Nursing Elites

1. A nurse is caring for a patient who is being treated for leukemia in the hospital. The patient was able to maintain her nutritional status for the first few weeks following her diagnosis but is now exhibiting early signs and symptoms of malnutrition. In collaboration with the dietitian, what intervention should the nurse implement?

• A. Arrange for total parenteral nutrition (TPN).
• B. Facilitate placement of a percutaneous endoscopic gastrostomy (PEG) tube.
• C. Provide the patient with several small, soft-textured meals each day.
• D. Assign responsibility for the patient's nutrition to the patient's friends and family.

Correct answer: C

Rationale: For patients experiencing difficulties with oral intake, the provision of small, easily chewed meals may be beneficial. Option A (TPN) and B (PEG tube placement) are more invasive interventions and should be considered if non-oral routes are necessary. Option D is not appropriate as the primary responsibility for a patient's nutrition should lie with healthcare professionals to ensure proper management and monitoring.

2. When working with clients experiencing alopecia, what is the best method for a nurse to help them manage the psychosocial impact of this issue?

• A. Assisting the client in pre-planning for this event.
• B. Reassuring the client that alopecia is temporary.
• C. Teaching the client ways to protect the scalp.
• D. Telling the client that there are worse side effects.

Correct answer: A

Rationale: Assisting the client in pre-planning for alopecia is the best method to help them manage the psychosocial impact of the issue. By helping clients anticipate and prepare for the challenges associated with alopecia, they can cope better with the psychological impact. Reassuring the client that alopecia is temporary (choice B) may provide false hope as some types of alopecia are permanent. Teaching ways to protect the scalp (choice C) is important but not the most effective method for managing the psychosocial impact. Telling the client that there are worse side effects (choice D) is dismissive of the client's feelings and not helpful in addressing the psychosocial impact of alopecia.

3. A client is receiving rituximab. What assessment by the nurse takes priority?

• A. Blood pressure.
• B. Temperature.
• C. Oral mucous membranes.
• D. Pain.

Correct answer: A

Rationale: When a client is receiving rituximab, the nurse's priority assessment should be monitoring the blood pressure. Rituximab can lead to infusion-related reactions, such as hypotension. Therefore, assessing the client's blood pressure is crucial to detect and manage any potential adverse reactions promptly. While monitoring temperature, oral mucous membranes, and pain are essential aspects of care, they are not the priority when a client is receiving rituximab.

4. A patient has a diagnosis of multiple myeloma and the nurse is preparing health education in preparation for discharge from the hospital. What action should the nurse promote?

• A. Daily performance of weight-bearing exercise to prevent muscle atrophy
• B. Close monitoring of urine output and kidney function
• C. Daily administration of warfarin (Coumadin) as ordered
• D. Safe use of supplementary oxygen in the home setting

Correct answer: B

Rationale: Renal function must be monitored closely in the patient with multiple myeloma.

5. Nurse Kent is teaching a male client to perform monthly testicular self-examinations. Which of the following points would be appropriate to make?

• A. Testicular cancer is a highly curable type of cancer
• B. Testicular cancer is very difficult to diagnose.
• C. Testicular cancer is the number one cause of cancer deaths in males.
• D. Testicular cancer is more common in older men.

Correct answer: A

Rationale: Testicular cancer is indeed highly treatable and curable, particularly when detected early through regular self-examinations. The survival rates for testicular cancer are very high, with many cases being treatable even if the cancer has spread, thanks to effective treatment options such as surgery, chemotherapy, and radiation therapy. Educating clients on the importance of early detection through monthly testicular self-examinations can empower them to recognize any changes early, increasing the likelihood of successful treatment.

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