Nursing Elites

1. A client with cancer is admitted to a short-term rehabilitation facility. The nurse prepares to administer the client’s oral chemotherapy medications. What action by the nurse is most appropriate?

• A. Crush the medications if the client cannot swallow them.
• B. Give one medication at a time with a full glass of water.
• C. No special precautions are needed for these medications.
• D. Wear personal protective equipment when handling the medications.

Correct answer: D

Rationale: Oral chemotherapy requires the same precautions as IV chemotherapy; personal protective equipment is necessary.

2. A patient with acute lymphocytic leukemia (ALL) is undergoing chemotherapy and develops neutropenia. What is the most important nursing intervention for this patient?

• A. Administering antipyretics
• B. Restricting visitors
• C. Maintaining a sterile environment
• D. Administering prophylactic antibiotics

Correct answer: C

Rationale: Maintaining a sterile environment is crucial to prevent infection in neutropenic patients.

3. A patient with leukemia has developed stomatitis and is experiencing a nutritional deficit. An oral anesthetic has consequently been prescribed. What health education should the nurse provide to the patient?

• A. Chew with care to avoid inadvertently biting the tongue.
• B. Use the oral anesthetic 1 hour prior to meal time.
• C. Brush teeth before and after eating.
• D. Swallow slowly and deliberately.

Correct answer: A

Rationale: If oral anesthetics are used, the patient must be warned to chew with extreme care to avoid inadvertently biting the tongue or buccal mucosa.

4. The nurse is caring for a 39-year-old woman with a family history of breast cancer. She requested a breast tumor marking test and the results have come back positive. As a result, the patient is requesting a bilateral mastectomy. This surgery is an example of what type of oncologic surgery?

• A. Salvage surgery
• B. Palliative surgery
• C. Prophylactic surgery
• D. Reconstructive surgery

Correct answer: C

Rationale: Prophylactic surgery refers to the preventive removal of tissues or organs at high risk for developing cancer, even when no cancer is currently present. In this case, the patient has a positive breast tumor marking test and a significant family history of breast cancer, which places her at increased risk for developing the disease. A bilateral mastectomy is performed to significantly reduce this risk by removing both breasts, thereby preventing the potential future occurrence of breast cancer.

5. Nurse Joy is caring for a client with an internal radiation implant. When caring for the client, the nurse should observe which of the following principles?

• A. Limit the time with the client to 1 hour per shift
• B. Do not allow pregnant women into the client’s room
• C. Remove the dosimeter badge when entering the client’s room
• D. Individuals younger than 16 years old may be allowed to go in the room as long as they are 6 feet away from the client

Correct answer: B

Rationale: Clients with internal radiation implants (also known as brachytherapy) emit a small amount of radiation, which can pose a risk to others. Pregnant women are particularly vulnerable to the harmful effects of radiation because it can affect both the mother and the developing fetus. Radiation exposure can lead to birth defects, miscarriage, or other developmental issues, so pregnant women should avoid any exposure by not entering the client's room.

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