Nursing Elites

1. A client undergoing chemotherapy is at risk for developing mucositis. What nursing intervention is most appropriate to help manage this condition?

• A. Encourage the client to drink plenty of fluids.
• B. Administer antifungal mouthwash.
• C. Teach the client to avoid spicy or acidic foods.
• D. Apply a topical anesthetic to the oral mucosa before meals.

Correct answer: C

Rationale: Avoiding spicy or acidic foods can help prevent irritation of the mucosa, which is already sensitive during mucositis.

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. A nurse is creating a plan of care for an oncology patient and one of the identified nursing diagnoses is risk for infection related to myelosuppression. What intervention addresses the leading cause of infection-related death in oncology patients?

• A. Encourage several small meals daily.
• B. Provide skin care to maintain skin integrity.
• C. Assist the patient with hygiene, as needed.
• D. Assess the integrity of the patient’s oral mucosa regularly.

Correct answer: B

Rationale: In oncology patients, particularly those undergoing chemotherapy or radiation therapy, myelosuppression (the decrease in bone marrow activity that leads to reduced white blood cells, red blood cells, and platelets) increases the risk of infection. Maintaining skin integrity is crucial because the skin acts as the body's first line of defense against infections. If the skin becomes compromised, such as through radiation burns, rashes, or breakdowns, it provides a potential entry point for pathogens, increasing the risk of infection. Since infections in oncology patients can quickly become severe due to their weakened immune systems, maintaining skin integrity is a critical intervention to reduce infection risk, especially for patients who are immunosuppressed.

4. What advice should the oncology nurse give to a client planning a beach vacation after completing radiation treatments for cancer?

• A. Avoid getting salt water on the radiation site.
• B. Do not expose the radiation area to direct sunlight.
• C. Have a wonderful time and enjoy your vacation!
• D. Remember you should not drink alcohol for a year.

Correct answer: B

Rationale: The correct answer is B because the skin at the radiation site is sensitive to sunlight, and exposure can cause further damage. It is crucial to protect the area from direct sunlight to prevent skin irritation or burns. Choice A is incorrect as salt water typically does not pose a significant risk to the radiation site. Choice C is a positive and encouraging response but does not provide necessary advice for post-radiation care. Choice D, while important in some cases, is not directly related to the client's beach vacation after completing radiation treatments.

5. The clinic nurse is caring for a patient whose grandmother and sister have both had breast cancer. She requested a screening test to determine her risk of developing breast cancer and it has come back positive. The patient asks you what she can do to help prevent breast cancer from occurring. What would be your best response?

• A. Research has shown that eating a healthy diet can provide all the protection you need against breast cancer.
• B. Research has shown that taking the drug tamoxifen can reduce your chance of breast cancer.
• C. Research has shown that exercising at least 30 minutes every day can reduce your chance of breast cancer.
• D. Research has shown that there is little you can do to reduce your risk of breast cancer if you have a genetic predisposition.

Correct answer: B

Rationale: Tamoxifen is a selective estrogen receptor modulator (SERM) that has been shown to significantly reduce the risk of developing breast cancer in women who are at high risk, particularly those with a family history of the disease or a positive genetic test for BRCA mutations. Large-scale studies have demonstrated that tamoxifen can reduce the incidence of breast cancer by up to 50% in high-risk women. It works by blocking estrogen receptors in breast tissue, which helps prevent the development of estrogen receptor-positive breast cancers.

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