Nursing Elites

1. A client is receiving chemotherapy for the treatment of cancer. The nurse monitors the client for which of the following signs indicating a complication of the therapy?

• A. Alopecia
• B. Weight gain
• C. Elevated temperature
• D. Decreased hemoglobin level

Correct answer: C

Rationale: The correct answer is C: Elevated temperature. A fever may indicate infection, a common and serious complication of chemotherapy, requiring prompt intervention. Choice A, Alopecia, is a common side effect of chemotherapy but not a sign of a complication. Choice B, Weight gain, is not typically a sign of a complication of chemotherapy. Choice D, Decreased hemoglobin level, may occur due to chemotherapy but is not a direct sign of a complication.

2. Nurse Kate is reviewing the complications of conization with a client who has microinvasive cervical cancer. Which complication, if identified by the client, indicates a need for further teaching?

• A. Infection
• B. Hemorrhage
• C. Cervical stenosis
• D. Ovarian perforation

Correct answer: D

Rationale: The correct answer is D, 'Ovarian perforation.' Ovarian perforation is not a complication associated with conization; therefore, if the client identifies this as a potential complication, it indicates a need for further teaching. Choices A, B, and C are incorrect: Infection, hemorrhage, and cervical stenosis are potential complications of conization, so identifying them would not necessarily indicate a need for further teaching.

3. While a patient is receiving IV doxorubicin hydrochloride for the treatment of cancer, the nurse observes swelling and pain at the IV site. The nurse should prioritize what action?

• A. Stopping the administration of the drug immediately
• B. Notifying the patient's physician
• C. Continuing the infusion but decreasing the rate
• D. Applying a warm compress to the infusion site

Correct answer: A

Rationale: The correct action for the nurse to take when observing swelling and pain at the IV site during the administration of doxorubicin hydrochloride is to stop the administration of the drug immediately. Doxorubicin hydrochloride can cause severe tissue damage, so discontinuing the infusion is crucial to prevent further harm to the patient. Notifying the physician is important, but it should not take precedence over stopping the drug. Continuing the infusion, even at a decreased rate, can exacerbate tissue damage. Applying a warm compress is not appropriate in this situation and may worsen the tissue injury caused by the drug.

4. The nurse is developing a plan of care for the client with multiple myeloma and includes which priority intervention in the plan?

• A. Encouraging fluids
• B. Providing frequent oral care
• C. Coughing and deep breathing
• D. Monitoring the red blood cell count

Correct answer: A

Rationale: The correct answer is A: Encouraging fluids. In a client with multiple myeloma, encouraging fluids is a priority intervention to prevent kidney damage from high calcium levels. Adequate hydration helps maintain renal function and prevents complications. Providing frequent oral care (Choice B) is essential for clients at risk of mucositis or oral infections, such as those undergoing chemotherapy. Coughing and deep breathing exercises (Choice C) are commonly used for clients at risk of respiratory complications, like postoperative patients. Monitoring the red blood cell count (Choice D) is important for conditions like anemia but is not the priority in a client with multiple myeloma, where fluid management is crucial.

5. Nurse Joy is caring for a client with cancer who has been receiving cisplatin (Platinol-AQ). Which laboratory result requires an intervention by the nurse?

• A. White blood cell count of 6000 cells/microL
• B. Serum potassium level of 3.5 mEq/L
• C. Blood urea nitrogen (BUN) of 18 mg/dL
• D. Platelet count of 150,000 cells/microL

Correct answer: C

Rationale: The correct answer is C. A BUN level of 18 mg/dL is within the normal range; however, since cisplatin is nephrotoxic, it requires close monitoring. Elevated BUN levels can indicate impaired kidney function. Choices A, B, and D are within normal ranges and do not directly relate to cisplatin therapy or require immediate intervention.

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