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Lung Cancer HESI Case Study

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What important education should the nurse provide to the client related to this medication? (Select all the apply.)
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“Take medication on an empty stomach.” “Do not take antacids while on this medication.” “The medication may cause some abdominal discomfort and diarrhea.”
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What herbal supplement does the nurse anticipate Mr. Stringfellow will use for his current symptoms?
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Echinacea
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While waiting to obtain the lab and x-ray, what information from the client’s history is priority for the nurse to collect? (Select all that apply.)
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“Have you experienced any hoarseness?” “Do you currently, or have you ever smoked?” “Tell me about your work history.”
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What instructions should the nurse provide to Mr. Stringfellow for the x-ray?
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“You will need to remove your clothes down to the waist and remove any jewelry on the neck or chest.”
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Mr. Stringfellow states, “I have already had a chest x-ray. Why do I need a CT scan?” What is the nurse’s best response?
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“A CT scan can differentiate differences in tissue density.”
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Which instructions should the nurse provide related to the bronchoscopy? (Select all that apply.)
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“You must not eat or drink anything for 6 to 8 hour prior to the procedure.” “You will receive a medication to dry up secretions and another medication to make you sleepy.” “The oral and nasal pharynx will be sprayed with a local anesthetic.”
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What nursing action should the nurse expect to implement following the bronchoscopy?
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Keep client NPO until the gag reflex returns.
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What information in Mr. Stringfellow’s history places him at risk for lung cancer? (Select all that apply.)
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Both of Mr. Stringfellow’s parents were cigarette smokers. Twenty years of employment in a manufacturing plant.
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What response by the nurse is most therapeutic?
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Sit quietly with Mr. Stringfellow and allow him the opportunity to talk.
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How would the nurse explain the purpose of cancer staging?
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Staging helps determine the client’s prognosis and best treatment.
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Mr. Stringfellow asks the nurse why two cancer medications are needed. What is the nurse’s best explanation?
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“These two medications work during different phases of the cell cycle to increase the effectiveness of the therapy.”
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The use of which venous access site reduces the risk for extravasation during chemotherapy treatments?
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Subclavian vein
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What is the priority action for the nurse?
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Assess breath sounds.
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After the assessment of breath sounds, which action should the nurse take next?
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Notify radiology of the need for an x-ray.
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The nurse obtains these x-ray results before initiating fluids to prevent which complication?
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Fluid infiltration
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The nurse certified in chemotherapy administration prepares to administer carboplatin (Paraplatin) 360 mg/m2 in 150 mL of normal saline (NS) via IV pump. The drug is prescribed to run over 30 minutes. At what rate should the nurse set the IV pump? (Enter numeric value only. If rounding is necessary, round to the whole number.)
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300
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The nurse identifies a potential nursing diagnosis of imbalanced nutrition: less than body requirements. Which meal recommendation is appropriate?
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Broiled chicken, greens, and cheese bread.
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Mr. Stringfellow asks about common side effects of carboplatin (Paraplatin). Which common side effects should the nurse discuss with the client? (Select all that apply.)
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Loss of taste Ringing in ears Nausea and vomiting
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The nurse recognizes that Mr. Stringfellow is experiencing which conditions? (Select all that apply.)
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Leukopenia Anemia Thrombocytopenia Hypokalemia
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Which nursing intervention has the highest priority when administering this medication?
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Evaluate the client’s level of pain regularly.
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The HCP also orders epoetin alfa (Procrit). What nursing assessment is most important with this medication?
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Monitor for sudden onset of chest pain.
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What is the priority nursing intervention?
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Wash hands before and after caring for Mr. Stringfellow.
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What is the next priority action for the nurse at this time?
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Call the Rapid Response Team.
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Each vial contains 100 mg/mL after reconstitution, and the prescription requires 1000 mg. How many milliliters of medication should the nurse draw up after reconstitution? (Enter numeric value only. If rounding is necessary, round to the whole number.)
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10
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At what rate should the medication be infused in mL/hr? (Enter numeric value only. If rounding is necessary, round to the whole number.)
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200
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The nurse suspects which etiologic factor is responsible for both the objective and subjective assessment data?
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Fear
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What is the best nursing response to Mr. Stringfellow’s question?
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“Tell me what makes you feel afraid?”
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Which nursing action is most important to implement at this time?
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Inquire more about the process of contacting a shaman.
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What intervention should be implemented by the nurse?
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Continue to monitor the drainage system regularly.
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What assessment should the nurse perform?
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Observe the client’s respirations.
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What intervention should the nurse implement next?
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Inspect the insertion site and tubing to check for air leaks.
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Based on this assessment finding, what action is indicated?
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Ask Mr. Strongfellow to cough and change positions.
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What other nursing interventions should be included in Mr. Stringfellow’s care? (Select all that apply.)
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Assess the client’s lung sounds. Encourage deep breathing exercises. Record drainage according to facility policy.
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Mr. Stringfellow is scheduled to being external beam radiation. Which instructions should be included in the teaching plan? (Select all that apply.)
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Gently wash the area with a mild soap and pat the skin dry. Do not apply lotions, creams, or other products to the skin unless prescribed by the HCP.
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With which interdisciplinary team member should the nurse collaborate to develop a plan of care?
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Registered dietician