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4. The patient is probably continuing to have pain but is benefiting from the placebo effect of taking action against the tumor.Correct Answer: 1Rationale 1: Radiation treatments can help to reduce the symptoms of cancer by shrinking tumor size.Rationale 2: Pain control chemicals are not secreted by the tumor or initiated by the radiation.Rationale 3: The patient is not getting used to having pain.Rationale 4: Radiation has physical effects that can reduce pain from the tumor.Global Rationale: Cognitive Level: AnalyzingClient Need: Physiological IntegrityClient Need Sub: Pharmacological and Parenteral TherapiesNursing/Integrated Concepts: Nursing Process: PlanningLearning Outcome: 57-5Question 14Type: MCSAA patient’s carcinoembryonic antigen (CEA) level was initially16 ng/mL. The current level is 6 ng/mL. How would the nurse evaluate this change?1. The patient’s treatment for cancer is effective.2. The patient’s treatment regimen should be more aggressive.3. The patient has a new cancer site.4. The patient’s cancer is gone.Correct Answer: 1
Rationale 1: CEA levels can be used to assess response to treatment. The decline in CEA level means the treatment is working.Rationale 2: The value does not indicate the need for more aggressive treatment.Rationale 3: This laboratory test cannot determine new cancer sites.Rationale 4: The test result is still elevated, so the cancer is probably still present. It would require more than one test to determine it has been eliminated.Global Rationale: Cognitive Level: AnalyzingClient Need: Physiological IntegrityClient Need Sub: Physiological AdaptationNursing/Integrated Concepts: Nursing Process: AssessmentLearning Outcome: 57-4Question 15Type: MCMAA patient will be receiving busulfan (Myleran) as treatment for leukemia. Which interventions should the nurse include in the patient’s plan of care?Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.1. Assess for infection.2. Monitor for hearing loss.3. Monitor for a decrease in BUN level.4. Institute fall precautions.5. Reduce the amount of sodium in the patient’s diet.Correct Answer: 1,2,4Rationale 1: Busulfan will likely cause suppression of immunity, so the patient should be monitored for the development of infection.Rationale 2: Busulfan is otoxic and may cause hearing loss.Rationale 3: Busulfan may cause dehydration, which will result in an increased BUN level.
Rationale 4: The patient taking busulfan may develop peripheral neuropathy as well as anemia, so fall precautions are indicated.Rationale 5: There is no specific reason to alter the patient’s diet unless electrolyte measurements indicate a need.Global Rationale: Cognitive Level: AnalyzingClient Need: Physiological IntegrityClient Need Sub: Pharmacological and Parenteral TherapiesNursing/Integrated Concepts: Nursing Process: PlanningLearning Outcome: 57-6Question 16Type: MCMAA patient diagnosed with breast cancer is receiving 5-fluorouracil (5-FU). Based on anticipated adverse effects or