Nursing Elites

1. A nurse is caring for a patient with myelodysplastic syndrome (MDS) who is receiving erythropoietin therapy. What should the nurse monitor to evaluate the effectiveness of this treatment?

• A. Platelet count
• B. Hemoglobin level
• C. White blood cell count
• D. Oxygen saturation

Correct answer: B

Rationale: Erythropoietin therapy is used to stimulate the production of red blood cells in patients with myelodysplastic syndrome (MDS), a disorder characterized by ineffective blood cell production, including red blood cells. The primary goal of erythropoietin therapy is to increase red blood cell count, improving the patient's oxygen-carrying capacity and reducing symptoms of anemia, such as fatigue and weakness. Monitoring hemoglobin levels is the best way to evaluate the effectiveness of this therapy because it directly reflects the patient's red blood cell count and the success of erythropoiesis (red blood cell production).

2. A client has been prescribed epoetin alfa for anemia related to chemotherapy. What lab value should the nurse monitor to determine the effectiveness of this medication?

• A. Hemoglobin level.
• B. Hematocrit level.
• C. White blood cell count.
• D. Platelet count.

Correct answer: A

Rationale: Epoetin alfa is a medication used to treat anemia, particularly anemia related to chemotherapy or chronic kidney disease. It stimulates the bone marrow to produce more red blood cells, which increases the hemoglobin level. Monitoring hemoglobin is the best way to assess the effectiveness of epoetin alfa, as an increase in hemoglobin indicates that the body is producing more red blood cells and the anemia is improving.

3. After receiving a diagnosis of acute lymphocytic leukemia, a patient is visibly distraught, stating, I have no idea where to go from here. How should the nurse prepare to meet this patients psychosocial needs?

• A. Assess the patients previous experience with the health care system.
• B. Reassure the patient that treatment will be challenging but successful.
• C. Assess the patients specific needs for education and support.
• D. Identify the patients plan of medical care.

Correct answer: C

Rationale: In order to meets the patients needs, the nurse must first identify the specific nature of these needs.

4. Nurse Ben is reviewing the laboratory results of a client undergoing chemotherapy. Which of the following values would require immediate intervention?

• A. Platelet count of 150,000/mm3
• B. White blood cell count of 6,000/mm3
• C. Hemoglobin level of 14 g/dL
• D. Absolute neutrophil count of 500/mm3

Correct answer: D

Rationale: An absolute neutrophil count of 500/mm3 indicates severe neutropenia, putting the client at high risk for infection. Neutrophils are crucial in fighting off infections; a low count increases susceptibility to infections. Platelet count, white blood cell count, and hemoglobin levels are within normal ranges and do not require immediate intervention in this scenario.

5. The nurse is admitting an oncology patient to the unit prior to surgery. The nurse reads in the electronic health record that the patient has just finished radiation therapy. With knowledge of the consequent health risks, the nurse should prioritize assessments related to what health problem?

• A. Cognitive deficits
• B. Impaired wound healing
• C. Cardiac tamponade
• D. Tumor lysis syndrome

Correct answer: B

Rationale: The correct answer is B: Impaired wound healing. Patients who have undergone radiation therapy are at risk for impaired wound healing due to tissue damage. While cognitive deficits, cardiac tamponade, and tumor lysis syndrome can be concerns for oncology patients, the immediate priority following radiation therapy is assessing for impaired wound healing to prevent complications post-surgery.

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