Nursing Elites

1. A nurse is creating a plan of care for an oncology patient and one of the identified nursing diagnoses is risk for infection related to myelosuppression. What intervention addresses the leading cause of infection-related death in oncology patients?

• A. Encourage several small meals daily.
• B. Provide skin care to maintain skin integrity.
• C. Assist the patient with hygiene, as needed.
• D. Assess the integrity of the patient’s oral mucosa regularly.

Correct answer: B

Rationale: In oncology patients, particularly those undergoing chemotherapy or radiation therapy, myelosuppression (the decrease in bone marrow activity that leads to reduced white blood cells, red blood cells, and platelets) increases the risk of infection. Maintaining skin integrity is crucial because the skin acts as the body's first line of defense against infections. If the skin becomes compromised, such as through radiation burns, rashes, or breakdowns, it provides a potential entry point for pathogens, increasing the risk of infection. Since infections in oncology patients can quickly become severe due to their weakened immune systems, maintaining skin integrity is a critical intervention to reduce infection risk, especially for patients who are immunosuppressed.

2. A nurse working with oncology clients knows that an age-related decrease in which function increases the older client’s susceptibility to infection during chemotherapy?

• A. Immune function.
• B. Kidney function.
• C. Liver function.
• D. Cardiac function.

Correct answer: A

Rationale: As people age, the immune system becomes less efficient, a phenomenon known as immunosenescence. This decline in immune function includes reduced production of immune cells (such as T cells and B cells) and diminished responses to infections. During chemotherapy, which further suppresses the immune system, older clients are at a significantly higher risk of developing infections due to this age-related decrease in immune function. This is especially concerning because chemotherapy targets rapidly dividing cells, which include immune cells, making it even harder for the body to fight off infections.

3. Nurse Casey is preparing to administer chemotherapy to a client with leukemia. The nurse wears gloves and a gown to administer the medication and to prevent exposure to the agent by which of the following routes?

• A. By ingestion
• B. By skin contact
• C. By absorption
• D. By inhalation

Correct answer: D

Rationale: Chemotherapeutic agents can be hazardous to healthcare workers if they are exposed to the drugs during preparation or administration. One of the primary risks is inhalation, where small particles or aerosols of the drug can become airborne and be inhaled, potentially causing harm to the nurse. Protective gear such as gloves and a gown, as well as masks or respirators in some cases, helps prevent this type of exposure.

4. When reviewing the safe administration of antineoplastic agents, what action should the nurse emphasize?

• A. Adjust the dose based on the patient's present symptoms.
• B. Wash hands with an alcohol-based cleanser before and after administration.
• C. Use gloves and a lab coat when preparing and administering the medication.
• D. Dispose of the antineoplastic wastes in the hazardous waste receptacle.

Correct answer: D

Rationale: The correct answer is to dispose of the antineoplastic wastes in the hazardous waste receptacle. Antineoplastic agents are hazardous materials, and proper disposal is crucial to prevent harm to individuals and the environment. Option A is incorrect because adjusting the dose based on the patient's present symptoms may not be safe without proper authorization. Option B is incorrect as hand hygiene should be performed both before and after administering medications. Option C is incorrect as gloves and a lab coat should be worn primarily during handling and administration, not just during preparation.

5. A nurse knows that the patient with stage 3 based on Ann-arber staging has:

• A. 2 or more lymph node involvement and outside the lymph nodes
• B. 2 or more lymph node involvement on one side of the body
• C. 2 or more lymph nodes on the breasts
• D. 2 or more lymph node involvement on both sides of the body

Correct answer: D

Rationale: In the Ann Arbor staging system for lymphomas, Stage 3 indicates that the disease has spread beyond the initial lymph node region to involve lymph nodes on both sides of the diaphragm (i.e., the areas above and below the diaphragm). This includes lymphatic involvement in both the thoracic and abdominal regions, signifying a more advanced disease state.

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