Nursing Elites

1. A 35-year-old male is admitted to the hospital complaining of severe headaches, vomiting, and testicular pain. His blood work shows reduced numbers of platelets, leukocytes, and erythrocytes, with a high proportion of immature cells. The nurse caring for this patient suspects a diagnosis of what?

• A. AML
• B. CML
• C. MDS
• D. ALL

Correct answer: D

Rationale: Acute Lymphocytic Leukemia (ALL) is a type of cancer where immature lymphocytes (a type of white blood cell) proliferate uncontrollably in the bone marrow. This leads to a reduction in the production of platelets, leukocytes, and erythrocytes, causing symptoms such as fatigue, anemia, bleeding tendencies, and increased susceptibility to infection. In ALL, leukemic cell infiltration into other organs is common, which can manifest as severe headaches (due to central nervous system involvement), vomiting, and testicular pain (due to infiltration of leukemic cells into the testes). These are hallmark signs of ALL, especially in younger patients.

2. Nurse Mandy is teaching a client about the side effects of radiation therapy. Which of the following should the nurse emphasize?

• A. Radiation therapy is painless.
• B. You may experience hair loss.
• C. Fatigue is a common side effect.
• D. You may experience nausea and vomiting.

Correct answer: C

Rationale: Fatigue is one of the most frequent and profound side effects of radiation therapy. It often occurs because radiation can damage both cancerous and healthy cells, and the body requires energy to repair the damage caused by the treatment. Fatigue from radiation can be cumulative, meaning it may worsen as treatments progress, and can significantly affect the client’s daily activities, requiring the nurse to educate the client on energy conservation techniques.

3. The nurse knows that all of the following are risk factors for breast cancer except:

• A. Family history
• B. Nulliparity
• C. Chest xray
• D. Multiple sex partners

Correct answer: D

Rationale: Multiple sex partners are not a recognized risk factor for breast cancer. Breast cancer is primarily influenced by hormonal, genetic, and environmental factors, not sexual activity or the number of sexual partners. Established risk factors for breast cancer include family history, hormonal factors such as early menarche, late menopause, and nulliparity (having no children), as well as certain environmental exposures.

4. A nurse is caring for a patient diagnosed with chronic myeloid leukemia (CML) who is receiving the drug imatinib (Gleevec). What should the nurse monitor in this patient to assess for side effects of this therapy?

• A. Cardiac function
• B. Renal function
• C. Liver function
• D. Pulmonary function

Correct answer: A

Rationale: The correct answer is A: Cardiac function. Imatinib can cause fluid retention and heart failure, so cardiac function should be closely monitored. Renal function (choice B) is not typically affected by imatinib. Liver function (choice C) is not the primary concern with this medication. Pulmonary function (choice D) is not directly impacted by imatinib therapy.

5. A nurse at a long-term care facility is amending the care plan of a resident who has just been diagnosed with essential thrombocythemia (ET). The nurse should anticipate the administration of what medication?

• A. Dalteparin
• B. Allopurinol
• C. Hydroxyurea
• D. Hydrochlorothiazide

Correct answer: C

Rationale: Hydroxyurea is effective in lowering the platelet count for patients with ET.

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