Nursing Elites

1. A 60-year-old patient with chronic myeloid leukemia will be treated in the home setting and the nurse is preparing appropriate health education. What topic should the nurse emphasize?

• A. The importance of adhering to the prescribed drug regimen
• B. The need to ensure that vaccinations are up to date
• C. The importance of daily physical activity
• D. The need to avoid shellfish and raw foods

Correct answer: A

Rationale: Chronic myeloid leukemia (CML) is typically treated with targeted therapies, such as tyrosine kinase inhibitors (TKIs), which can help control the disease and prolong survival. The effectiveness of these medications relies heavily on strict adherence to the prescribed drug regimen. Patients need to take their medication consistently and as directed to maintain therapeutic drug levels and effectively manage the disease. Non-adherence can lead to disease progression or resistance to treatment, which is why it is crucial for the nurse to emphasize this point during health education.

2. Mina, who is suspected of an ovarian tumor is scheduled for a pelvic ultrasound. The nurse provides which preprocedure instruction to the client?

• A. Eat a light breakfast only
• B. Maintain an NPO status before the procedure
• C. Wear comfortable clothing and shoes for the procedure
• D. Drink six to eight glasses of water without voiding before the test

Correct answer: D

Rationale: A pelvic ultrasound requires the client to have a full bladder because the bladder acts as a window through which pelvic organs, such as the uterus and ovaries, can be visualized more clearly. The full bladder pushes the intestines out of the way and provides a better acoustic pathway for the ultrasound waves. Without this, the pelvic organs might be obscured, and the images would be less accurate.

3. The nurse is reviewing the history of a client with bladder cancer. The nurse expects to note documentation of which most common symptom of this type of cancer?

• A. Dysuria
• B. Hematuria
• C. Urgency on urination
• D. Frequency of urination

Correct answer: B

Rationale: Hematuria, or blood in the urine, is the most common and distinctive symptom associated with bladder cancer. It can present as either gross hematuria (visible blood) or microscopic hematuria (detected only through urinalysis). The presence of blood in the urine often prompts further evaluation for potential underlying causes, including bladder cancer. It is crucial for healthcare providers to recognize this symptom, as early detection significantly impacts treatment outcomes.

4. A client in the oncology clinic reports her family is frustrated at her ongoing fatigue 4 months after radiation therapy for breast cancer. What response by the nurse is most appropriate?

• A. Are you getting adequate rest and sleep each day?
• B. It is normal to be fatigued even for months afterward.
• C. This is not normal and I’ll let the primary health care provider know.
• D. Try adding more vitamins B and C to your diet.

Correct answer: B

Rationale: Radiation-induced fatigue can last for months; it’s important to normalize this for the client.

5. A nurse is caring for a client with thrombocytopenia. Which action is the highest priority to reduce the risk of bleeding?

• A. Use an electric razor instead of a straight razor.
• B. Apply pressure to any bleeding sites for at least 5 minutes.
• C. Avoid invasive procedures unless absolutely necessary.
• D. Monitor for signs of internal bleeding.

Correct answer: C

Rationale: The highest priority action to reduce the risk of bleeding in a client with thrombocytopenia is to avoid invasive procedures unless absolutely necessary. Thrombocytopenia is a condition characterized by a low platelet count, which impairs the blood's ability to clot properly. By avoiding invasive procedures, the nurse minimizes the potential for bleeding episodes that could be challenging to control due to the low platelet count. Using an electric razor instead of a straight razor (Choice A) is a good practice to prevent cuts, but it is not as critical as avoiding invasive procedures in this scenario. Applying pressure to bleeding sites (Choice B) and monitoring for signs of internal bleeding (Choice D) are important interventions but are secondary to the priority of preventing bleeding by avoiding invasive procedures.

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