Nursing Elites

1. A nurse is caring for a patient with myelodysplastic syndrome (MDS) who is at risk for anemia. What is the most appropriate intervention to address this risk?

• A. Administering iron supplements
• B. Administering blood transfusions
• C. Providing a high-iron diet
• D. Administering erythropoietin

Correct answer: D

Rationale: In myelodysplastic syndrome (MDS), the bone marrow does not produce enough healthy blood cells, leading to conditions such as anemia. Administering erythropoietin is an effective intervention to manage anemia in MDS patients because it stimulates the production of red blood cells. This can help improve the patient’s hemoglobin levels, reducing symptoms such as fatigue and weakness associated with anemia. Erythropoietin is commonly used in MDS to enhance red blood cell production and reduce the need for frequent blood transfusions.

2. The nurse knows that all of the following are risk factors for breast cancer except:

• A. Family history
• B. Nulliparity
• C. Chest xray
• D. Multiple sex partners

Correct answer: D

Rationale: Multiple sex partners are not a recognized risk factor for breast cancer. Breast cancer is primarily influenced by hormonal, genetic, and environmental factors, not sexual activity or the number of sexual partners. Established risk factors for breast cancer include family history, hormonal factors such as early menarche, late menopause, and nulliparity (having no children), as well as certain environmental exposures.

3. A 54-year-old has a diagnosis of breast cancer and is tearfully discussing her diagnosis with the nurse. The patient states, 'They tell me my cancer is malignant, while my coworker's breast tumor was benign. I just don't understand at all.' When preparing a response to this patient, the nurse should be cognizant of what characteristic that distinguishes malignant cells from benign cells of the same tissue type?

• A. Slow rate of mitosis of cancer cells
• B. Different proteins in the cell membrane
• C. Differing size of the cells
• D. Different molecular structure in the cells

Correct answer: B

Rationale: The correct answer is B. Malignant cells have different proteins in their membranes, such as tumor-specific antigens, which distinguish them from benign cells. Choice A is incorrect as cancer cells typically have a rapid and uncontrolled rate of mitosis. Choice C is incorrect as the size of cells alone does not distinguish between malignant and benign cells. Choice D is incorrect as the molecular structure is not the primary characteristic that distinguishes between malignant and benign cells.

4. A client is diagnosed as having a positive reaction to the Mantoux test. Which of the following is the most appropriate nursing action?

• A. Isolate the client in a private room.
• B. Administer isoniazid (INH) as prescribed.
• C. Schedule the client for a chest x-ray.
• D. Begin a 9-month course of medication therapy.

Correct answer: C

Rationale: The correct answer is to schedule the client for a chest x-ray. A positive Mantoux test indicates exposure to TB, but it does not confirm active disease. A chest x-ray is necessary to assess the presence of active TB disease. Isolating the client in a private room (Choice A) is not necessary based solely on a positive Mantoux test result. Administering isoniazid (INH) (Choice B) or beginning a 9-month course of medication therapy (Choice D) is premature without confirming active TB through a chest x-ray.

5. A patient with acute myeloid leukemia (AML) is receiving induction therapy. What is the priority nursing intervention during this phase of treatment?

• A. Administering pain management
• B. Monitoring for signs of infection
• C. Providing emotional support
• D. Monitoring fluid balance

Correct answer: B

Rationale: Induction therapy for acute myeloid leukemia (AML) involves intensive chemotherapy aimed at achieving remission by eliminating a large number of cancerous cells. However, this aggressive treatment also severely reduces the production of healthy blood cells, including neutrophils, which leads to neutropenia (a dangerously low number of neutrophils). This makes the patient highly susceptible to infections, which can be life-threatening. Monitoring for signs of infection is critical during this phase, as infections may occur quickly and progress rapidly due to the compromised immune system. Early detection and prompt treatment of infections are vital to improving patient outcomes during induction therapy.

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