Nursing Elites

1. A client is admitted with superior vena cava syndrome. What action by the nurse is most appropriate?

• A. Administer a dose of allopurinol.
• B. Assess the client’s serum potassium level.
• C. Gently inquire about advance directives.
• D. Prepare the client for emergency surgery.

Correct answer: C

Rationale: The correct answer is to gently inquire about advance directives. Superior vena cava syndrome is often a late-stage manifestation, indicating a serious condition. Discussing advance directives with the client is crucial to ensure their wishes are known in case of deterioration. Administering allopurinol (Choice A) is not indicated for superior vena cava syndrome. Assessing the client’s serum potassium level (Choice B) is not the priority when managing this syndrome. Emergency surgery (Choice D) is not typically the initial treatment for superior vena cava syndrome.

2. 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.

3. Nurse Kent is teaching a male client to perform monthly testicular self-examinations. Which of the following points would be appropriate to make?

• A. Testicular cancer is a highly curable type of cancer
• B. Testicular cancer is very difficult to diagnose.
• C. Testicular cancer is the number one cause of cancer deaths in males.
• D. Testicular cancer is more common in older men.

Correct answer: A

Rationale: Testicular cancer is indeed highly treatable and curable, particularly when detected early through regular self-examinations. The survival rates for testicular cancer are very high, with many cases being treatable even if the cancer has spread, thanks to effective treatment options such as surgery, chemotherapy, and radiation therapy. Educating clients on the importance of early detection through monthly testicular self-examinations can empower them to recognize any changes early, increasing the likelihood of successful treatment.

4. A client who is at risk for disseminated intravascular coagulation (DIC) has a serum fibrinogen level of 110 mg/dL. The nurse should take which of the following actions first?

• A. Recheck the fibrinogen level in 4 hours
• B. Notify the health care provider
• C. Continue to monitor the client
• D. Administer cryoprecipitate as prescribed

Correct answer: B

Rationale: A serum fibrinogen level of 110 mg/dL indicates a low level, which puts the client at risk for bleeding in DIC. The priority action for the nurse is to notify the health care provider. Rechecking the fibrinogen level may delay necessary interventions, administering cryoprecipitate should be done based on the provider's prescription, and while monitoring is important, immediate notification of the provider is crucial to address the low fibrinogen level promptly.

5. Which of the following management strategies is not included for a patient taking chemotherapeutic drugs?

• A. Limit exposure of pregnant visitors
• B. Protect client from infection
• C. Allow client to use makeup and wig
• D. Administer IV fluids as ordered

Correct answer: C

Rationale: The correct answer is C. Chemotherapy can lead to hair loss, and while using wigs is common, it is not a primary management strategy. The focus should be on limiting exposure to pregnant visitors to prevent harm to the fetus, protecting the client from infections due to a compromised immune system, and administering IV fluids as ordered to maintain hydration levels. Allowing the client to use makeup and wigs is not a primary concern when managing a patient taking chemotherapeutic drugs.

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