxycodone should the nurse monitor for and be prepared tointervene when present? (Select all that apply.)X Orthostatic hypotensionX ConstipationJoint painX PruritisX Respiratory depressionSide effects of oxycodone can include orthostatic hypotension, constipation, respiratorydepression, and pruritis. Have naloxone available to reverse the respiratory depression.Adjust diet or use stool softeners if needed for constipation. Pruritis can be treated with anantihistamine or discontinued if an allergic reaction is suspected. Joint pain is not a usualfinding with oxycodone.NCLEX Connection: Pharmacological Therapies, Pharmacological Pain Management3. A nurse is caring for a client who is to undergo neurolytic ablation. The nurse should recognizethat this treatment is used only when other measures have failed due to the risk ofA. increased pain.B. myelosuppression.C. thrombocytopenia.D. irreversible nerve damage.Neurolytic ablation causes permanent nerve destruction. It is usually used only after otherpain relief methods have been unsuccessful.NCLEX Connection: Reduction of Risk Potential, Potential for Complications of DiagnosticTests/Treatments/ProceduresPain Management for Clients with CancerPN ADULT MEDICAL SURGICAL NURSING 9934. Match the alternative approach to cancer pain in the left column to its description in the rightcolumn.B Distraction A. Stimulation of nerve pathways by small needlesC Relaxation B. Listening to musicA Acupuncture C. Meditation

PREOP CARE

1. A 68-year-old client is undergoing an endoscopy, which will require moderate sedation. Which ofthe following findings in the clients history indicates the need for further data collection?A. History of goutB. Allergic to bee stingsC. History of GI bleedD. Chronic obstructive pulmonary disease

2. An adult woman on a cardiac unit is experiencing episodes of paroxysmal supraventriculartachycardia (PSVT). After performing all other possible interventions, the provider decides toperform cardioversion and to use midazolam (Versed) to relax the client for the procedure.A nurse checks the chart to verify that all the necessary steps have been completed prior toadministering the midazolam. Which of the following findings should the nurse expect to see inthe chart? (Select all that apply.)X Signed informed consentX Allergy historyX Baseline vital signs and cardiac rhythmX Medications administeredX Documentation of the last time the client ate or drankType and cross match

3. Which of the following preoperative client findings should be reported to the clients provider?(Select all that apply.)Serum potassium 3.9 mEq/LSerum sodium 145 mEq/LX Serum creatinine 2.8 mg/dLX Prothrombin time of 23 secondsX Blood glucose 235 mg/dLX WBC 17,850/mm34. The surgeon is behind schedule and asks the licensed practical nurse (LPN) to complete theconsent form. Which of the following statements by the LPN is correct?A. I can have surgery personnel discuss the procedure with the client.B. I can have the RN discuss the surgical complications you foresee.C. I can witness the clients signature on the form.D. I can discuss the surgical complications you foresee.select all p. 1023ch. 88 POSTOP Care1. A client who had a hysterectomy resumed a regular diet earlier in the day. Now the client isreporting nausea and has vomited once. Which of the following actions should the nurse takefirst?A. Monitor for bowel sounds.B. Administer an antiemetic.C. Check the clients pain level.D. Place the client on NPO status.Pt. had abd sx 7 days ago. LPN observes serosanguieous drainage. Which are appropriate actions:X Report the finding to the charge nurseX Reinforce coughing, but avoid forceful coughing. Supine position w/ knees bent is good.X Splint the incision upon mvmt.