Nursing Elites

1. A client is receiving rituximab and asks how it works. What response by the nurse is best?

• A. It causes rapid lysis of the cancer cell membranes.
• B. It destroys the enzymes needed to create cancer cells.
• C. It prevents the start of cell division in the cancer cells.
• D. It sensitizes certain cancer cells to chemotherapy.

Correct answer: C

Rationale: Rituximab is a monoclonal antibody that targets CD20, a protein found on the surface of certain B-cells, including some cancerous B-cells, such as in non-Hodgkin's lymphoma and chronic lymphocytic leukemia (CLL). Rituximab works by binding to the CD20 protein, which leads to the destruction of the cancerous B-cells through various mechanisms, including preventing the initiation of cell division. By blocking the division process, rituximab helps slow the growth and proliferation of cancer cells, allowing the immune system and additional treatments to clear them more effectively.

2. A patient who is undergoing consolidation therapy for the treatment of leukemia has been experiencing debilitating fatigue. How can the nurse best meet this patients needs for physical activity?

• A. Teach the patient about the risks of immobility and the benefits of exercise.
• B. Assist the patient to a chair during awake times, as tolerated.
• C. Collaborate with the physical therapist to arrange for stair exercises.
• D. Teach the patient to perform deep breathing and coughing exercises.

Correct answer: B

Rationale: For patients undergoing consolidation therapy for leukemia, severe fatigue is a common side effect of treatment due to factors such as anemia, decreased nutritional intake, and the body’s response to chemotherapy. While exercise is beneficial, the patient's fatigue may limit their ability to engage in strenuous activity. Assisting the patient to sit in a chair during awake times is a practical way to encourage some physical activity while respecting their fatigue levels. This intervention helps prevent complications associated with immobility, such as muscle atrophy and venous stasis, without overwhelming the patient. It allows the patient to engage in light activity that is manageable and promotes recovery.

3. 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.

4. 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.

5. When educating a patient with multiple myeloma who is being discharged home, what should the nurse emphasize regarding the management of this condition?

• A. Increasing fluid intake
• B. Avoiding sunlight exposure
• C. Monitoring for signs of infection
• D. Managing pain

Correct answer: C

Rationale: The correct answer is C: Monitoring for signs of infection. Patients with multiple myeloma have a compromised immune system, making them more susceptible to infections. Emphasizing the importance of monitoring for signs of infection helps in early detection and prompt treatment. Increasing fluid intake (choice A) is essential for many health conditions but is not the priority in managing multiple myeloma. Avoiding sunlight exposure (choice B) may be relevant for certain skin conditions or medications but is not a key aspect of multiple myeloma management. Managing pain (choice D) is important, but in the context of multiple myeloma, monitoring for signs of infection takes precedence due to the increased risk of infections in these patients.

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