Nursing Elites

1. A nurse is caring for a client admitted for Non-Hodgkin’s lymphoma and chemotherapy. The client reports nausea, flank pain, and muscle cramps. What action by the nurse is most important?

• A. Request an order for serum electrolytes and uric acid.
• B. Increase the client’s IV infusion rate.
• C. Instruct assistive personnel to strain all urine.
• D. Administer an IV antiemetic.

Correct answer: A

Rationale: The client's symptoms of nausea, flank pain, and muscle cramps are suggestive of tumor lysis syndrome (TLS), a potentially life-threatening complication of chemotherapy in which cancer cells break down rapidly, releasing large amounts of intracellular components into the bloodstream. This leads to imbalances in electrolytes (elevated potassium, phosphate, and uric acid levels, with low calcium levels), which can cause severe metabolic disturbances, including kidney damage, arrhythmias, and muscle cramps. Checking serum electrolytes and uric acid levels is crucial for diagnosing and managing TLS early, preventing further complications.

2. A nurse enters the room of a patient with bladder cancer. The patient asks the nurse about the actions of chemotherapeutic drugs. Which of the following statements by the nurse is correct?

• A. Chemotherapeutic drugs will kill all of your cancer cells
• B. Chemotherapeutic medications are attracted mostly to slowly dividing cells
• C. Chemotherapy can cure cancer
• D. Chemotherapy is specifically destroying cancer cells

Correct answer: D

Rationale: Chemotherapy drugs are designed to target and destroy rapidly dividing cells, which include cancer cells. Cancer cells often divide more quickly than normal cells, and chemotherapeutic agents exploit this characteristic to inhibit their growth and promote cell death. While chemotherapy can also affect other rapidly dividing normal cells (such as those in the bone marrow, gastrointestinal tract, and hair follicles), the primary goal is to target cancerous cells.

3. The nurse is caring for a patient who is to begin receiving external radiation for a malignant tumor of the neck. While providing patient education, what potential adverse effects should the nurse discuss with the patient?

• A. Impaired nutritional status
• B. Cognitive changes
• C. Diarrhea
• D. Alopecia

Correct answer: A

Rationale: Corrected Rationale: Impaired nutritional status is a potential adverse effect of radiotherapy to the head and neck due to alterations in oral mucosa and taste. While cognitive changes, diarrhea, and alopecia can be side effects of other treatments or conditions, they are not typically associated with external radiation for a malignant tumor of the neck. Therefore, the nurse should primarily focus on discussing the risk of impaired nutritional status with the patient.

4. 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.

5. Which of the following statements by the oncology nurse displays understanding about antineoplastic medications?

• A. Chemotherapy is not going to spread throughout the body
• B. Chemotherapy affects the immune system
• C. Chemotherapy is specific to cancer cells only
• D. Chemotherapy makes the patient radioactive

Correct answer: B

Rationale: Chemotherapy targets rapidly dividing cells, which include both cancerous and healthy cells, such as those in the bone marrow, hair follicles, and the lining of the digestive tract. Since the bone marrow produces immune cells (white blood cells), chemotherapy can weaken the immune system by reducing the body’s ability to produce these cells, making patients more susceptible to infections. This is why close monitoring and supportive measures to protect immune function are important during chemotherapy treatment.

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