Nursing Elites

1. A nurse is caring for a patient who has been diagnosed with leukemia. The nurse's most recent assessment reveals the presence of ecchymoses on the patient's sacral area and petechiae on her forearms. In addition to informing the patient's primary care provider, what action should the nurse take?

• A. Initiate measures to prevent venous thromboembolism (VTE).
• B. Check the patient's most recent platelet level.
• C. Place the patient on protective isolation.
• D. Ambulate the patient to promote circulatory function.

Correct answer: B

Rationale: The patient's signs of ecchymoses and petechiae are suggestive of thrombocytopenia, which is a common complication of leukemia. Thrombocytopenia is a condition characterized by a low platelet count, leading to abnormal bleeding. Checking the patient's most recent platelet level is crucial to assess the severity of thrombocytopenia and guide further interventions. Initiating measures to prevent venous thromboembolism (VTE) (Choice A) is not directly related to the patient's current signs. Placing the patient on protective isolation (Choice C) is not necessary for ecchymoses and petechiae. Ambulating the patient (Choice D) is not appropriate without addressing the underlying cause of abnormal bleeding.

2. 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.

3. A patient with non-Hodgkin lymphoma (NHL) is receiving monoclonal antibody therapy. What is the priority assessment during the infusion of this medication?

• A. Vital signs
• B. Skin reactions
• C. Respiratory status
• D. Renal function

Correct answer: A

Rationale: The correct answer is A: Vital signs. Monitoring vital signs is crucial during the infusion of monoclonal antibody therapy as there is a risk of infusion reactions such as fevers, chills, hypotension, and tachycardia. Assessing vital signs allows for early detection of any adverse reactions, enabling prompt intervention. Skin reactions (choice B), respiratory status (choice C), and renal function (choice D) are important assessments in general patient care but are not the priority during the infusion of monoclonal antibody therapy.

4. The public health nurse is presenting a health-promotion class to a group at a local community center. Which intervention most directly addresses the leading cause of cancer deaths in North America?

• A. Monthly self-breast exams
• B. Smoking cessation
• C. Annual colonoscopies
• D. Monthly testicular exams

Correct answer: B

Rationale: In North America, lung cancer is the leading cause of cancer deaths among both men and women, and the primary risk factor for lung cancer is smoking. Therefore, promoting smoking cessation is a critical public health intervention that directly addresses this significant health issue. By helping individuals quit smoking, healthcare providers can significantly reduce the incidence of lung cancer and associated deaths, making this intervention a priority in cancer prevention efforts.

5. A patient with advanced leukemia is responding poorly to treatment. The nurse finds the patient tearful and trying to express his feelings, but he is clearly having difficulty. What is the nurses most appropriate action?

• A. Tell him that you will give him privacy and leave the room.
• B. Offer to call pastoral care.
• C. Ask if he would like you to sit with him while he collects his thoughts.
• D. Tell him that you can understand how hes feeling.

Correct answer: C

Rationale: Providing emotional support and discussing the uncertain future are crucial.

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