The nurse is caring for a patient with cervical cancer. The nurse notes that the cervical implant has become dislodged. Which of the following actions should the nurse take first?

Appeared in: NORCET 8 Prelims-2025

Explanation

The immediate priority in a radiation emergency is to contain the radioactive source to protect the patient, staff, and visitors from exposure.
This action adheres to the three core principles of radiation safety: minimizing time of exposure, maximizing distance from the source, and using appropriate shielding.
Using long-handled forceps maximizes the distance between the nurse's body and the radioactive source, significantly reducing the radiation dose.
Placing the implant into a designated lead-lined container provides effective shielding, containing the radiation.
This intervention must be performed before notifying other departments to stop the ongoing radiation hazard immediately.

Option A: This action is delayed. Staying with the patient without first securing the implant prolongs radiation exposure for both the nurse and the patient.
Option B: A blanket offers no shielding from the gamma radiation emitted by cervical implants. This is a dangerous and ineffective action that provides a false sense of security.
Option C: This is an assessment action, not a priority intervention. A dosimeter measures the radiation dose received but does not protect from exposure. The priority is to stop the exposure first.

Visual 1: Diagram - The three principles of radiation safety: Time, Distance, and Shielding. This helps visualize the core concepts behind the correct action.
Visual 2: Image - A standard radiation safety kit for brachytherapy, showing long-handled forceps and a lead-lined container ('pig'). This provides a concrete image of the tools required.

Clinical Relevance

Nursing practice connection: Use the key finding related to Priority nursing action for a dislodged radioactive implant (brachytherapy) to guide bedside assessment, documentation, and the next nursing action.
A dislodged radioactive implant is a medical emergency requiring immediate and correct action to prevent significant radiation exposure to the patient, healthcare staff, and other patients.
Nurses caring for patients with brachytherapy must be trained on emergency procedures and know the location of the lead container and forceps at all times.
All materials from the room (linens, dressings, etc.) must be checked by the radiation safety officer before removal to ensure no radioactive material is accidentally discarded.

How to Approach the Question

Identify the question type: This is a priority-setting question, indicated by the word 'first'.
Analyze the clinical scenario: A radioactive implant has become dislodged. This is a critical safety emergency.
Recall the core principles of radiation safety: Time (minimize it), Distance (maximize it), and Shielding (use it).
Evaluate each option against these three principles. Ask yourself: 'Does this action minimize exposure time? Does it increase distance from the source? Does it provide adequate shielding?'
The option that involves picking up the source with long forceps (Distance) and placing it in a lead container (Shielding) is the most immediate and effective way to contain the hazard and minimize exposure (Time).
Actions like notifying others or assessing exposure are secondary to the primary intervention of making the scene safe.

Concept Tested & Keywords

Concept Tested: Priority nursing action for a dislodged radioactive implant (brachytherapy).
Stem keywords: cervical cancer, cervical implant, dislodged
Lead-in keywords: first

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Practise the full NORCET 8 Prelims-2025

Attempt every question from this paper in a timed mock, then review the full solution for each one.